The most common cause of severe diarrhoea in infants and young children is 
rotavirus gastroenteritis (RVGE), which is associated with significant 
morbidity, healthcare resource use and direct and indirect costs in 
industrialized nations. The monovalent rotavirus vaccine RIX4414 (Rotarix™) is 
administered as a two-dose oral series in infants and has demonstrated 
protective efficacy against RVGE in clinical trials conducted in developed 
countries. In addition, various naturalistic studies have demonstrated 
'real-world' effectiveness after the introduction of widespread rotavirus 
vaccination programmes in the community setting. Numerous cost-effectiveness 
analyses have been conducted in developed countries in which a universal 
rotavirus vaccination programme using RIX4414 was compared with no universal 
rotavirus vaccination programme. There was a high degree of variability in 
base-case results across studies even when conducted in the same country, often 
reflecting differences in the selection of data sources or assumptions used to 
populate the models. In addition, results were sensitive to plausible changes in 
a number of key input parameters. As such, it is not possible to definitively 
state whether a universal rotavirus vaccination programme with RIX4414 is cost 
effective in developed countries, although results of some analyses in some 
countries suggest this is the case. In addition, international guidelines 
advocate universal vaccination of infants and children against rotavirus. It is 
also difficult to draw conclusions regarding the cost effectiveness of rotavirus 
vaccine RIX4414 relative to that of the pentavalent rotavirus vaccine, which is 
administered as a three-dose oral series. Although indirect comparisons in 
cost-effectiveness analyses indicate that RIX4414 provided more favourable 
incremental cost-effectiveness ratios when each vaccine was compared with no 
universal rotavirus vaccination programme, results were generally sensitive to 
vaccine costs. Actual tender prices of a full vaccination course for each 
vaccine were not known at the time of the analyses and therefore had to be 
estimated.