Skip to main content
SpringerLink
Log in

The State of Health Economic Evaluation Research in Nigeria

A Systematic Review

  • Review Article
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Abstract

This study assessed the state of health economic evaluation (including pharmacoeconomic) research in Nigeria. A literature search was conducted to identify health economic articles pertaining to Nigeria. Two reviewers independently scored each article in the final sample using a data collection form designed for the study.

A total of 44 studies investigating a wide variety of diseases were included in the review. These articles were published in 34 different journals, mostly based outside of Nigeria, between 1988 and 2009. On average, each article was written by four authors. Most first authors had medical/clinical affiliations and resided in Nigeria at the time of publication of the study. Based on a 1 to 10 scale, with 10 indicating the highest quality, the mean quality score for all studies was 7.29 (SD 1.21) and 59% of the articles were of fair quality (score 5–7); 5% were of even lower quality. The quality of articles was statistically significantly (p 0.05) related to the country of residence of the primary author (non-Nigeria = higher), country of the journal (non-Nigeria = higher), primary objective of the study (economic analysis = higher) and type of economic analysis conducted (economic evaluations higher than cost studies).

The conduct of health economic (including pharmacoeconomic) research in Nigeria was limited and about two-thirds of published articles were of suboptimal quality. More and better quality health economic research in Nigeria is warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Table I
Fig. 2
Table II
Table III

Similar content being viewed by others

References

  1. Wammanda RD, Ejembi CL, Lorliam T. Drug treatment costs: projected impact of using the intergrated management of childhood illnesses. Trop Doct 2003; 33: 86–8

    PubMed  CAS  Google Scholar 

  2. Hargreaves S. Time to right the wrongs: improving basic health care in Nigeria. Lancet 2002; 359 (9322): 2030–5

    Article  PubMed  Google Scholar 

  3. Wouters A. The cost and efficiency of public and private health care facilities in Ogun state, Nigeria. Health Econ 1993; 2 (1): 31–42

    Article  PubMed  CAS  Google Scholar 

  4. Ojanuga DN. Construction of Mujedawa dispensary in Kaduna state, Nigeria through self-help. World Health Forum 1985; 6: 108–9

    Google Scholar 

  5. Gustafsson-Wright E, van der Gaag J. An analysis of Nigeria’s health sector by state: recommendations for the expansion of the Hygeia Community Health Plan. Amsterdam: Amsterdam Institute for International Development (AIID), 2008 [online]. Available from URL: http://www.aiid.org/docs/NigeriaHealthSectorReport%202008.pdf [Accessed 2010 Mar 20]

    Google Scholar 

  6. Waka UA. ISPOR International Fellowship Report: development of pharmacoeconomics and outcomes research in Nigeria. ISPOR Connections 2009 May/June; 15 (3): 19–20

    Google Scholar 

  7. Famuyiwa OO, Edozien EM, Ukoli CO. Social, cultural and economic factors in the management of diabetes mellitus in Nigeria. Afr J Med Med Sci 1985 Sep-Dec; 14 (3-4): 145–54

    PubMed  CAS  Google Scholar 

  8. Johnson D. Nigeria: a paper produced by DFIDs Health Systems Resource Centre for the UK Department for International Development. London: DFID Health Systems Resource Centre: Country Health Briefing Paper, 2000 [online]. Available from URL: http://www.dfidhealthrc.org/publications/Country_health/Nigeria.pdf [Accessed 2010 Mar 20]

    Google Scholar 

  9. Lambo E. An optimization-simulation model of a rural health center in Nigeria. Interfaces 1983; 13: 29–35

    Article  Google Scholar 

  10. Drummond MF, Sculpher MJ, Torrance GW, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press, 2005

    Google Scholar 

  11. Wyatt J. Use and sources of medical knowledge. Lancet 1991; 338: 1368–73

    Article  PubMed  CAS  Google Scholar 

  12. Walker D, Fox-Rushby JA. Economic evaluation of communicable disease interventions in developing countries: a critical review of the published literature. Health Econ 2000; 9 (8): 681–98

