COST EFFECTIVENESS OF INTRADERMALANTI-RABIES VACCINATION- A HOSPITAL RECORD BASED STUDY IN CENTRAL INDIA.

Abstract

Introduction:Rabies a 100% fatal disease is completely preventable with timely post exposure prophylaxis. According to the Gold standard Essen intramuscular regimen, ve doses of 0.5 ml of anti rabies vaccine is required as compared to Updated Thai Red Cross intradermal regimen which requires four doses of only 0.1 ml each at 2 sites . Hence the present study was conducted to determine the cost effectiveness and compliance of 4 dose intradermal regimen of antirabies vaccine over 5 dose intramuscular regimen of anti rabies vaccine for post exposure prophylaxis. Methods: The present study is a hospital record-based study of 1020 cases attending antirabies vaccination clinic who received IM regimen of ARV in the year 2015 and 2256 cases who received ARVunder ID regimen during 2021. The cost effectiveness and compliance of both regimen was estimated. Results : A total of 3276 animal bite patient were studied. Antirabies vaccine by the Intramuscular route was administered to 1020 patients in the year 2015. While around 2256 patients were administered the Antirabies vaccine by the Intradermal route in the year 2021 costing Rs.14,18,352. If same number of cases were to be given intra muscular vaccination then the cost of vaccination would be Rs. 35,19,360. Thus a saving of Rs. 21,01,008 was effected in ID regimen over IM regimen. 53.72% patients completed the Intramuscular route of Antirabies vaccine schedule and 73.04% patients completed the Intradermal route of Antirabies vaccine schedule. Conclusion: Intradermal regimen is more cost effectiveness than intramuscular (Essen) regimen. And the compliance to post-exposure vaccination is better in case of ID regimen as compared to IM regimen