The State of Health Economic Evaluation Research in Nigeria

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 < or = 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 sub-optimal quality. More and better quality health economic research in Nigeria is warranted.

A Systematic Review of the State of Economic Evaluation for Health Care in India

“…Some areas which need significant attention of the researchers are focus of the viewpoint of the evaluations being undertaken, justification on the type of economic evaluation being used, lack of use of discount rates, weak costing methodologies and the extent to which these studies address the uncertainties in methodologies of economic evaluation, especially for model-based evaluations. Overall, our findings on quality of evidence are again very similar to what others have reported in the developing countries [125][126][127][128]. However, the overall quality in India seems better than what is reported for most of other developing countries.…”

“…The 104 papers included in this review compares to 1249 papers on cost effectiveness published in the USA between 1979 and 1990, and 1167 published between 1991 and 1996 [123]. Nevertheless, this exceeds the number of economic evaluation studies we found when using the same inclusion criteria in relation to other developing countries such as South Africa (n = 45), Thailand (n = 39), Vietnam (n = 26), Bangladesh (n = 12), Nigeria (n = 44) and Zimbabwe (n = 26) [124][125][126][127][128][129]. However, the gap in current economic evidence in India is exacerbated by the need for region-or state-specific studies that account for variations in epidemiological transition, health-care costs, and health-care infrastructure across the country.…”

Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature

“…The findings showed that the number of economic evaluation studies in Iran is limited. This is comparable with settings such as Bangladesh [60], Nigeria [26], Saudi Arabia [61], Zimbabwe [62], and lagging behind countries such as Thailand [29], South Korea [24], India [63] and South Africa [64]. The number of available studies remains very low compared with high-income countries where economic evaluation is a relatively well-established and formal part of the policy making process [21,65].…”

“…Systematic reviews of economic evaluation studies in some other settings (both developed and developing countries) have reported similar shortcomings [21,23,24,26,29,60-65]. For this reason, many countries have developed formal and informal guidelines to standardize and improve the quality of economic evaluation in health care [71].…”

“…Assessment of the quality of included studies was done using a questionnaire adapted from existing guidelines, checklists and other review articles of economic evaluations [1,19,20,24,26]. The questionnaire included both general information and economic evaluation features of the selected articles.…”