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Pharmacoeconomic Analysis Of Hiv/Aids Management At Murtala Muhammad Specialist Hospital, Kano, Nigeria


Pharmacoeconomic Analysis Of Hiv/Aids Management At Murtala Muhammad Specialist Hospital, Kano, Nigeria


The HIV/AIDS pandemic has resulted in mortality surge and life expectancy drop throughout the world. Developing countries are mostly affected due to their limited health care system and resources to handle the increasing costs of management of HIV/AIDS and associated opportunistic infections. The objective of this study is to estimate direct and indirect costs of managing HIV/AIDS to both the health sector and the patients, at Murtala Muhammad Specialist Hospital, Kano (MMSH). Patients‘ data from a sample of 256 adults and 28 children were collected between 1st January and 31st December 2010.

The study revealed that majority of the patients were aged between 15 and 49 (87.7%), female (66.2%) and married (71.48%), while about forty percent were unemployed (39.8%) and 27.1% had an income of less N20,000. The average annual income for the patients was estimated to be N143,796. About half of the respondents had a CD4 count test done once (52.5%), most were on antiretrovirals (94.37%), a few had co-morbid illnesses (12.32%), side effects/adverse drug reactions (10.9%), hospitalized (11.27%) or had National Health Insurance Scheme (NHIS) coverage(3.87%).

The estimated average total annual costs to the health sector and patients were N323,303 and N10,516 respectively. Major contributors to health sector costs which were all direct-medical costs were antiretroviral drugs (83.60%) and health care personnel (12.37%).Direct-medical costs to patients amounted to aboutN3,055 (2.12%) with major contributions from hospitalisation , treatment of co-morbid illnesses and laboratory tests.

6 Direct non-medical and indirect costs to patients were derived from transport (N2,634, 1.83%) and productivity loss (N4,827; 3.36%) respectively, the total patients cost of N10,516 amounted to 7.31% of their average annual income of N143,796. Thus, data obtained suggested that the management of HIV/AIDS at MMSH poses a serious economic burden on the health care system and on patients living with the disease.

Majority of the health care costs (antiretrovirals) were provided by Non Governmental Organisations (NGOs); this scenario applies all over the country. In the event that the NGOs withdraw their aid in the future, the burden to the health sector may be too much for the Government to bear. The expansion of the NHIS to include HIV/AIDS management will decrease the burden on the Government and the patients. Increasing efforts on HIV infection prevention should also significantly decrease the burden of HIV/AIDS in the long run.


Title Page——————————————————————————————-ii
Table of Contents——————————————————————————–viii
List of Tables————————————————————————————-xii
List of Figures————————————————————————————xiii
List of Appendices——————————————————————————-xiv

1.1 About this Study——————————————————————————-1
1.2 Statement of Research Problem————————————————————-1
1.3 Justification for the Study——————————————————————–2
1.4 Theoretical Framework———————————————————————–3
1.5Aim and Objective of the Study————————————————————–4
1.6 Statement of Research Hypothesis———————————————————-4

2.1 Overview of HIV/AIDS———————————————————————-5
2.1.1 HIV/AIDs Timeline————————————————————————-7
2.1.2 Method of Transmission of HIV/AIDS ————————————————12
2.1.3 Impact of HIV/AIDS———————————————————————-14
2.1.4 Factors Militating Against Accessing ART and HIV Care————————–18
2.1.5 HIV Treatment in Nigeria —————————————————————19
2.1.6 Funding for HIV/AIDS——————————————————————-23
2.2 Epidemiology of HIV/AIDS—————————————————————-25
2.2.1 Global Epidemiology of HIV/AIDS—————————————————-25
2.2.2 Epidemiology, Africa———————————————————————27
2.2.3 Epidemiology, Nigeria——————————————————————–28
2.3 Pharmacoeconomics ————————————————————————29
2.3.1 Cost-Effectiveness Analysis————————————————————–30
2.3.2 Cost-Minimization Analysis————————————————————-30
2.3.3 Cost-Benefit Analysis———————————————————————31
2.3.4 Cost-Utility Analysis———————————————————————-31
2.4 Cost of Illness Analysis ——————————————————————–33

3.1 Methodology———————————————————————————-35
3.1.1 Study Hospital——————————————————————————35
3.1.2 Study Perspective————————————————————————–35
3.1.3 Study Design——————————————————————————-35
3.1.4 Study Population—————————————————————————35
3.1.5 Study Period——————————————————————————–36
3.1.6 Data Source———————————————————————————36
3.1.7 Sample Size Determination————————————————————–37
3.1.8 Statistical Analysis and Data Presentation———————————————37
3.1.9 Pharmacoeconomic Method————————————————————–38
3.2 Limitation of Study————————————————————————–38