    Article  PubMed  CAS  Google Scholar 

  13. Lee KS, Brouwer WB, Lee SI, et al. Introducing economic evaluation as a policy tool in Korea: will decision makers get quality information? A critical review of published Korean economic evaluations. Pharmacoeconomics 2005; 23 (7): 709–21

    Article  PubMed  Google Scholar 

  14. Gavaza P, Rascati KL, Lawson K, et al. The state of health economics and pharmacoeconomics research in Zimbabwe. Curr Therap Res 2008; 69 (3): 268–85

    Article  Google Scholar 

  15. Sullivan SD, Lyles A, Luce BR, et al. AMCP guidance for submission of clinical and economic evaluation data to support formulary listing in US health plans and pharmacy benefits management organizations. J Manag Care Pharm 2001; 7 (4): 272–82

    Google Scholar 

  16. Zarnke K, Levine M, O’Brien B. Cost-benefit analysis in the health care literature: don’t judge a study by its label. J Clin Epidemiol 1997; 50 (7): 817–22

    Article  Google Scholar 

  17. Offman J, Sullivan S, Neumann P, et al. Examining the value and quality of health economic analyses: implications of utilizing the QHES. J Manag Care Pharm 2003; 9 (1): 53–61

    Google Scholar 

  18. Vogel RJ. Health care cost-recovery simulations from parametric estimates: methodology and results for Ogun State, Nigeria. Int J Health Plann Manage 1994; 9 (2): 183–98

    Article  PubMed  CAS  Google Scholar 

  19. Onwujekwe O, Chima R, Okonkwo P. Economic burden of malaria illness on households versus that of all other illness episodes: a study in five malaria holo-endemic Nigerian communities. Health Policy 2000; 54 (2): 143–59

    Article  PubMed  CAS  Google Scholar 

  20. Fatiregun AA, Osungbade KO, Olumide AE. Cost-effectiveness of screening methods for urinary schistosomiasis in a school-based control programme in Ibadan, Nigeria. Health Policy 2009; 89 (1): 72–7

    Article  PubMed  Google Scholar 

  21. Gureje O, Chisholm D, Kola L, et al. Cost-effectiveness of an essential mental health intervention package in Nigeria. World Psychiatry 2007; 6 (1): 42–8

    PubMed  Google Scholar 

  22. Monath TP, Nasidi A. Should yellowfever vaccine be included in the expanded program of immunization in Africa? A cost-effectiveness analysis for Nigeria. Am J Trop Med Hyg 1993; 48 (2): 274–99

    PubMed  CAS  Google Scholar 

  23. Adegbehingbe OO, Akinyoola AL, Ariyibi AL, et al. Direct integration of government funding and family support for musculoskeletal tumor care in a resource-constrained country. Oncology 2009; 76 (6): 398–404

    Article  PubMed  CAS  Google Scholar 

  24. Tongo OO, Orimadegun AE, Ajayi SO, et al. The economic burden of preterm/very low birth weight care in Nigeria. J Trop Pediatr 2009; 55 (4): 262–4

    Article  PubMed  CAS  Google Scholar 

  25. Olusanya BO, Emokpae A, Renner JK, et al. Costs and performance of early hearing detection programmes in Lagos, Nigeria. Trans R Soc Trop Med Hyg 2009; 103 (2): 179–86

    Article  PubMed  CAS  Google Scholar 

  26. Chisholm D, Gureje O, Saldivia S, et al. Schizophrenia treatment in the developing world: an interregional and multinational cost-effectiveness analysis. Bull World Health Organ 2008; 86 (7): 542–51

    Article  PubMed  Google Scholar 

  27. Mahal A, Canning D, Odumosu K, et al. Assessing the economic impact of HIV/AIDS on Nigerian households: a propensity score matching approach. AIDS 2008; 22 Suppl. 1: S95–101

