Table 1.
Rabies post-exposure vaccination regimens investigated and costs to patients under different pricing strategies and travel costs. The 5-visit Essen [22] and 5-visit TRC regimens [23] were not examined as these were previously replaced by the 2-week IM and 1-month 2-site ID regimens respectively [2]. Regimens included in the analysis were reviewed by the SAGE working group and deemed ± safe, but not WHO-approved/selected due to cost-effectiveness, feasibility or limited availability of clinical outcome data. We compared indirect costs assuming low travel costs ($2.5/clinic visit) for patients who live close to a clinic and high travel costs ($15/clinic visit) for those who live far from a clinic. Regimens with reduced numbers of patient visits to clinics have lower indirect costs, therefore reducing visits should be prioritized for future regimens.
| Regimen | Route | Visits | Schedule (days) | Injections | Vials | Vol (mL)* | Travel | $2.5 ID dose/$10 vial | $15 PEP/$10 vial | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Near | Far | Near | Far | Near | Far | |||||||
| 2-Week IM (4-dose Essen) [24] | IM | 4 | 0,3,7,14 | 1,1,1,1 | 4 | 4(2 * ) | 10 | 60 | 50 | 100 | 50 | 100 |
| 3-Week IM (Zagreb) [25,26] | IM | 3 | 0, 7, 21 | 2, 1, 1 | 4 | 4(2 * ) | 7.5 | 45 | 47.5 | 85 | 47.5 | 85 |
| 1-Month 2-site ID (Updated TRC) [27] | ID | 4 | 0, 3, 7, 28 | 2, 2, 2, 2 | 4 | 0.8 | 10 | 60 | 30 | 80 | 25 | 75 |
| 1-Week 2-site ID [28] | ID | 3 | 0, 3, 7 | 2, 2, 2 | 3 | 0.6 | 7.5 | 45 | 22.5 | 60 | 22.5 | 60 |
| 1-Week 4-site ID [29–31] | 3 | 0, 3, 7 | 4, 4, 4 | 3 | 1.2–1.5 | 7.5 | 45 | 37.5 | 75 | 22.5 | 60 | |
| 1-Month simplified 4-site ID [32] | ID | 3 | 0, 7, 28 | 4, 2, 1 | 3 | 0.7 | 7.5 | 45 | 25 | 62.5 | 22.5 | 60 |
Calculated assuming use of 0.5 mL vials.