Cost Analysis of Post Exposure Prophylaxis of Rabies in A Tertiary Care Centre- A Cross Sectional Study

Abstract

India is a rabies endemic country with the highest incidence of rabies cases with approximately 30,000 deaths per year and more than 1,000,000 people undergoing anti rabies vaccination every year. Around 30 to 60% of pre exposure prophylaxis are given to children below the age of 15.The following study was conducted in the district of Thrissur, in the state of Kerala. This study was conducted to analyze the cost of post exposure prophylaxis and to compare assumed cost of pre exposure prophylaxis. Our study included 213 patients attended anti rabies clinic for post exposure prophylaxis. Among the group 63.4% were adults and 36.6% were children. Majority were category III exposure The analysis of the direct cost of post exposure vaccination was done and compared with the cost of pre exposure prophylaxis. The post exposure vaccination included 4 doses of Intra dermal rabies vaccination -two site regime (modified Thai red cross regime) along with rabies immunoglobulin for category 3, added up to $ 4540. This was compared with the cost that would have occurred if these patients had previously received pre exposure prophylaxis which was $890. It was found that Pre exposure prophylaxis came to only to one fifth the cost of post exposure prophylaxis. We infer that Pre exposure prophylaxis is a cost effective strategy which can aid in the control and elimination of rabies in endemic countries. th