4.1 Clinic Population and Clinic Days———————————————————39
4.2 Patients Bio Data —————————————————————————39
4.2.1 Age——————————————————————————————39
4.2.2 Sex——————————————————————————————-39
4.2.3 Education———————————————————————————–41
4.2.4 Marital Status——————————————————————————-41
4.2.5 Education———————————————————————————–41
4.2.6 Income————————————————————————————–41
4.2.7 Household Size—————————————————————————–41
4.2.8 Financial Sponsor————————————————————————–45
4.3 Medical History——————————————————————————45
4.3.1 Diagnostic Tests—————————————————————————45
4.3.2 Treatment Category———————————————————————–45
4.3.3 Co-morbid Illnesses———————————————————————–45
4.3.4 Self-medication—————————————————————————-49
4.3.5 Side Effects/Adverse drug Reaction—————————————————-49
4.3.6 Emergency Room Visits——————————————————————49
4.3.7 Hospitalisation—————————————————————————–49
4.3.8 Alternate Source of Care——————————————————————49
4.4 Costs——————————————————————————————-52
4.4.1 Transport Cost to the Hospital———————————————————–52
4.4.2 Cost Contribution of Health Care Personnel——————————————-52
4.4.3 Cost Contribution of Laboratory Investigations—————————————52
4.4.4 Cost of Drugs——————————————————————————-57
4.4.5 Productivity Losses————————————————————————64
4.4.6 Estimated Contribution of Costs to Health Care Workers and the Patients——–64

6.1 Summary————————————————————————————–77
6.2 Conclusion————————————————————————————77
6.3 Recommendation—————————————————————————–78



About the study Ill-health can result in an increase in economic burden on individuals, contributing to income loss, asset depletion as well as investment of a large amount of National resources to combating that disease. These processes are brought into sharper focus by the social and economic impact of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic.

Concern about the links between ill-health and impoverishment has placed health at the centre of development agencies‘ poverty reduction targets and strategies. This has strengthened arguments for a substantial increase in health sector investment to improve access for the world‘s poorest people to combat poverty as well as reduce disease burden (Russel, 2004). This thesis reports on an evaluation of costs committed to HIV/AIDS management in a secondary health facility, (MMSH) in Kano, Nigeria.


AVERT (2009). Averting HIV and AIDS: AIDS timeline.

Benson, C.A., Kaplan, J.E., Masur, H., Pau, A., Holmes, K.K. (2009). Treating Opportunistic Infections among HIV-Infected Adults and Adolescents; Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. pp. 1-5.

Bill, R. (2005). Workplace HIV/AIDS Program: An action guide for managers. Retrieved 14th May, 2013.

Click to access workplacefhi_en.pdf

CASCADE EU (2000), Time from HIV-1 seroconversion to AIDS and death before widespread use of highly active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action. Concerted Action on Seroconversion to AIDS and Death in Europe. Lancet 355 (9210): 1131–7.

Centre for Disease Control and Prevention, (2009). Cost Analysis: Cost of Illness/CDC. In Economic Evaluation Tutorials.

Clay, P.G. (2004). Examining the Pharmacoeconomics of HIV treatment. In: The Body; the Complete HIV/AIDS Resource. Retrieved 16th December, 2011.

Connely, P. (2001). The Cost of Treating HIV/AIDS with ARVs in South Africa. Retrieved 20th February, 2013.

Crecon, R.C. (2007). The Essence of Pharmacoeconomics. Retrieved 16th December, 2011. 3.html

Danjuma, N.M., Zezi, A.U., Maiha, B.B., Yaro, A.H., (2007). Pharmacoeconomic Evaluation of Tuberculosis Chemotherapy at Ahmadu Bello University Teaching

Hospital (ABUTH), Zaria, Nigeria. Nigerian Journal of Pharmaceutical Research 13(1): 75-79.

Federal Republic of Nigeria, Federal Ministry of Health (2008). HIV/STI Integrated Biological and Behavioural Surveillance Survey (IBBSS). pp 11-14.

Freedberg, K.A., Scharfstein, J.A., Searge, G.R., Losina, E., Weinstein, M.C., Craven, D.E. and Pattiel, A.D. (1998). The Cost Effectiveness of Preventing AIDS-related OIs: Clinical Economics Research Unit. Retrieved 20th February, 2013.

Guinness, L., Arthur, G., Bhatt, S.M., Achiya, G., Kariuki, S. and Gilks, C.F. (2002). Costs of Hospital Care for HIV-Positive and HIV-Negative Patients at Kenyatta National Hospital, Nairobi, Kenya. AIDS. 2002 Apr 12; 16(6):901-8.
Gwarzo, N.S. (1998). HIV/AIDS: The National Epidemiology. The Journal of Pharmacy, 30(1): 9-10.

Hargreaves, J.D. and Howe, L.D. (2010). Changes in HIV Prevalence among Differently Educated Groups in Tanzania Between 2003 and 2007. Retrieved 16th May, 2013.

Health Economics Netherlands (2009). Health Economics and Pharmacoeconomics Glossary of Terms, Pharmacoeconomics in Health Economics. Retrieved 16th February, 2011.

Hilleman, D.E., Dewan, N., Malesker, M. and Friedman, M. (2000). Pharmacoeconomic Evaluation of COPD. Journal of the American college of chest physicians, 118: 1278-1285

HIV/AIDS and HRC (2006). Two Decades of Fighting Life. The Human Rights Campaign. Retrieved 16th March, 2014

James, H. (2009). Three Top Economists Agree 2009 Worst Financial Crisis since Great Depression; Risks increase if right steps are not taken.. Retrieved 28th February, 2011 from Business Wire News database.

Kaiser Family Foundation (KFC), (2007). The Multi-Sectoral Impact of the HIV/AIDS Epidemic – A Primer. Retrieved 28th February,

Kennedy, M.B., Jean, R., Martin, E.J. (2009) Intrapartum Management Modules: a Perinatal Education Program. Module 10, Pp 300-310.

Lynn, L.A., Schulman, K.A., Eisenberg, J.M. (1992). The Pharmacoeconomics of HIV Disease. Pharmacoeconomics. NIH 1(3):161-74.

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