title: Cost-effectiveness of rabies post exposure prophylaxis in Iran.
abstract: BACKGROUND
  The rabies is one of the most important officially-known viral zoonotic diseases for its global distribution, outbreak, high human and veterinary costs, and high death rate and causes high economic costs in different countries of the world every year. The rabies is the deadliest disease and if the symptoms break out in a person, one will certainly die. However, the deaths resulting from rabies can be prevented by post-exposure prophylaxis. To do so, in Iran and most of the countries in the world, all the people who are exposed to animal bite receive Post-Exposure Prophylaxis (PEP) treatment. The present survey aimed to investigate the cost-effectiveness of PEP in southern Iran.
  
  
  METHODS
  The present study estimated the PEP costs from the government`s Perspective with step-down method for the people exposed to animal bite, estimated the number of DALYs prevented by PEP in the individuals using decision Tree model, and computed the Incremental cost-effectiveness Ratio. The information collected of all reported animal bite cases (n=7111) in Fars Province, who referred rabies registries in urban and rural health centers to receive active care. Performing the PEP program cost estimated 1,052,756.1 USD for one  year and the estimated cost for the treatment of each animal bite case and each prevented death was 148.04 and 5945.42 USD, respectively. Likewise 4,509.82 DALYs were prevented in southern Iran in 2011 by PEP program.
  
  
  RESULTS
  The incremental cost-effectiveness ratio for each DALY was estimated to be 233.43 USD. In addition to its full effectiveness in prophylaxis from rabies, PEP program saves the financial resources of the society, as well.
  
  
  CONCLUSIONS
  This study showed performing PEP to be more cost-effective.
authors.affiliation: Department of Health Service Administration , School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Hatam
authors.affiliation: Student Research Committee, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Firooz
authors.initials: F
authors.lastname: Esmaelzade
authors.affiliation: Deputy of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mirahmadizadeh
authors.affiliation: Department of Health Economic School of Management and Information Sciences Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Khosro
authors.initials: K
authors.lastname: Keshavarz
authors.affiliation: Student Research Committee, Department of Epidemiology , School of Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Abdolhalim
authors.initials: A
authors.lastname: Rajabi
authors.affiliation: Center of Diseases Control, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Afsar Kazerooni
authors.affiliation: Center of Diseases Control, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Ataollahi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001733:Bites and Stings / Q000150:complications / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D008875:Middle Aged; D056990:Post-Exposure Prophylaxis / Q000191:economics* / Q000379:methods; D011818:Rabies / Q000191:economics* / Q000209:etiology / Q000517:prevention & control; D011819:Rabies Vaccines / Q000191:economics*; D055815:Young Adult; D015047:Zoonoses / Q000191:economics* / Q000209:etiology / Q000517:prevention & control
chemical_list: D011819:Rabies Vaccines
keywords: Cost-effectiveness analysis; DALY; Rabies; post-exposure prophylaxis