    Article  Google Scholar 

  28. Goldie SJ, O’Shea M, Campos NG, et al. Health and economic outcomes of HPV 16,18 vaccination in 72 GAVIeligible countries. Vaccine 2008; 26 (32): 4080–93

    Article  PubMed  Google Scholar 

  29. Henshaw SK, Adewole I, Singh S, et al. Severity and cost of unsafe abortion complications treated in Nigerian hospitals. Int Fam Plan Perspect 2008; 34 (1): 40–50

    Article  PubMed  Google Scholar 

  30. Onwujekwe O, Uzochukwu B, Eze S, et al. Improving equity in malaria treatment: relationship of socio-economic status with health seeking as well as with perceptions of ease of using the services of different providers for the treatment of malaria in Nigeria. Malar J 2008; 7 (5): 1–10

    Google Scholar 

  31. Fatiregun AA, Yisa IO, Olumide AE. Utilization and costs of medical services at military health facilities in Ibadan, Nigeria. J Med Sys 2007; 31 (6): 505–9

    Article  Google Scholar 

  32. Sadoh WE, Oviawe O. The economic burden to families o HIV and HIV/tuberculosis coinfection in a subsidized HIV treatment program. J Natl Med Assoc 2007; 99 (6): 627–31

    PubMed  Google Scholar 

  33. Jimoh A, Sofola O, Petu A, et al. Quantifying the economic burden of malaria in Nigeria using the willingness to pay approach. Cost Eff Res Alloc 2007; 5: 1–6

    Article  Google Scholar 

  34. Ebri A, Kuper H, Wedner S. Cost-effectiveness of cycloplegic agents: results of a randomized controlled trial in Nigerian children. Invest Ophthalmol Vis Sci 2007; 48 (3): 1025–31

    Article  PubMed  Google Scholar 

  35. Okogun GRA, Amadi AN. Epidemiology, therapeutic agents and cost of management of paediatric malaria in a Nigerian tertiary hospital. J Vector Borne Dis 2005; 42 (3): 87–94

    PubMed  Google Scholar 

  36. Amoo G, Ogunlesi AO. Financial cost of treating Nigerian in-patients with schizophrenia. Afr J Med Med Sci 2005; 34 (1): 15–23

    PubMed  CAS  Google Scholar 

  37. Meremikwu MM, Ehiri JE, Nkanga DG, et al. Socioeconomic constraints to effective management of Burkitts lymphoma in south-eastern Nigeria. Trop Med Int Health 2005; 10 (1): 92–8

    Article  PubMed  CAS  Google Scholar 

  38. Onwujekwe O, Uzochukwu B, Shu E, et al. Is combination therapy for malaria based on user-fees worthwhile and equitable to consumers? Assessment of costs and willingness to pay in Southeast Nigeria. Acta Trop 2004; 91 (2): 101–15

    Article  PubMed  Google Scholar 

  39. Onwujekwe O, Chima R, Shu E, et al. Community-directed treatment with ivermectin in two Nigerian communities: an analysis of first year start-up processes, costs and consequences. Health Policy 2002; 62 (1): 31–51

    Article  PubMed  Google Scholar 

  40. Onwujekwe O, Shu E, Onwuameze O, et al. Onchocerciasis control in Nigeria: will households be able to afford community- directed treatment with ivermectin? Acta Trop 2001; 80 (3): 277–81

    Article  PubMed  CAS  Google Scholar 

  41. Onwujekwe OE, Shu EN, Nwagbo D, et al. Willingness to pay for community-based ivermectin distribution: a study of three onchocerciasis-endemic communities in Nigeria. Trop Med Int Health 1998; 3 (10): 802–8

