Cost Comparative Study of Equine and Human Rabies Immunoglobulin in Thailand

Thailand is the endemic area of rabies. One modality to be offered for preventing rabies in post-exposure patients is to prophylaxis with rabies immunoglobulin. There are two kinds of rabies immunoglobulin which are HRIG (obtained from human) and ERIG (obtained from horse). The standard regimen prefers to use HRIG because of the possibly occurrence of serious complication of ERIG. However, the provision of HRIG is still the problem according to the limitation of donors. The objectives of this study are to analyze the cost per unit and compare those costs per unit of equine rabies immunoglobulin and Human rabies immunoglobulin which expected to obtain the information as the basis criterion to suggest whether what Kind of rabies immunoglobulin Thailand should produce. The result of this study is based on secondary data from Thai Red Cross Society and Ministry of Public Health. At the initial stage, it explored the direct cost-cost of production of both products. Then, it looked into the indirect cost which includes mortality cost, morbidity cost and cost of the complication. Two categories of costs are combined to get the total cost. The unit cost of each product is retrieved form the total cost divided by volume of production. Final results of this study showed that the cost per unit of HRIG is nearly three hundreds times higher than that of ERIG. This high unit cost was arisen from indirect of HRIG, especially cost of life loss or mortality cost when we use strictly only HRIG, and the limited volume of production. This study suggests that Thailand should produce more of ERIG at this present itme.