Table 3.
Baseline cost data for the evaluation of the HARSP, in the communes of Pétionville, Carrefour, and Croix-des-Bouquets, West Department, Haiti, 2014–2015
| Item | Units | Unit value | Sources |
|---|---|---|---|
| PEP | |||
| Basic vaccine dose (including administration)* | $/dose | 14.45 | |
| Material costs (needles, swabs, etc.) | $/dose | 0.12 | Knobel and others12 |
| Overhead costs per visit | $/visit | 0.61 | Knobel and others12 |
| Tissue-culture vaccine | $/dose | 12.20 | Knobel and others12 |
| Cold-chain | $/dose | 0.05 | Acharya and others22 |
| Cost per outpatient visit† | $/outpatient | 1.47 | WHO-Choice23 |
| Injections/doses per patient | N | 5 | Poxvirus and Rabies Branch |
| Vaccine doses per visit | N/visit | 1 | Recommendations |
| RIG‡ | $ | 134.15 | Knobel and others12 |
| PEP treatment paid for by the government | (%) | (0, 50, 100) | Range used for estimates |
| Surveillance | |||
| Vehicle (motorcycle) (annual) | $/vehicle | 1,000 | HARSP data |
| Maintenance (annual) | $/vehicle | 100 | HARSP data |
| Animal capture equipment | $/worker | 800 | HARSP data |
| Communications (mobile, radios, etc.) | $/worker | 200 | Estimated |
| Rabies prevention supplies (annual) | $/worker | 500 | HARSP data |
| Office rental§ | $/year | 4,000 | Estimated |
| Utilities, supplies, etc. | $/year | 1,200 | HARSP data |
| Personnel (annual) | $/worker | 3,300 | HARSP data |
| Diagnostics | |||
| Equipment | $/year | 4,195 | HARSP data |
| Equipment maintenance | $/year | 500 | Estimated |
| Rabies reagents | $/year | 1,200 | HARSP data |
| Supplies | $/year | 5,000 | HARSP data |
| Personnel (annual) | $/worker | 6,006 | HARSP data |
| Training∥ | |||
| Teacher (year) | $/training | 1,487 | HARSP data |
| Implementation (supplies, participants, etc.) | $/training | 301 | HARSP data |
HARSP = Haiti Animal Rabies Surveillance Program; PEP = postexposure prophylaxis; RIG = rabies immunoglobulin; WHO = World Health Organization. Additional cost data and details on calculations are shown in the Supplemental File 2, Appendix A.
Millien and others19 reported a stock of more than 15,000 does of human vaccine for PEP in stock (November 2014), from 20,000 Vero cell rabies vaccines for intramuscular administration donated by Brazil in 2013. Those authors also reported an annual use rate of about 8,000 human vaccine doses.
WHO-Choice23 estimates: for a public facility. We used the average estimated costs for an outpatient visit of 1.47 (health center = $1.21, health center with beds = $1.50, primary-level hospital = $1.71, and secondary-level hospital = $1.78) and adjusted the cost to 2014 US$.
The overhead and material costs from RIG were included in the basic PEP treatment of category III exposures.
If owned, we estimated the cost per square meter for an office in the same area. Office rental and utilities costs were considered separately for laboratories and rabies surveillance. If the office space was shared, we adjusted the value by multiplying it by the share of time dedicated to rabies.
These costs represent the costs of training prorated in 5 years. See Supplemental File 2, Appendix A, for details.