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AFRICAN JOURNAL OF HEALTH ECONOMICS - Volume 11 Issue 2, December 2022

Pages: 1-11

Date of Publication: 01-Dec-2022


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Economic analysis of hypertension management in public hospitals in Southwestern Nigeria: evidence from secondary data analysis

Author: Theophilus Ehidiamen Oamen, Kanayo Patrick Osemene, Maduabuchi Romanus Ihekoronye

Category: Review & Research

Abstract:

Background: The rising out-of-pocket expenditure on anti-hypertension medications is a huge economic concern for low-income patients. In resource-limited settings, healthcare providers require empirical evidence to support cost reduction without compromising treatment effectiveness. The study aims to conduct a comparative economic analysis of hypertension management in public hospitals in Southwestern Nigeria. Methods: A retrospective cross-sectional study of randomly selected two hundred and fifty-five (N=255) hypertensive patients from two purposively selected public hospitals (n=145 in secondary and n=110 in tertiary) in Abeokuta, Ogun state. Stratification into 3 treatment groups was based on Eighth Joint National Convention guidelines. The perspective of the economic analysis was healthcare provider based and focused only on direct medical costs. Costs were computed from the prices of generic drugs prescribed per clinic visit. The outcome measure was the attainment of blood pressure below < 140mmHg systolic and/or 90mmHg diastolic or <130 mmHg systolic and/or 80mmHg for diabetic hypertensive patients at the end of the 1-year study. Incremental cost-effectiveness ratios (ICERs) namely cost/mmHg and cost/controlled patient were computed by comparing treatment versus 'no therapy' groups. Results: Total medication costs were higher in the tertiary hospital (US$29,218.3) compared to the secondary (US$19,357.4). Hypertension medication costs were higher in the tertiary hospital (US$12,388.2) compared to the secondary (US$9,583.7). The cost per mmHg was generally lower in the tertiary hospital due to better treatment outcomes. Costs per controlled patient were more favorable in the secondary hospital due to higher patient numbers. Conclusion: Higher medication costs were associated with better blood pressure control. The study provided useful cost analysis information for subgroups of hypertensive patients in different healthcare settings. ICERs enable healthcare providers to execute evidence-based resource allocation.

Keywords: Hypertension, Cost-Effectiveness, Public Hospitals, Pharmacoeconomics, Economic Evaluation, Antihypertensive drugs

DOI: doi.org/10.35202/AJHE.2022.112111

DOI URL: http://doi.org/10.35202/AJHE.2022.112111

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