Browsing by Author "Olayinka, B.O"
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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 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.