    Article  PubMed  CAS  Google Scholar 

  42. Chiwuzie J, Okojie O, Okolocha C, et al. Emergency loan funds to improve access to obstetric care in Ekpoma, Nigeria. The Benin PMM Team. Int J Gynaecol Obstet 1997; 59 Suppl. 2: S231–6

    Article  Google Scholar 

  43. Amadasun JE. The cost effective medical treatment of suppurative otitis media in a Nigerian environment. West Afr J Med 1997; 16 (2): 85–7

    PubMed  CAS  Google Scholar 

  44. Ogunbekun I, Adeyi O, Wouters A, et al. Costs and financing of improvements in the quality of maternal health services through the Bamako Initiative in Nigeria. Health Policy Plan 1996 Dec 1; 11 (4): 369–84

    Article  PubMed  CAS  Google Scholar 

  45. Konje JC, Obisesan KA, Ladipo OA. Health and economic consequences of septic induced abortion. Int J Gynecol Obstet 1992; 37 (3): 193–7

    Article  CAS  Google Scholar 

  46. Ogunseitan OA. The cost of environmental lead (Pb) poisoning in Nigeria. African J Environ Sci Technol 2007; 1 (2): 27–36

    Google Scholar 

  47. Onwujekwe O, Chima R, Shu E, et al. Altruistic willingness to pay in community-based sales of insecticide-treated nets exists in Nigeria. Soc Sci Med 2002; 54 (4): 519–27

    Article  PubMed  Google Scholar 

  48. Onwujekwe O, Chima R, Shu E, et al. Hypothetical and actual willingness to pay for insecticide-treated nets in five Nigerian communities. Trop Med Int Health 2001; 6 (7): 545–53

    Article  PubMed  CAS  Google Scholar 

  49. Suleiman TG, Ohaeri JU, Lawal RA, et al. Financial cost of treating out-patients with schizophrenia in Nigeria. Br J Psychiatry 1997; 171: 364–8

    Article  PubMed  CAS  Google Scholar 

  50. Onwujekwe O, Dike N, Chukwuka C, et al. Examining catastrophic costs and benefit incidence of subsidized antiretroviral treatment (ART) programme in south-east Nigeria. Health Policy 2009; 90 (2-3): 223–9

    Article  PubMed  Google Scholar 

  51. Onwujekwe O, Hanson K, Fox-Rushby J. Inequalities in purchase of mosquito nets and willingness to pay for insecticide- treated nets in Nigeria: challenges for malaria control interventions. Malar J 2004; 3 (6): 1–8

    Google Scholar 

  52. Alhasan SU, Aji SA, Mohammed AZ, et al. Transurethral resection of the prostate in Northern Nigeria, problems and prospects. BMC Urol 2008; 8 (18): 1–6

    Google Scholar 

  53. Isenalumhe AE, Oviawe O. Polypharmacy: its cost burden and barrier to medical care in a drug-oriented health care system. Int J Health Serv 1988; 18 (2): 335–42

    Article  PubMed  CAS  Google Scholar 

  54. Makanjuola AB. A cost comparison of traditional and orthodox mental health care. Niger Postgrad Med J 2003; 10 (3): 157–61

    PubMed  CAS  Google Scholar 

  55. Gosselin R, Maldonado A, Elder G. Comparative costeffectiveness analysis of two MSF surgical trauma centers. World J Surg 2010; 34 (3): 415–9

    Article  PubMed  Google Scholar 

  56. Veeken H, Ritmeijer K, Hausman B. Priority during a meningitis epidemic: vaccination or treatment? Bull World Health Organ 1998; 76 (2): 135–41

    PubMed  CAS  Google Scholar 

  57. Onwujekwe O, Uzochukwu B, Nwobe E, et al. Socioeconomic inequalities in household expenditures to prevent and treat endemic tropical diseases in Southwest Nigeria. J Int Med Res 2004; 2: 29–39

    Google Scholar 

  58. Enwere OO, Salako BL, Falade CO. Prescription and cost consideration at a diabetic clinic in Ibadan,Nigeria: a report. Ann Ibadan Postgrad Med 2006; 4 (2): 35–9

