Browsing by Author "Giwa, H.B.F"
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Item Comparative Cost-Effectiveness Analysis of Streptomycin and Ethambutol in the Treatment of Tuberculosis in a University Teaching Hospital in Nigeria(African Society for Clinical Microbiology, 2009) Giwa, A; Osagbemi, G.K; Olayinka, B.O; Giwa, H.B.FHealthcare organizations, governments and individuals have been forced by prevailing circumstances of economic crisis to be increasingly oriented towards cost containment due to escalating nature of health expenditure. Objective: The objective of this study is to determine the comparative cost effectiveness of various antituberculous therapeutic options and to make recommendation for the adoption of costeffectiveness evaluations in National Health Policy formulation and decision-making. Method Retrospective cost effectiveness analysis was carried out for prescribed/dispended antibiotic to outpatients with tuberculosis among other infectious diseases in outpatients case notes between 2005 and 2007 in Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Results The result shows that ethambutol tablet cost N8.40/unit of effectiveness while streptomycin injection cost N81.50/unit of effectiveness in the treatment of tuberculosis. Ethambutol tablet therefore appears to be more cost effective than streptomycin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of ethambutol (95%) and streptomycin injection (76.73%) (X2 =13.75; p<0.5). Therefore there is association between effectiveness and therapeutic option chosen with ethambutol tablet being a more cost effective option. The result of this study is significant because ethambutol is usually traded off for less cost-effective streptomycin in many cases even when there is no contraindication to the use of ethambutol. CONCLUSION Ethambutol tablet is more cost effective than streptomycin injection at their usual therapeutic doses in combination with isoniazed, rifampicin and pyrazinamide in the treatment of tuberculos1 at the intensive phase.Item Comparative Pharmacoeconomic Analysis of Benzathine Penicillin and Procaine Penicillin in the treatment of early syphilis in a University Teaching Hospital in Nigeria(Published by Faculty of Pharmaceutical Sciences, University of Jos., 2008) Giwa, H.B.F; Giwa, A; Osagbemi, G.K; Atata, R.FComparative pharmacoeconomic analysis of benzathine and procaine penicillin in the treatment of early syphilis in Ahmadu Bello University Teaching Hospital, Zaria, northern Nigeria was carried out retrospectively for prescribed/dispensed antibacterial drugs to outpatients with early syphilis among other infectious diseases, by examining outpatients case notes between 2005 and 2007. Results show that benzathine penicillin cost N 4.31/unit of effectiveness while procaine penicillin injection cost N 18.19/unit of effectiveness in the treatment of early syphilis. Benzathine penicillin injection therefore appears to be more cost effective than procaine penicllin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of benzathine penicillin and procaine penicillin injection, (56.2%) (χ2 = 48.58, P<0.5), Therefore there is association between effectiveness and therapeutic option chosen with benzathine penicillin being a more cost effective option. The result of this study is significant because benzathine penicillin is usually traded off for less cost-effective procaine penicillin in many cases even when there is no contraindication to the use of benzathine penicillin. Benzathine penicillin injection is more cost effective than procaine penicillin injection at their usual therapeutic dose in the treatment of early syphilis.Item Comparative Pharmacoeconomic Analysis of Benzathine Penicillin and Procaine Penicillin in the treatment of early syphilis in a University Teaching Hospital in Nigeria(Published by Faculty of Pharmaceutical Sciences, University of Jos, 2008) Giwa, A; Osagbemi, G.K; Atata, R.F; Giwa, H.B.FComparative pharmacoeconomic analysis of benzathine and procaine penicillin in the treatment of early syphilis in Ahmadu Bello University Teaching Hospital, Zaria, northern Nigeria was carried out retrospectively for prescribed/dispensed antibacterial drugs to outpatients with early syphilis among other infectious diseases, by examining outpatients case notes between 2005 and 2007. Results show that benzathine penicillin cost N 4.31/unit of effectiveness while procaine