Cost Effectiveness Analysis of Combined Anti-Retroviral Therapy in a Tertiary Health Institution
No Thumbnail Available
Date
2018
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Published by West African Postgraduate College of Pharmacy
Abstract
Background: 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.
Description
Keywords
Cost-Effectiveness analysis,, cART,, HIV/AIDS,, Defined Daily Dose
Citation
A.Giwa, HB Giwa, MO Jamiu (2018): Cost Effectiveness Analysis of Combined Anti-Retroviral Therapy in a Tertiary Health Institution. West African Journal of Pharmacy, 29(1); 59-69, Published by West African Postgraduate College of Pharmacy