Browsing by Author "Giwa, H.B."
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Item Cost Effectiveness Analysis of Combined Anti-Retroviral Therapy in a Tertiary Health Institution(Published by West African Postgraduate College of Pharmacy, 2018) Giwa, H.B.; Giwa, A; Jamiu, M.OBackground: The increasing health care spending from government, donors and private stand-point has a lot of challenge in health care related decision making. Hence, there is need to examine closely the cost and benefits of drug interventions especially in chronic illnesses like HIV/AIDS. Objective: To conduct cost-effectiveness analysis of combined antiretroviral therapy (cART) in a tertiary health institution Methods: A retrospective review of systematically sampled 360 case notes was conducted. World Health Organization Defined Daily Dose method of evaluating drug use and probability method for potential effectiveness of cART options from literature analysis was employed in determining cost-effectiveness of each option identified from cART drug utilization studies. Results: Zidovudine (AZT )+Lamivudine (3TC) +Nevirapine (NVP)which cost N89 2 ($ 0.3 per unit effectiveness) was more frequently prescribed (86%, =100.82; P=0.00; df=1). This combination was more cost effective than the less frequently prescribed first line option of Tenofovir (TDF) +Lamivudine (3TC) +Efavirenz (EFV)at a cost per unit effectiveness of NGN 134 ($0.45).Similarly, 2 AZT+3TC+Lopinavir/Ritonavir (LPV/r)which was more frequently prescribed (71.4%, =33.62; P=0.00; df=1)]with cost per unit effectiveness of NGN379 ($1.26)was more cost effective than TDF+3TC+LPV/r [NGN403($ 1.34) per unit of effectiveness] in the management of HIV/AIDS patients as second line regimen. Conclusions: AZT+3TC+NVPwas more cost-effective than TDF+3TC+EFV in the management of HIV/AIDS patients as firstline regimen. However, AZT+3TC+LPV/r appeared to, but was not necessarily more cost effective than TDF+3TC+LPV/r in the management of HIV/AIDS patients as second line regimen.Item Evaluation of Direct Medical Cost for HIV/AIDS Management in Iran.(Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin., 2022) Giwa, H.B.; Giwa, A.; Davari, M.; Jamiu, M.O.; Seyed, A.S.A.; Mohraz, M.; Aiyelero, O.M.Background: Although Iran has a low prevalence of HIV/AIDS, government budgets and developmental assistance in the management of the disease have reduced over the years. Accurate knowledge of direct medical costs is key to developing and prioritizing healthcare policies and interventions, as well as allocating healthcare resources within budget constraints, to achieve policy efficiency. Objective: To evaluate direct medical costs for the management of HIV/AIDS Patients in Iran. Method: A one-year retrospective review of 2000 case notes of HIV/AIDS patients of Imam Khomeini Hospital Tehran (Iranian Research Centre for HIV/AIDS) out of which 322 were selected as the sample size for both Pre-ART and ART patients between January and December 2019. Subsequently, systematic sampling was done, with sampling interval offive . Prevalence rate method is used to determine direct medical costs. Results: Annual cost for management of 322 Pre-ART and 322 ART patients was found to be $191,718 with components of $ 141,492.58 (74%), $48,582.77(25%) and $1,612.92(1%) representing the cost of medications, diagnostic tests and personnel respectively. The main cost driver was found to be medications. The annual cost per prevalent case for HIV/AIDS for Iran was found to be $599.25, with $129.25 representing cost for pre - ART care and $470 for ART care. Conclusion Annual cost per prevalent case of HIV/AIDS was 55% of annual expenditure per capita. This is quite enormous considering other diseases of high burden. The annual National cost for Iran is $ 4.9 Million.