penicillin injection cost N 18.19/unit of effectiveness in the treatment of early syphilis. Benzathine penicillin injection therefore appears to be more cost effective than procaine penicllin injection. Subjecting the cost and effectiveness to sensitivity analysis did not change this conclusion. Statistical analysis shows that there is a statistically significant difference in the effectiveness (outcome) of benzathine penicillin and procaine penicillin injection, (56.2%) (χ2 = 48.58, P<0.5), Therefore there is association between effectiveness and therapeutic option chosen with benzathine penicillin being a more cost effective option. The result of this study is significant because benzathine penicillin is usually traded off for less cost-effective procaine penicillin in many cases even when there is no contraindication to the use of benzathine penicillin. Benzathine penicillin injection is more cost effective than procaine penicillin injection at their usual therapeutic dose in the treatment of early syphilis.Item Cost of Illness Analysis of Human Immuno Deficiency Virus/ACQUIRED Immuno Deficiency Syndrome (HIV/AIDS) in a Developing Economy.(West African Postgraduate College of Pharmacy, 2018) Giwa, A; Giwa, H.B.F; Jamiu, M.OBackground: Highly Active Antiretroviral Therapy is for lifetime of the patients from time of diagnosis of HIV/AIDS. This translates into a substantial cost in drug therapy to the patients, government and donor agencies. Objective: To conduct cost of illness analysis of HIV/AIDS in a Developing Economy in 2016. Methods: A one-year retrospective review of 2560 prescriptions of 396 HIV/AIDS patients' case notes from January to December, 2016 obtained by systematic random sampling from 4800 case-notes of subjects that participated in this study was conducted. Sampling Interval =10 A data collection form was designed and used to collect data generated from the selected case notes. Cost of Illness was determined by prevalence rate method, using direct costs only. Results: The annual cost of illness for the 396 HIV/AIDS patients on highly active antiretroviral therapy was ?40,674,760 (US$127,108.3) with drug, diagnostic/monitoring tests, transport, care/support and personnel cost components of ?25,479,760; US$79,624.3 (62.64%), ?7,200,000; US$22,500 (17.71%), ?1,440,000; US$4,500(3.54%), ?2,880,000; US$9,000 (7.08%) and ?3,675,000; US$11484 (9.03%) respectively. The annual average cost of illness of HIV/AIDS was ?102,714.04 (US$320.98) Conclusion: The annual average cost of illness of HIV/AIDS represent 97% of annual per capita income. This is enormous. The Annual National cost of illness for HIV/AIDS in Nigeria, a developing economy may be about N590 billion annuallyItem Cost-Minimization Analysis of Antimicrobial Therapy in A Tertiary Healthcare institution in Nigeria(Published by Faculty of Pharmaceutical Sciences, University of Jos, 2008) Giwa, H.B.F; Giwa, A; Osagbemi, G.K; Atata, R.FCost Minimization Analysis of antimicrobial therapy in a tertiary health care institution in a developing economy country was carried out. The most applicable tool for generic equivalent drugs was used in Ahmadu Bello University Teaching Hospital, a tertiary healthcare Institution in Nigeria, between 2005 and 2007. Relevant information such as diagnosis, cost of drugs (in Naira – N), dosage, duration of therapy among others were obtained retrospectively from patient case-notes for which antibacterial are the mainstay of therapy and dispensed prescriptions. The mean cost per defined daily dosage (DDD) of generic and branded for each antibacterial was computed. These were compared using Student’s t-test. The outcome measure was potential eradication of bacterial in question by the respective antibacterial drug. The analyses showed that the use of expensive branded drugs were very rampant even when the much cheaper generic equivalent is available. The differences in the mean cost/DDD were very significant for all the antimicrobial agents at p<0.05. For example the mean cost/DDD of ciprofloxacin was N267 for branded product and N80.00 for generic (t = 421.2 at p<0.05).Sensitivity analysis also Confirm this decision. Prescriptions of expensive branded drugs were rampant even when the much cheaper generic equivalents are available. The mean cost per Defined Daily Dose of Branded and Generic equivalent were significantly different for all antibiotics applicable for cost