Kundu Bijit Kumar, Meshram Girish Gulab, Bhargava Shrinath, Meena Omprakash
Department of Medicine, Postgraduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India.
Department of Pharmacology, Postgraduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India.
Trop Med Infect Dis. 2019 Mar 22;4(1):50. doi: 10.3390/tropicalmed4010050.
Replacement of the Essen intramuscular (EIM) by the updated Thai Red Cross intradermal (UTRCID) regimen for rabies post-exposure prophylaxis (PEP), in high-throughput hospitals of India, has been advocated since 2006 thanks to its cost-effectiveness. However, several anti-rabies clinics in India and other parts of the world have not initiated this switchover of regimens because of the paucity of financial literature, generated in realistic settings, regarding the same. We calculated the procurement costs of various items required for providing rabies vaccinations via the EIM regimen and UTRCID regimen, on an annual basis, a year before and after the switchover. From a healthcare provider's perspective, the cost of vaccination per patient was calculated to be 5.60 USD for the EIM regimen and 2.40 USD for the UTRCID regimen. The switchover to the UTRCID regimen from the EIM regimen reduced the financial burden of the rabies vaccination by almost 60%. Procurement of vaccine vials contributed to the majority of the cost (>94%) in both of the regimens. Procurement of syringes with fixed needles contributed negligibly (<6%) to the financial burden in both the regimens. A policy to progressively switch over to the UTRCID regimen from the EIM in all high-throughput anti-rabies centers of India would dramatically reduce the economic burden of running a successful anti-rabies program.
自2006年以来，由于其成本效益，印度的高通量医院一直提倡用更新后的泰国红十字会皮内注射（UTRCID）方案取代埃森肌内注射（EIM）方案进行狂犬病暴露后预防（PEP）。然而，由于缺乏在实际环境中产生的关于此方案的财务文献，印度和世界其他地区的几家抗狂犬病诊所尚未开始这种方案转换。我们计算了在方案转换前后一年，通过EIM方案和UTRCID方案提供狂犬病疫苗接种所需的各种物品的年度采购成本。从医疗服务提供者的角度来看，EIM方案每位患者的疫苗接种成本计算为5.60美元，UTRCID方案为2.40美元。从EIM方案转换到UTRCID方案使狂犬病疫苗接种的财务负担降低了近60%。两种方案中，疫苗瓶的采购占成本的大部分（>94%）。两种方案中，带固定针头注射器的采购对财务负担的贡献可忽略不计（<6%）。在印度所有高通量抗狂犬病中心逐步从EIM方案转换到UTRCID方案的政策将大大减轻开展成功的抗狂犬病项目的经济负担。
