Cost-utility and cost-consequence analysis of different cervical cancer therapies received by patients in two Nigerian tertiary hospitals

Abstract

Background: High treatment costs pose a lot of economic burden on cervical cancer (CC) patients and their family members. Studies on cost-utility and cost-consequences analysis of CC therapies are lacking in Nigeria. Objective: To evaluate the cost-utility and cost-consequence of different CC therapies received by patients in two Nigerian tertiary hospitals. Method: This study employed a prospective longitudinal design with a 12-month patient follow- up. It was conducted at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto and Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, North-Western Nigeria. Data of all the 157 eligible CC patients were collected at baseline, after therapy and at 12 months follow up. Data analysis was done with appropriate descriptive and inferential statistics using SPSS V. 20 for windows. P<0.05 was considered statistically significant. Results: The mean total cost of therapy per patient for adjuvant chemoradiation therapy (CRTS) was the highest (₦663,497±164,690). The incremental cost-utility ratio (ICUR) for adjuvant chemotherapy (CTS) was the lowest (₦529,042 per QALY), while CRT had the highest ICUR, ₦9,511,087 per QALY. Adjuvant radiotherapy (RTS) had ₦452,009±10,619 mean total cost per patient against best symptoms’ resolution and survival; unfortunately, fertility not preserved. Conclusion: Adjuvant chemotherapy (CTS) was found to be the most cost-effective therapy option, while CRT was found to be least cost-effective therapy option received by the patients. Adjuvant radiotherapy (RTS) had a moderate mean total cost per patient with the best symptoms’ resolution and survival; unfortunately, fertility not preserved.