Changalucha/PEP_cost_effectiveness

This repository contain data and scripts used to analyse the cost-effectiveness of rabies control through post exposure vaccine in Tanzania # Comparative effectiveness and cost-effectiveness of policies for provisioning rabies post-exposure vaccines Authors: Joel Changalucha*, Elaine A Ferguson, Martha M Luka, Kennedy Lushasi, Eleanor Rees, Danni Anderson, Husna Hoffu, John Gwakisa, Zacharia Mtema, Maganga Sambo, Kimera Sharadhuri, Lwitiko Sikana, Athumani Lupindu, Jonathan Yoder, Felix Lankester, & Katie Hampson* # About This repository contains the full analytical workflow for the cost-effectiveness evaluation of rabies post-exposure prophylaxis (PEP) to prevent human rabies in Tanzania, accompanying the manuscript titled above. Rabies remains a major public health problem across low- and middle-income countries, causing an estimated 59,000 human deaths annually and imposing substantial economic strain on affected households and health systems. In settings where dog rabies persists, timely and accessible PEP is essential to preventing these fatal outcomes. # Methods The analyses in this repository evaluate the health and economic impacts of alternative PEP delivery policies in Tanzania, comparing the current practice to the WHO-recommended one-week intradermal regimen and complementary improvements in access and integrated bite case management (IBCM). Using IBCM surveillance data from four regions and a decision-tree model parameterised with empirical and literature-based estimates, we simulate how different PEP policies influence healthcare seeking, regimen completion, vaccine vial requirements, programme costs, and rabies deaths averted at national scale. The modelling framework incorporates stochastic elements that reflect the uncertainty and variability inherent in rabies exposures and health-seeking behaviours. Annual bite incidence at the district level is drawn from Poisson distributions, high- and low-risk bite classifications are assigned using binomial draws, and probability values governing health-seeking and PEP completion are sampled across empirically informed ranges. Scenario anal …