    Google Scholar 

  59. Adeneye AK, Mafe MA, Appelt B, et al. Willingness to pay for praziquantel treatment in a hyperendemic community of Ogun State, Nigeria. Res Social Admin Pharm 2006; 2 (1): 83–95

    Article  CAS  Google Scholar 

  60. Teerawattananon Y, Russell S, Mugford M. A systematic review of economic evaluation literature in Thailand: are the data good enough to be used by policy-makers? Pharmacoeconomics 2007; 25 (6): 467–79

    Article  PubMed  Google Scholar 

  61. Neumann PJ, Stone PW, Chapman RH, et al. The quality of reporting in published cost-utility analyses, 19761997. Ann Int Med 2000; 132 (12): 964–72

    PubMed  CAS  Google Scholar 

  62. Federal Ministry of Health. The national health policy of Nigeria. Lagos: Federal Ministry of Health, 1992

    Google Scholar 

  63. Federal Ministry of Health. National strategic plan for roll back malaria in Nigeria 2001. Abuja: Federal Ministry of Health, 2001

    Google Scholar 

  64. Ejezie GC, Ezedinachi EN, Usanga EA, et al. Malaria and its treatment in rural villages of Aboh Mbaise, Imo State Nigeria. Acta Trop 1990 Oct; 48 (1): 17–24

    Article  PubMed  CAS  Google Scholar 

  65. Drummond MF, Iglesias CP, Cooper NJ. Systematic reviews and economic evaluations conducted for the National Institute for Health and Clinical Excellence in the United Kingdom: a game of two halves? Int J Technol Assess Health Care 2008 Spring; 24 (2): 146–50

    Article  PubMed  Google Scholar 

  66. Gerard K. Cost-utility in practice: a policy makers guide to the state of the art. Health Policy 1992; 21 (3): 249–79

    Article  PubMed  CAS  Google Scholar 

  67. Udvarhelyi IS, Colditz GA, Rai A, et al. Cost-effectiveness and cost-benefit analyses in the medical literature: are the methods being used correctly? Ann Int Med 1992; 116 (3): 238–44

    PubMed  CAS  Google Scholar 

  68. Adams ME, McCall NT, Gray DT, et al. Economic analysis in randomized control trials. Med Care 1992; 30 (3): 231–43

    Article  PubMed  CAS  Google Scholar 

  69. Freemantle N, Mason J. Publication bias in clinical trials and economic analyses. Pharmacoeconomics 1997; 12 (1): 10–6

    Article  PubMed  CAS  Google Scholar 

  70. Bell CM, Urbach DR, Ray JG, et al. Bias in published cost effectiveness studies: systematic review. BMJ 2006; 332 (7543): 699–701

    Article  PubMed  Google Scholar 

  71. Hillman AL, Eisenberg JM, Pauly MV, et al. Avoiding bias in the conduct and reporting of cost-effectiveness research sponsored by pharmaceutical companies. J Res Pharm Econ 1992; 4 (2): 3–13

    Google Scholar 

Download references

Acknowledgements

The authors acknowledge help received from The University of Texas at Austin Library in accessing the articles used in the study. Some of the articles were accessed through the university’s interlibrary loan facility.

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest relevant to the content of this review.

Author information

Authors and Affiliations

  1. College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA

    Paul Gavaza, Karen L. Rascati, Abiola O. Oladapo & Star Khoza

Authors
  1. Paul Gavaza
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karen L. Rascati
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abiola O. Oladapo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Star Khoza
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul Gavaza.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gavaza, P., Rascati, K.L., Oladapo, A.O. et al. The State of Health Economic Evaluation Research in Nigeria. Pharmacoeconomics 28, 539–553 (2010). https://doi.org/10.2165/11536170-000000000-00000

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11536170-000000000-00000

Keywords

Search

Navigation