Gabriel Chodick1,2, Orith Waisbourd-Zinman3, Varda Shalev1,2, Ehud Kokia1,2, Mordechai Rabinovich1, Shai Ashkenazi2,3

Background: Rotavirus is a common cause of acute gastroenteritis in children under 5 years of age.

Two effective vaccines against rotavirus gastroenteritis were recently licensed in many countries throughout the world. The study aimed to investigate the cost effectiveness of vaccinating an Israeli birth cohort of 143 500 children. Methods: The cost-effectiveness analysis was determined using a
decision analytical model, based on evidence-based estimates of the medical burden of rotavirus gastroenteritis in Israel. Results: According to our model, a routine rotavirus immunization program
using Rotarix
and RotaTeq
would prevent 17 801 and 13 288 office visits and 645 and 535 hospitalizations every year, respectively. When direct healthcare costs and societal costs are taken into account, the incremental cost-effectiveness ratio per gained QALY for Rotarix
and RotaTeq
are $10 995 and $30 674, respectively. Conclusion: Rotavirus vaccination can be considered a cost-effective intervention in Israel, depending on the precise vaccine price

Mordechai Rabinovich
Maccabi Healthcare Services and Ben-Gurion University of the Negev

Francis Wood
Maccabi Healthcare Services

Joshua Shemer
Gertner Institute for Epidemiology and Health Policy Research and Tel-Aviv University

Objectives: The aim of this study was to estimate the impact of new medical technologies
on public healthcare expenditures in Israel over the period 2000–07.
Methods: For each year, government estimates for the costs of new technologies
recommended as high-priority for public funding were summarized. The ratio of projected
costs of these technologies to total public healthcare expenditures was calculated and
compared with actual governmental budget allocations for new technologies.
Results: Funding all new high-priority medical technologies would have increased
healthcare expenditures by 2.1 percent per year. Government allocations for new
technologies raised expenditures by 1.0 percent per year.
Conclusions: New medical technologies significantly increase healthcare expenditures in
Israel. Budgetary constraints have reduced their actual impact by 52 percent. This study
indicates the need for an annual addition of 2 percent to public healthcare budget for
funding new high-priority technologies.
Keywords: Healthcare expenditures, National list of health services, New medical
technologies

Year 2006 Update of the Israel National List of Health Services
Orly Tamir MHA MSc1
*, Mordechai Rabinovich BPharm MBA2,3* and Mordechai Shani MD1,4

1. Israeli Center for Technology Assessment in Health Care, Gertner Institute for Epidemiology and Health Policy Research,
   Tel Hashomer, Israel
2. Maccabi Healthcare Services, Tel Aviv, Israel
3. School of Pharmacy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel 4
   School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
   Key words: health services, priority setting, resource allocation, public funding, medical advances

Mordi Rabinovich BPharm MBA1 and Menahem Fainaru MD1,2 1 Maccabi Healthcare Services, Tel Aviv, Israel 2

Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel

The case reported by Amital et al. in this issue of IMAJ [1], in
addition to its impressive results, raises one of the most difficult
dilemmas of modern medicine ± the economic possibilities of
modern society lagging behind the technological potential, an issue
aggravated by the Regulator and Courts.