minimization analysis, with Generic Products much cheaper than Branded equivalentItem Cost-Minimization Analysis of Antimicrobial Therapy in A Tertiary Healthcare institution in Nigeria(Published by Faculty of Pharmaceutical Sciences, University of Jos., 2008) Giwa, A; Osagbemi, G.K; Atata, R.F; Giwa, H.B.FCost Minimization Analysis of antimicrobial therapy in a tertiary health care institution in a developing economy country was carried out. The most applicable tool for generic equivalent drugs was used in Ahmadu Bello University Teaching Hospital, a tertiary healthcare Institution in Nigeria, between 2005 and 2007. Relevant information such as diagnosis, cost of drugs (in Naira – N), dosage, duration of therapy among others were obtained retrospectively from patient case-notes for which antibacterial are the mainstay of therapy and dispensed prescriptions. The mean cost per defined daily dosage (DDD) of generic and branded for each antibacterial was computed. These were compared using Student’s t-test. The outcome measure was potential eradication of bacterial in question by the respective antibacterial drug. The analyses showed that the use of expensive branded drugs were very rampant even when the much cheaper generic equivalent is available. The differences in the mean cost/DDD were very significant for all the antimicrobial agents at p<0.05. For example the mean cost/DDD of ciprofloxacin was N267 for branded product and N80.00 for generic (t = 421.2 at p<0.05).Sensitivity analysis also Confirm this decision. Prescriptions of expensive branded drugs were rampant even when the much cheaper generic equivalents are available. The mean cost per Defined Daily Dose of Branded and Generic equivalent were significantly different for all antibiotics applicable for cost minimization analysis, with Generic Products much cheaper than Branded equivalent. ______________________________________________________________________________Item Pharmaco-Economic Evaluation of Doxycycline and Tetracycline in the Treatment of Chlamydia implicated Non-Gonococcal Urethritis in a Tertiary Healthcare Institution in Nigeria.(African Society for Clinical Microbiology, 2009) Giwa, A; Osagbemi, G.K; Olayinka, B.O; Giwa, H.B.FWith depressing nature of economy in many countries such as Nigeria where per capita income is low, there is need for utmost consideration for cost containment measures. Objective: The objective of this study is to conduct pharmacoeconomic evaluation of two antichlamydial indicated non-gonococcal urethritis therapeutic options and to make recommendations for inclusion of economic evaluation of drug therapies in health policy formulations and decision making. Methods: Cost effectiveness analysis was carried out retrospectively for prescribed/dispensed antibacterials to out-patients with chlamydial implicated non-gonococcal urethritis among other infectious diseases, by examining out-patient case notes between 2005 and 2007 in Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Results : The result shows that doxycycline costs N1.33/unit of effectiveness while tetracycline costs N2.77/unit of effectiveness in the treatment of chlamydial implicated non-gonococcal urethritis. Doxycycline is therefore more cost effective than tetracycline capsules. Subjecting the costs and effectiveness to sensitivity analysis did not change this conclusion. There is tatistically significant difference in the effectiveness (outcome) of doxycycline (78.8%) and tetracycline (58.7%) ( x2 =9.4; p<0.05) There is therefore association between effectiveness and therapeutic option chosen with doxycycline being a more cost-effective option. The result is significant because doxycycline is not currently included in the Essential Drug list of Nigeria1. However, the result is in agreement with Zimbabwean Essential Drug list which recommended that tetracycline be replaced by doxycycline in all indications and should be used only when doxycycline is not available2. Also doxycycline is a drug of choice for other disease like gonorrhorea and syphilis in non-pregnant women2. It was concluded that Doxycycline 100mg bd x 1/52 is more cost effective than Tetracycline 500mg qid x 1/52 in the treatment of chlamydial implicated non gonococcal urethritis. Adoption of economic evaluation of drug therapies in Nigeria Health policy formulation and decisions is likely to enhance overall Health System cost effectiveness.