Olumide Adesola Oluwafunmilola, Shmueli Amir, Omotade Olayemi O, Adebayo Emmanuel S, Alonge Temitope O, Ogun Gabriel O
Institute of Child Health, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo State, Nigeria
Department of Health Management and Economics, School of Public Health, The Hebrew University of Jerusalem, Jerusalem, Israel.
BMJ Open. 2021 Apr 24;11(4):e044969. doi: 10.1136/bmjopen-2020-044969.
WHO revealed that morbidity and mortality from non-communicable diseases (NCDs) are on the increase and NCDs accounted for approximately 29% of all deaths in Nigeria in 2016. This study was conducted to estimate the economic cost of selected NCDs-lung cancer, liver cancer and liver cirrhosis. These diseases are known to be associated with key modifiable health risk behaviours (smoking and alcohol use), which are prevalent in Nigeria and often commence during the adolescent years.
Data were obtained between 2016 and 2017, from mortality records of patients managed for the selected diseases in the University College Hospital, a major referral centre in Nigeria. Information on costs of treatment, clinic visits, admission and transportation was obtained. Average costs of terminal in-patient care and transportation costs (in 2020 prices) were computed per patient. Costs were converted to the US dollar equivalent using the current official rate of US$1: ₦360.50.
Twenty-two (out of 90 cases recorded) could be retrieved and all the patients had been diagnosed in the terminal stages of the disease. The average direct costs were ₦510 152.62 (US$1415.13) for an average of 49.2 days of terminal care for lung cancer; ₦308 950.27 (US$857.00) and ₦238 121.83 (US$660.53) for an average of 16.6 and 21.7 days of terminal care for patients managed for liver cancer and liver cirrhosis, respectively.
The economic costs of each of the diseases were very high. Findings emphasise the need for aggressive efforts to promote primary prevention, improve early diagnosis and provide affordable treatment in view of the fact that the monthly minimum wage is less than US$85.00 and treatment costs are borne out-of-pocket by the generality of the population in Nigeria.
世界卫生组织公布，非传染性疾病的发病率和死亡率呈上升趋势，2016年在尼日利亚，非传染性疾病约占所有死亡人数的29%。本研究旨在估算特定非传染性疾病（肺癌、肝癌和肝硬化）的经济成本。众所周知，这些疾病与主要的可改变健康风险行为（吸烟和饮酒）有关，而这些行为在尼日利亚很普遍，且往往始于青少年时期。
2016年至2017年期间，从尼日利亚主要转诊中心大学学院医院治疗所选疾病的患者死亡率记录中获取数据。获取了治疗费用、门诊就诊、住院和交通方面的信息。计算了每位患者的终末期住院护理平均费用和交通费用（按2020年价格计算）。使用当前1美元兑换3六百零五十奈拉的官方汇率将成本换算为美元等值。
（记录的90例病例中）有22例可检索到，所有患者均在疾病终末期被诊断。肺癌终末期护理平均49.2天的平均直接成本为510152.62奈拉（1415.13美元）；肝癌和肝硬化患者终末期护理平均16.6天和21.7天的平均直接成本分别为308950.27奈拉（857.00美元）和238121.83奈拉（660.53美元）。
每种疾病的经济成本都非常高。鉴于尼日利亚月最低工资低于85.00美元，且治疗费用由广大民众自掏腰包，研究结果强调需要积极努力促进一级预防、改善早期诊断并提供可负担得起的治疗。
