Open AccessA decision-analytic approach to postexposure rabies prophylaxis.
Author(s) -
Scott B. Cantor,
Richard D. Clover,
Robert Thompson
Publication year - 1994
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.84.7.1144
Subject(s) - rabies , medicine , quality adjusted life year , decision analysis , cost–benefit analysis , environmental health , cost effectiveness , statistics , risk analysis (engineering) , mathematics , virology , ecology , biology
The risks and benefits of postexposure rabies prophylaxis were analyzed from clinical and economic perspectives. A decision-analytic model was constructed by using probability and outcome data from the literature and the state health department. Health outcomes were measured in quality-adjusted life years. In the base case (overweight adult male), treatment is optimal when the probability of animal rabidity is greater than 1 in 2000. Sensitivity analysis showed robustness in the treatment decision; however, the incremental cost-effectiveness ratio ($140,000/quality-adjusted life year) is sensitive to the rabidity probability. Treatment is optimal from the patient's perspective; however, it may not be cost-effective when the probability of rabidity is low.