Cost Minimization Analysis of Antibacterial Therapy in a Developing Country

Background: There is the need for improved efficiency and minimization in cost of antibacterial therapy in developing countries. The study objective was to carry out cost minimisation analysis of antibacterial in a tertiary health care facility in Nigeria between the year 2005 and 2006. Methods: Drug utilization review was carried out using prescriptions in 525 consecutively sampled case notes of some infectious diseases retrospectively. Relevant data such as demographics; diagnosis; prescribed drugs; and dosages were extracted. Cost per defined daily dose of each drug; the cost of each prescription and theaverage cost of antibacterial agents per patient were determined. This was followed by economic evaluation using Cost Minimization Analysis. Data were analysed appropriately. Results: Amoxicillin and coamoxiclav for ENT infections and ciprofloxacin/doxycycline for STIs were the mostwidely utilized. Generic products; higher strength; solid dosage forms and oral formulations are more costeffective than branded agents; lower strength; liquid formulations and injections of the same drug entityrespectively. For instance; the use of generic product of ciprofloxacin for 5 days for 1000 patients (5000DDDs) resulted in a cost saving of NGN1.04million (USD9;333.33). Conclusion: Only few drug items were predominantly responsible for high antibacterial therapy costs which need to be closely monitored for cost to be appreciably minimized. Generic antibacterial agents; higher strength preparations of the same drugs; solid forms in preference to syrups among school age children andoral agents in preference for injection should be used. Significant cost could be minimised and improved accessto essential drugs assured if these are followed

Assessment of Community Pharmacists' Willingness to become Tuberculosis DOTS Services Providers in Lagos State

"Background: Hospital based Directly Observed Therapy Short course (DOTS) for the treatment of tuberculosis though effective has constraints to its effectiveness e.g. restricted timings of TB clinics; long distance to travel by tuberculosis patients to TB DOTS clinics; etc. Community pharmacy based TB DOTS services under thesupervision of community pharmacists can address these constraints. Objectives: To assess community pharmacists' willingness to become Tuberculosis Directly Observed TherapyShort course (TB DOTS) service providers in Lagos state; Nigeria. Methods: A 25 item self completion questionnaire was administered to 120 community pharmacists spreadacross three; Association of Community Pharmacists zones of Ikotun; Iyana-Ipaja; as well as Festac zones in Lagos state; Nigeria respectively. These community pharmacists' zones were formed in Lagos state to ensure theease of administration and prevention of the operation of illegal premises in Lagos state and the twelve zones inLagos state are duly recognized by both the Pharmaceutical Society of Nigeria and the State Chapter of the Association of Community Pharmacists. Data was collected on a scale that ranged from 8 to 40 with an assumedneutral point of 24 and statistically analysed. Results: Community pharmacists in Lagos state Nigeria were willing to be TB DOTS services providers as shownby a mean score of 30.53+ 6.71 in 77 of the respondents. On the 5-point rating scale; ""5"" represented thehighest mean score while ""1"" represented the lowest mean score. On the 8 item scale; the lowest mean score is 8and the highest mean score is 40 with a neutral point of 24. The percentage performance was the number of respondents that scored above the critical or neutral point on the rating scale. Statistically not significant association was observed between having heard of TB DOTS services and their willingness (X2 =0.66; P=0.3485;P0.05). Association between training in the provision of TB DOTS services and the willingness observed was2statistically also not significant (X =2.08; P=0.2525; P0.05).So also for the association between number of yearsof community pharmacy practice and their willingness to be TB DOTS service providers (X2=1.18; p=0.371;P0.05). Conclusion: Community pharmacists in Lagos state Nigeria are willing to be TB DOTS services providers. Howevertheir willingness to be TB DOTS services providers is not associated with the level of training that they have hadon TB DOTS services provisions; neither is it associated with their level of awareness about TB DOTS services.Their years of community pharmacy practice experience also had no influence on their willingness to be TB DOTSservices providers."