Pharmacoeconomic Evaluation Of Doxycycline And Tetracycline In The Treatment Of Chlamydial Implicated Non-Gonococcal Urethritis In A Tertiary Healthcare Institution In Nigeria

A Giwa, GK Osagbemi, BO Olayinka, HB Giwa



With 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 statistically 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 Nigeria. 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.

African Journal of Clinical and Experimental Microbiology Vol. 10 (1) 2009: pp. 35-46