A Cost-Effectiveness Analysis of Pre-Exposure Prophylaxis to Avert Rabies Deaths in School-Aged Children in India.

Autor:	Royal A; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia., John D; Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bengaluru 560054, India., Bharti O; State Institute of Health and Family Welfare, Department of Health & Family Welfare, Government of Himachal Pradesh, Shimla 171009, India., Tanwar R; Directorate of Health Services, Government of Madhya Pradesh, Bhopal 462002, India., Bhagat DK; Centre of Social Medicine and Community Health, Jawaharlal Nehru University, Delhi 110067, India., Padmawati RS; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia., Chaudhary V; Department of Physics, Bhagini Nivedita College, University of Delhi, Delhi 110021, India., Umapathi R; Department of Biological Sciences and Bioengineering, Inha University, Incheon 22212, Republic of Korea., Bhadola P; Centre for Theoretical Physics and Natural Philosophy, Mahidol University, Nakhonsawan Campus, Phayuha Khiri, NakhonSawan 60130, Thailand., Utarini A; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
Jazyk:	angličtina
Zdroj:	Vaccines [Vaccines (Basel)] 2022 Dec 30; Vol. 11 (1). Date of Electronic Publication: 2022 Dec 30.
DOI:	10.3390/vaccines11010088
Abstrakt:	Children contribute to one-half of the total painful rabies mortalities in India. The state-of-the-art rabies mortality averting strategies need exploration for the effective implementation of pre-exposure prophylaxis (PrEP) in India. This study reports on the economic evaluation of various PrEP and post-exposure prophylaxis (PEP) strategies to avert rabies mortalities in school-aged children in India. A decision tree model has been developed for children in the age group of 5-15 years to evaluate various PrEP + PEP and PEP only regimens. The 2-site intradermal regimen administered on day zero and seven was chosen as the intervention [PrEP (I)]. ICER was calculated from the quasi-societal and quasi-health systems' perspectives for the base case analysis, along with one-way sensitivity, and scenario analyses for each regimen. The incremental DALYs averted per million population with the implementation of PrEP (I) ranged between 451 and 85,069 in 2020. The ICER was reported in the range of USD 384-352/DALY averted (non-dominant) in comparison to PEP regimens from a quasi-societal perspective. PrEP (I) is reported to be 'very cost effective' in comparison with PEP regimens from the quasi-societal and quasi-health systems' perspectives and reduce deaths by up to 89.9%. This study concludes that the PrEP (I) regimen is a cost-effective and life-saving strategy to avert painful mortalities due to rabies in school-aged children in India.
Databáze:	MEDLINE
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