Evaluating the cost-effectiveness of rabies post-exposure prophylaxis: a case study in Tanzania.

Vaccine
Eunha ShimAlison P Galvani

Abstract

Although fatal if untreated, human rabies can be prevented through post-exposure prophylaxis (PEP), which involves a course of vaccination and immunoglobulin administered immediately after exposure. However, high costs and frequent lack of rabies vaccine and immunoglobulin lead to about 55,000 deaths per year worldwide. Using data from a detailed study of rabies in Tanzania, we calculate a cost-effectiveness ratio for PEP when the WHO-recommended Essen regimen, a 5-dose intramuscular vaccination schedule, is adopted. Our analyses indicate a cost-effectiveness ratio for PEP of $27/quality-adjusted life year (QALY) from a health care perspective and $32/QALY from a societal perspective in Tanzania. From both perspectives, it is "very cost-effective" to administer PEP to patients bitten by an animal suspected to be rabid. Moreover, PEP remains "very cost-effective" provided that at least 1% of doses are administered to people who were actually exposed to rabies.

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Citations

Sep 29, 2012·BMC Medical Informatics and Decision Making·Amani Thomas Mori, Bjarne Robberstad
Aug 10, 2013·Cost Effectiveness and Resource Allocation : C/E·Bruce A Larson
Apr 18, 2015·Bulletin of the World Health Organization·Elliot MarseilleSydney Rosen
Oct 24, 2014·PLoS Neglected Tropical Diseases·Barbara HäslerJonathan Rushton
Apr 17, 2015·PLoS Neglected Tropical Diseases·Katie HampsonUNKNOWN Global Alliance for Rabies Control Partners for Rabies Prevention
Aug 4, 2016·PLoS Neglected Tropical Diseases·Akmetzhan A SultanovPaul R Torgerson
Mar 11, 2018·Zoonoses and Public Health·T J BeyeneH Hogeveen
Sep 7, 2018·PLoS Neglected Tropical Diseases·Issaka TiembréMaïna L'Azou
Aug 31, 2013·PLoS Neglected Tropical Diseases·Sunny E TownsendKatie Hampson
Dec 21, 2016·Proceedings of the National Academy of Sciences of the United States of America·Meagan C FitzpatrickAlison P Galvani
Nov 18, 2016·Proceedings. Biological Sciences·Alyssa M BilinskiAlison P Galvani
Jun 27, 2019·The Journal of General Virology·Samuel P SmithAshley C Banyard
Jul 31, 2018·Journal of Tropical Medicine·Boakye-Yiadom AdomakoEdwin Afari
Mar 17, 2011·PLoS Neglected Tropical Diseases·Katie HampsonDeborah Briggs
Feb 22, 2018·PloS One·Tariku Jibat BeyeneHenk Hogeveen
Sep 29, 2020·Journal of Family Medicine and Primary Care·Tarundeep SinghNeha Dahiya
Jul 19, 2017·The American Journal of Tropical Medicine and Hygiene·Eduardo A UndurragaRyan M Wallace
Mar 5, 2021·PLoS Neglected Tropical Diseases·Jesús Felipe González-RoldánJosé Ramón Hernández-Pérez

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