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

Shim, E., Hampson, K. , Cleaveland, S. and Galvani, A.P. (2009) Evaluating the cost-effectiveness of rabies post-exposure prophylaxis: a case study in Tanzania. Vaccine, 27(51), pp. 7167-7172. (doi:10.1016/j.vaccine.2009.09.027) (PMID:19925948) (PMCID:PMC3272373)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleaveland, Professor Sarah and Hampson, Dr Katie
Authors: Shim, E., Hampson, K., Cleaveland, S., and Galvani, A.P.
Subjects:Q Science > QR Microbiology > QR180 Immunology
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Vaccine
Publisher:Elsevier
ISSN:0264-410X
ISSN (Online):1873-2518
Published Online:17 November 2009

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
539491Understanding the role of contact networks in the epidemiological and evolutionary dynamics of zootonic diseaseSarah CleavelandWellcome Trust (WELLCOME)082715/B/07/ZRI BIODIVERSITY ANIMAL HEALTH & COMPMED