Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation.

التفاصيل البيبلوغرافية
العنوان:	Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation.
المؤلفون:	Suijkerbuijk AW; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands., Mangen MJ; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands.; These authors contributed equally to this manuscript., Haverkate MR; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands.; These authors contributed equally to this manuscript., Luppino FS; Eurocross Assistance, Leiden, the Netherlands., Bantjes SE; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands., Visser LG; Leiden University Medical Center, Leiden, the Netherlands.; Department of Infectious Diseases, Leiden University, Leiden, the Netherlands., Swaan CM; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands., Ruijs WL; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands., Over EA; National Institute for Public Health and the Environment, RIVM, Bilthoven, the Netherlands.
المصدر:	Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin [Euro Surveill] 2020 Sep; Vol. 25 (38).
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: European Centre for Disease Prevention and Control (ECDC) Country of Publication: Sweden NLM ID: 100887452 Publication Model: Print Cited Medium: Internet ISSN: 1560-7917 (Electronic) Linking ISSN: 1025496X NLM ISO Abbreviation: Euro Surveill Subsets: MEDLINE
أسماء مطبوعة:	Publication: Stockholm, Sweden : European Centre for Disease Prevention and Control (ECDC) Original Publication: Saint-Maurice : Hôpital national de Saint-Maurice
مواضيع طبية MeSH:	Post-Exposure Prophylaxis/economics , Pre-Exposure Prophylaxis/economics , Rabies/prevention & control , Rabies Vaccines/administration & dosage , Rabies Vaccines/economics , Rabies virus/immunology, Animals ; Cost-Benefit Analysis ; Humans ; Models, Economic ; Post-Exposure Prophylaxis/statistics & numerical data ; Pre-Exposure Prophylaxis/statistics & numerical data ; Rabies/immunology ; Vaccination/economics ; Vaccination/methods
مستخلص:	BackgroundThe risk of contracting rabies is low for travellers. However, the number of Dutch travellers potentially exposed abroad following an animal-associated injury and needing post-exposure prophylaxis (PEP) has increased, resulting in increased costs.AimHere, we evaluated the costs and the cost-effectiveness of different pre- and post-exposure interventions in the Netherlands, taking into account the 2018 World Health Organization (WHO) recommendations for the prevention of rabies.MethodsA decision tree-based economic model was constructed. We calculated and compared the cost of different WHO pre-exposure prophylaxis (PrEP) recommendations, intramuscular vs intradermal vaccination and PEP subsequent to increased vaccination coverage in risk groups. We estimated cost-effectiveness, expressed as incremental costs per rabies immunoglobulin (RIG) administration averted, using a societal perspective. Statistical uncertainty regarding number of travellers and vaccination coverage was assessed.ResultsTotal costs at the national level were highest using previous WHO recommendations from 2012, estimated at EUR 15.4 million annually. Intradermal vaccinations in combination with the current recommendations led to the lowest costs, estimated at EUR 10.3 million. Higher vaccination uptake resulted in higher overall costs. The incremental costs per RIG administration averted varied from EUR 21,300-46,800.ConclusionsThe change in rabies PrEP and PEP recommendations in 2018 reduced total costs. Strategies with increased pre-travel vaccination uptake led to fewer RIG administrations and fewer vaccinations after exposure but also to higher total costs. Although larger scale intradermal administration of rabies vaccine can reduce total costs of PrEP and can positively influence vaccination uptake, it remains a costly intervention.
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فهرسة مساهمة:	Keywords: Netherlands; cost analysis; cost-effectiveness analysis; costs; post-exposure prophylaxis; pre-exposure prophylaxis; rabies; vaccination
المشرفين على المادة:	0 (Rabies Vaccines)
تواريخ الأحداث:	Date Created: 20200925 Date Completed: 20210105 Latest Revision: 20221227
رمز التحديث:	20221228
مُعرف محوري في PubMed:	PMC7533619
DOI:	10.2807/1560-7917.ES.2020.25.38.1900716
PMID:	32975187
قاعدة البيانات:	MEDLINE

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تدمد:	1560-7917
DOI:	10.2807/1560-7917.ES.2020.25.38.1900716