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The State of Health Economic Research in South Africa

A Systematic Review

  • Systematic Review
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Abstract

Background

Economic factors are a limiting factor toward the implementation of many health programmes and interventions. Economic evaluation has a great potential to contribute toward cost-effective healthcare delivery in South Africa. Little is known about the characteristics and quality of health economic (including pharmacoeconomic) research in South Africa.

Objective and Methods

This study assessed the state of health economic (including pharmacoeconomic) research in South Africa. PUBMED, MEDLINE, HealthSTAR, EconLit and PsycINFO databases were searched to identify health economic articles pertaining to South Africa published between 1 January 1977 and 30 April 2010. The searches used the following Medical Subject Headings (MeSH) terms and text words alone and in combination: ‘costs’, ‘health’ and ‘south Africa’. Our study included only original economic studies/analyses that pertained to South Africa, addressed a health-related topic, and had a statement or word in the title, abstract or keywords that indicated that an economic (including cost) analysis had been conducted. The study only included complete peer-reviewed publications (e.g. abstracts were excluded) that were reported in the English language. Two reviewers independently scored each article in the final sample using the data collection form designed for the study.

Results

In total, 108 studies investigating a wide variety of diseases were included in the study. These articles were published in 39 different journals mostly based outside of South Africa between 1977 and 2010. On average, each article was written by three authors. Most first authors had medical/clinical training and resided in South Africa at the time of publication of their study. Based on a 1–10 scale, with 10 indicating the highest quality, the mean quality score for all studies was 7.59 (SD 1.42) and half of the articles were of good quality (score 8–10) The quality of studies was related to the country in which the journal publishing the article was based (outside South Africa = higher); current residence of the primary author (outside South Africa = higher); method of economic analysis (economic evaluations higher than cost studies); type of data used (secondary higher than primary); primary training of the first author (health economics/pharmacoeconomics = higher); type of medical function (diagnosis = higher); study perspective (societal = higher); primary health intervention (pharmaceuticals = higher); study design (modelling = higher); number of authors (more = higher); and year of publication (more recent = higher) [p≥0.05].

Conclusion

Half of the articles were of poor or fair quality. Measures are needed to promote the commissioning of more and better quality health economic and pharmacoeconomic studies in South Africa.

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Acknowledgements

The authors acknowledge the help rendered by 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 inter-library loan facility. The authors have no conflicts of interest relevant to the content of this paper.

P. Gavaza and A.O. Oladapo reviewed and summarized all the articles included in the systematic review. S. Khoza acted as the tiebreaker for areas where P. Gavaza and A.O. Oladapo had conflicting views. P. Gavaza took the lead role in writing the manuscript with support from A.O. Oladapo. S. Khoza and K.L. Rascati helped to review and edit the manuscript. P. Gavaza came up with the idea to conduct the study and is the guarantor for the overall content of the article.

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  1. Appalachian College of Pharmacy, 1060 Dragon Road, Oakwood, Virginia, VA 24631, USA

    Paul Gavaza

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

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

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Gavaza, P., Rascati, K.L., Oladapo, A.O. et al. The State of Health Economic Research in South Africa. PharmacoEconomics 30, 925–940 (2012). https://doi.org/10.2165/11589450-000000000-00000

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