Evaluating the reduction in direct costs incurred with intradermal administration of cell culture rabies vaccine in comparison to intramuscular schedule in a tertiary hospital of north Kerala

:Objectives: 1) To assess the utilizationof antirabies vaccine (ARV) for a periodof 3 years in the preventive clinic 2) Tofind out the total cost of ARV used inthis period 3) To compare the cost ofintramuscular (IM) regimen withintradermal (ID) regimen in terms of costbenefits.Design: Retrospective study by analysisof Case Records.Setting: Preventive Clinic of CalicutMedical College. (Tertiary care teachinghospital)Participants: All cases that haveundergone treatment with ARVirrespective of category of bite.Main outcome measure: To Calculatethe cost benefits of ID regimen, if it hadbeen implemented in this tertiaryhospital for the past 3 years.Results: Only 0.8ml of vaccine isneeded for each patient resulting in useof less than 1vial/patient in ID regimenas opposed to 5 vials/patient in IMregime and only 4 visits are needed tocomplete the vaccination in ID regimencompared to the IM regimen as the visiton Day 14 is skipped. By ID method,we are able to reduce the indirect costinvolved in terms of cost of human hourslost, travel time and expenses forhospital visits.Conclusion: ID route of antirabiesvaccine administration may be acceptedfor its cost effectiveness and costbenefits and this is a good option for ourset up, as it significantly reduces thecost of vaccination and also morepatients will be able to get modern cellculture vaccines, provided propertraining is given to the paramedical staff.