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dc.contributor.authorRibadeau Dumas, Florence
dc.contributor.authorN'Diaye, Dieynaba S.
dc.contributor.authorPaireau, Juliette
dc.contributor.authorGautret, Philippe
dc.contributor.authorBourhy, Hervé
dc.contributor.authorLe Pen, Claude
dc.contributor.authorYazdanpanah, Yazdan
dc.date.accessioned2015-03-24T09:18:50Z
dc.date.available2015-03-24T09:18:50Z
dc.date.issued2015
dc.identifier.issn0264-410X
dc.identifier.urihttps://basepub.dauphine.fr/handle/123456789/14814
dc.language.isoenen
dc.subjectPost-exposure prophylaxis
dc.subjectRoad accident
dc.subjectCost-effectiveness
dc.subjectAdverse event
dc.subjectRabies
dc.subject.ddc334en
dc.subject.classificationjelI.I1.I12en
dc.subject.classificationjelI.I1.I11en
dc.titleCost-effectiveness of rabies post-exposure prophylaxis in the context of very low rabies risk: A decision-tree model based on the experience of France
dc.typeArticle accepté pour publication ou publié
dc.contributor.editoruniversityotherUniversié Pierre et Marie Curie, Paris;France
dc.contributor.editoruniversityotherUniversté Paris Diderot, Sorbonne Paris Cité;France
dc.description.abstractenIntroduction : Benefit-risk of different anti-rabies post-exposure prophylaxis (PEP) strategies after scratches or bites from dogs with unknown rabies status is unknown in very low rabies risk settings.Design and setting : A cost-effectiveness analysis in metropolitan France using a decision-tree model and input data from 2001 to 2011.Population : A cohort of 2807 patients, based on the mean annual number of patients exposed to category CII (minor scratches) or CIII (transdermal bite) dog attacks in metropolitan France between 2001 and 2011.Interventions : Five PEP strategies: (A) no PEP for CII and CIII; (B) vaccine only for CIII; (C) vaccine for CII and CIII; (D) vaccine+ rabies immunoglobulin (RIG) only for CIII; and (E) vaccine for CII and vaccine+ RIG for CIII.Main outcomes measures : The number of deaths related to rabies and to traffic accidents on the way to anti-rabies centers (ARC), effectiveness in terms of years of life gained by reducing rabies cases and avoiding traffic accidents, costs, and incremental cost-effectiveness ratios (ICER) associated with each strategy.Results : Strategy E led to the fewest rabies cases (3.6 × 10−8) and the highest costs (€1,606,000) but also to 1.7 × 10−3 lethal traffic accidents. Strategy A was associated with the most rabies cases (4.8 × 10−6), but the risk of traffic accidents and costs were null; therefore, strategy A was the most effective and the least costly. The sensitivity analysis showed that, when the probability that a given dog is rabid a given day (PA) was >1.4 × 10−6, strategy D was more effective than strategy A; strategy B became cost-effective (i.e. ICER vs strategy A <3 × French Gross Domestic Product per capita) when PA was > 1.4 × 10−4.Conclusions : In the metropolitan France's very low rabies prevalence context, PEP with rabies vaccine, administered alone or with RIG, is associated with significant and unnecessary costs and unfavourable benefit-risk ratios regardless to exposure category.
dc.relation.isversionofjnlnameVaccine
dc.relation.isversionofjnlvol33
dc.relation.isversionofjnlissue20
dc.relation.isversionofjnldate2015
dc.relation.isversionofjnlpages2367–2378
dc.relation.isversionofdoi10.1016/j.vaccine.2015.02.075
dc.subject.ddclabelEconomie socialeen
dc.relation.forthcomingnonen
dc.relation.forthcomingprintouien
dc.description.ssrncandidatenon
dc.description.halcandidateoui
dc.description.readershiprecherche
dc.description.audienceInternational
dc.relation.Isversionofjnlpeerreviewedoui
dc.date.updated2017-04-19T13:38:11Z
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hal.faultCode{"duplicate-entry":{"pasteur-01430064":{"doi":"1.0"}}}


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