Background:
The major problem that prompted the study is scarcity of facts on actual cost of illness to the patient and society at large.
Method:
It is a retrospective study and involved using 277 prescriptions from randomly selected 37 case notes of diabetic patients. In addition, stop watch time studies and standard cost accounting technique was employed. The hospital pharmacy costs of the drugs were used. Pieces of information such as demographic data prescribed drugs, fasting blood sugar level, blood pressure were abstracted from the case notes. The various cost components such as drug procurement, transport, personnel and diagnostic test costs over one year period were determined for each patient and added up. These were summed up to calculate the direct cost of illness for all the patients and the average determined.
Results:
No of patients studied = 37; No of patients on insulin= 4; No of patient on concurrent medication =32; Duration of diabetes (Range) = 4 months- 33 years (mean 8.1 years); Cost per-patient for those on insulin = N116, 026.79 ($828.76); Cost per-patient for those on oral agents =N27, 159.38 ($194.00); Cost per patient for concomitant medication=N39, 404.69 ($281.46). Hypertension occurred as a concurrent illness in most of the patients (n=31; 83.78%) and were equally treated for hypertension. The total cost of drugs in all the patients=
1, 219,932.70 ($8,713.81); Total cost of illness (COI) for one year for the 37 patients =
1, 360.369.80($9716.93); Average cost of illness per patient/year=
36, 766.75($262.22); 84% of annual per capital income. The cost of treating an estimated 3% prevalence of diabetes mellitus in the country is about
150 billion annually excluding the indirect cost.
Conclusion:
The cost associated with diabetes is enormous. Adequate consideration for cost implication of chosen therapy is indispensable. Economic evaluation of therapy should be encouraged to ensure improved cost effectiveness and efficiency in management. Regularly up-dated drug formulary and evidence-based standard treatment guidelines would ensure better choice of therapeutic options. More importantly, a concerted effort is needed to reduce the incidence of diabetes mellitus in the society.
