Comparative Cost-Effectiveness Analysis of Streptomycin and Ethambutol in the Treatment of Tuberculosis in a University Teaching Hospital in Nigeria
No Thumbnail Available
Date
2009
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
African Society for Clinical Microbiology
Abstract
Healthcare 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.
Description
Keywords
Pharmacoeconomics, cost effectiveness analysis, ethambutol, streptomycin, tuberculoses.
Citation
19. Giwa A, Osagbemi GK, Olayinka BO and Giwa HBF (2009): Comparative Cost-Effectiveness Analysis of Streptomycin and Ethambutol in the Treatment of Tuberculosis in a University Teaching Hospital in Nigeria. African Journal of Clinical and Experimental Microbiology. 10(1); 47-55, Published by African Society for Clinical Microbiology