20 Japan is one of the few rabies-free countries/territories which implement the policy 21 of mandatory vaccination of domestic dogs. In order to assess the economic 22 efficiency of such policy in reducing the economic burden of a future canine rabies 23 outbreak in Japan, a benefit-cost analysis (BCA) was performed using probabilistic 24 decision tree modelling. Input data derived from simulation results of published 25 mathematical model, field investigation conducted by the authors at prefectural 26 governments, literature review, international or Japanese database and empirical 27 data of rabies outbreaks in other countries/territories. The current study revealed 28 that the annual costs of implementing the current vaccination policy would be 29 US$160,472,075 (90% prediction interval [PI]: $149,268,669,974). The 30 economic burden of a potential canine rabies outbreak in Japan were estimated to