尼日利亚北部麻风病创新项目的经济评估：成本效益分析。

Economic evaluation of a leprosy innovation project in Northern Nigeria: cost-effectiveness analysis.

作者信息

Ezenduka Charles C, Namadi Abudulahi, Tahir Dahiru, Nwosu Uzoma, Musa Shuaibu N

机构信息

Health Policy Research Group (HPRG), Dept of Pharmacology & Therapeutic, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

Dept. of Health Administration & Management, Faculty of Health Sciences & Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

出版信息

Cost Eff Resour Alloc. 2022 Oct 29;20(1):57. doi: 10.1186/s12962-022-00393-w.

DOI:10.1186/s12962-022-00393-w

PMID:36309705

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9618221/

Abstract

BACKGROUND

The state of leprosy in Nigeria and the realities of post elimination era underscore the need for evidence- based cost-effective approach to early case detection for enhanced control and elimination of leprosy. This study evaluated the operational cost-effectiveness of a community delivered Legacy Innovative Project implemented to enhance leprosy case detection in northern Nigeria.

METHODS

Data were collected from an explorative cross-sectional study, undertaken in a practice setting among endemic communities in three states in northern Nigeria. Primary and secondary data were collected from the project, routine records and programme annual reports. Costs and effects were measured from both providers' and patients' perspectives, and outcome expressed as cost per new case detected. Incremental estimates of costs and effects of the project compared to routine practice were used to obtain the cost-effectiveness result, as incremental cost-effectiveness ratio (ICER). All costs were converted to the US Dollar at 2018exchange rate (N350 = US$1.00). Univariate sensitivity analysis was performed to evaluate uncertainties around the ICER.

RESULTS

The Project overall detected a total of 347 newly confirmed leprosy cases at a total annual cost of US$49,337.19, averaging US$142.18 per new case detected. Key cost drivers included routine meetings, which accounted for 28% of total expenditure, while Social Mobilization and Training/Workshop accounted for17% respectively. Findings were similar across the states. Overall, the Project dominated routine practice with ICER of US$(-17.73) per additional/new case detected, as a very cost-effective strategy. Sensitivity analysis reinforced the cost-effectiveness result.

CONCLUSIONS

The Legacy Innovative Project demonstrated a more efficient and cost-saving approach to leprosy case detection. Findings present important information to policy and programmes for enhanced control and elimination of leprosy in related settings. .

摘要

背景

尼日利亚的麻风病状况以及消除后时代的现实情况凸显了采用循证成本效益方法进行早期病例检测以加强麻风病控制和消除的必要性。本研究评估了在尼日利亚北部实施的一项由社区开展的传统创新项目在麻风病病例检测方面的运营成本效益。

方法

数据收集自一项探索性横断面研究，该研究在尼日利亚北部三个州的流行社区的实践环境中进行。从项目、常规记录和项目年度报告中收集了一级和二级数据。从提供者和患者的角度衡量成本和效果，结果以每检测到一例新病例的成本表示。与常规做法相比，该项目成本和效果的增量估计用于获得成本效益结果，即增量成本效益比（ICER）。所有成本均按照2018年汇率（350奈拉 = 1美元）换算为美元。进行单因素敏感性分析以评估ICER周围的不确定性。

结果

该项目总共检测到347例新确诊的麻风病病例，年度总成本为49,337.19美元，平均每检测到一例新病例花费142.18美元。主要成本驱动因素包括常规会议，占总支出的28%，而社会动员和培训/研讨会分别占17%。各州的结果相似。总体而言，该项目以每多检测到一例新病例ICER为（ - 17.73）美元的优势主导常规做法，是一种非常具有成本效益的策略。敏感性分析强化了成本效益结果。