488 Indirect Costs Caused by Acute Rotavirus Gastroenteritis in Spain

Background and aims: Impact of rotavirus in developed countries is mainly economic. The aim of this study was to assess the indirect costs induced by rotavirus acute gastroenteritis (RAGE) in Spain. Methods: A prospective observational study was conducted from Oct-2008-to-Jun-2009 including 682 children up to 5 years-old with AGE attended in primary care (n=18), and emergency-room and hospital settings (n=10), covering the regions of Galicia and Asturias (North-West Spain). All nonmedical expenses incurred were recorded in detail using personal interviews and telephone contacts. Results: Of 682 enrolled children, 207(30.4%) were rotavirus positive and 152(22%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17(182.70) euros. Costs were 1.7-fold higher when acute gastroenteritis was caused by rotavirus as compared to other etiologies: 192.7(219.8)euros vs.111.6(163.5)euros (p<.001). The costs for absenteeism were the most substantial with an average of 91.41(134.76)euros per family, resulting from the loss of 2.45(3.17) days of work. In RAGE group the cost was 120.4(154)euros compared to 75.8(123) of the other etiologies(p=.002), due to the loss of 3.5(3.6) vs1.9(2.9)days of work(p<.001). Meals costs were 2-fold-higher in RAGE: 48.5(55) vs 24.3(46)euros[p<.001]. Travel costs were 2.6-fold-higher in RAGE:32(92)vs12.5(21.1) euros [p=.005]. There were no differences between groups regarding hiring of caregivers or purchase of material costs. Patients with RAGE were admitted to hospital more frequently (47.8%vs14%)[p<.001]. Conclusions: Rotavirus generates a significant indirect economic burden that should be considered in the economic evaluation of the eventual inclusion of rotavirus vaccine in the spanish immunization schedule.