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Abstract
BackgroundDue to escalating treatment costs, pharmacoeconomic analysis has been assigned a key role in the quest for increased efficiency in resource allocation for drug therapies in high-income countries. The extent to which pharmacoeconomic analysis is employed in the same role in low-income countries is less well established. This systematic review identifies and briefly describes pharmacoeconomic studies which have been conducted in Tanzania and further assesses their influence in the selection of essential medicines.MethodsPubmed, Embase, Cinahl and Cochrane databases were searched using “economic evaluation”, “cost-effectiveness analysis”, “cost-benefit analysis” AND “Tanzania” as search terms. We also scanned reference lists and searched in Google to identify other relevant articles. Only articles reporting full economic evaluations about drug therapies and vaccines conducted in Tanzania were included. The national essential medicine list and other relevant policy documents related to the identified articles were screened for information regarding the use of economic evaluation as a criterion for medicine selection.ResultsTwelve pharmacoeconomic studies which met our inclusion criteria were identified. Seven studies were on HIV/AIDS, malaria and diarrhoea, the three highest ranked diseases on the disease burden in Tanzania. Six studies were on preventive and treatment interventions targeting pregnant women and children under the age of five years. The national essential medicine list and the other identified policy documents do not state the use of economic evaluation as one of the criteria which has influenced the listing of the drugs.ConclusionCountry specific pharmacoeconomic analyses are too scarce and inconsistently used to have had a significant influence on the selection of essential medicines in Tanzania. More studies are required to fill the existing gap and to explore whether decision-makers have the ability to interpret and utilise pharmacoeconomic evidence. Relevant health authorities in Tanzania should also consider how to apply pharmacoeconomic analyses more consistently in the future priority-setting decisions for selection of essential medicines.
Highlights
Due to escalating treatment costs, pharmacoeconomic analysis has been assigned a key role in the quest for increased efficiency in resource allocation for drug therapies in high-income countries
Burden of diseases versus availability of pharmacoeconomic studies Tanzania has a list of twelve priority disease conditions referred to as a national package of essential health interventions, on which to prioritize the allocation of its scarce resources for health
This list rank disease conditions according to their burden of disease and is dominated by infectious diseases – HIV/AIDS, malaria and diarrhoeal diseases are at the top
Summary
Due to escalating treatment costs, pharmacoeconomic analysis has been assigned a key role in the quest for increased efficiency in resource allocation for drug therapies in high-income countries. Pharmacoeconomic analysis is the comparison of costs and consequences of alternative drug therapies so as to maximize therapeutic outcomes when resources are limited. Pharmacoeconomic evidence can help decision-makers judge whether the therapeutic benefits produced by a new drug are worth the extra costs [1]. In high-income countries pharmacoeconomic analysis is widely used to guide priority-setting decisions for pharmaceuticals [2]. National Institute of Clinical Excellence (NICE) in the UK and the Canadian Agency for Drugs and Technology in Health (CADTH) are examples of institutions which have been established for pharmacoeconomic evaluation of new pharmaceutical products and technologies [3,4]. In low-income countries applied economic evaluation studies are scarce, but their usefulness on essential medicine selection has been debated in the literature [6,7]
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