Comparative Cost-Effectiveness Analysis Of Streptomycin And Ethambutol In The Treatment Of Tuberculosis In A University Teaching Hospital In Nigeria

A Giwa, GK Osagbemi, BO Olayinka, HBF Giwa



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.
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.
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.
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.
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 tuberculos at the intensive phase.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 47-55