PHARMACOECONOMIC ANALYSIS OF HIV/AIDS MANAGEMENT

Thesis Abstract

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 about N3,055 (2.12%) with major contributions from hospitalisation , treatment of co-morbid illnesses and laboratory tests. 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.