Cushioning the economic burden of chronic kidney disease for patients in LMICs: The heightened need for a government-driven financial support policy

Okoro, Roland Nnaemeka

doi:10.1016/j.hlpt.2021.100507

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…This is because the majority of the population in low- and middle-income countries, including Nigeria is poor and the purchase of medications is mainly out-of-pocket due to an abysmal low coverage of health insurance. 53 Nevertheless, our finding is congruent with that of a US retrospective study that showed that most patients were also prescribed omeprazole. 34 A similar study conducted in Shanghai, China also reported omeprazole as the most frequently prescribed PPI.…”

Section: Discussionsupporting

confidence: 90%

Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria

Okoro

Abdullahi

Dayar

2021

Medicine Access @ Point of Care

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Background: Proton-pump inhibitor (PPI) is a widely used medication class globally. Because of its good safety profile, there is a huge likelihood of inappropriate use. Objectives: To determine the prevalence of PPI use and indications, describe its pattern of usage, and identify factors associated with inappropriate prescriptions at a federal tertiary teaching hospital in Maiduguri, Nigeria. Methods: PPI prescriptions were retrospectively assessed in the General Outpatients’ Department (GOPD) and Gastroenterology Unit (GITU) of a teaching hospital. Relevant data for the study were extracted from the patients’ medical records. Chi-square or Fisher’s exact tests where appropriate were used to identify factors associated with inappropriate PPI prescriptions. A p < 0.05 was considered to be significant. Results: PPIs were prescribed to 73.3% (220/300) of patients, while inappropriate prescriptions were noted in 91.4% (201/220) of these patients. Epigastric pain (49.5%) was the most common PPI indication, while omeprazole was the highest prescribed (53.4%). Nearly all inpatients (98.2%), those with epigastric pain (95.7%), and patients who were prescribed intravenous PPIs had more inappropriate PPI prescriptions compared to others. Conclusion: This study revealed a high prevalence of PPI use and inappropriate prescriptions at the study hospital. As a result, these findings highlight the importance PPI-based stewardship program at the study hospital.

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Section: Discussionsupporting

confidence: 90%

Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria

Okoro

Abdullahi

Dayar

2021

Medicine Access @ Point of Care

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“…The disease and economic burden of chronic kidney disease (CKD) is high in low- and middle-income countries (LMICs) [ 1 ]. The kidney is chronically damaged when its function decreases to a glomerular filtration rate of less than 60 mL/min per 1.73 m2 or the markers of kidney damage, such as albuminuria or haematuria, lasts for at least three months, regardless of the underlying cause [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The kidney is chronically damaged when its function decreases to a glomerular filtration rate of less than 60 mL/min per 1.73 m2 or the markers of kidney damage, such as albuminuria or haematuria, lasts for at least three months, regardless of the underlying cause [ 2 ]. The last stage of CKD, termed end-stage kidney disease, requires kidney replacement therapies (KRTs), such as kidney transplantation or dialysis [ 1 ]. Without KRTs, death is inevitable in end-stage kidney disease (ESKD) [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…The last stage of CKD, termed end-stage kidney disease, requires kidney replacement therapies (KRTs), such as kidney transplantation or dialysis [ 1 ]. Without KRTs, death is inevitable in end-stage kidney disease (ESKD) [ 1 ]. About 78% of the 500 million people affected globally by CKD reside in LMICs [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…South Africa adopts a mix of publicly funded haemodialysis using a sliding scale fee strategy and strategic purchasing using health insurance schemes [ 22 ]. In Nigeria, most ESKD patients pay out-of-pocket for haemodialysis, given that out-of-pocket spending is the most typical mode of payment for healthcare [ 1 , 6 ]. Additionally, only 10.8% of Abuja’s population is enrolled in Nigeria’s Formal Sector Social Health Insurance Programme [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Willingness to pay for haemodialysis among patients with chronic kidney disease in Abuja, Nigeria

Agada-Amade,

Ogbuabor,

Obikeze

et al. 2024

BMC Nephrol

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Background Evidence of willingness to pay for kidney replacement therapy is scarce in low-middle-income countries, including Nigeria’s Formal Sector Social Health Insurance Programme. The study, therefore, assessed the willingness to pay for haemodialysis among chronic kidney disease patients in Abuja, Nigeria. Methods The study adopted a cross-sectional survey design. We used the contingent valuation method to estimate the maximum stated willingness to pay (WTP) for haemodialysis among end-stage kidney disease (ESKD) patients. We obtained informed written consent from respondents before data collection. The socio-demographic characteristics and willingness to pay data were summarized using descriptive statistics. We evaluated the mean differences in respondents’ WTP using Mann-Whitney and Kruskal-Wallis tests. All variables that had p < 0.25 in the bivariate analysis were included in the Generalized Linear Model (gamma with link function) to determine the predictors of the WTP for one’s and another’s haemodialysis. The level of significance in the final model was ρ < 0.05. Results About 88.3% and 64.8% of ESKD patients were willing to pay for personal and altruistic haemodialysis, correspondingly. The mean annual WTP for haemodialysis for one’s and altruistic haemodialysis was USD25,999.06 and USD 1539.89, respectively. Private hospital patients were likelier to pay for their haemodialysis (β = 0.39, 95%CI: 0.21 to 0.57, p < 0.001). Patients attending public-private partnership hospitals were less likely to pay for altruistic haemodialysis than those attending public hospitals (β = -1.65, 95%CI: -2.51 to -0.79, p < 0.001). Conclusions The willingness to pay for haemodialysis for themselves and others was high. The type of facility ESKD patients attended influenced their willingness to pay for haemodialysis. The findings highlight the need for policies to enhance affordable and equitable access to haemodialysis in Nigeria through pre-payment mechanisms and altruistic financing strategies.

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Cost-effectiveness of sodium-glucose cotransporter 2 inhibitors in the treatment of chronic kidney disease: a systematic review

Toan,

Phung,

Dang

et al. 2024

Expert Review of Pharmacoeconomics & Outcomes Research

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Cushioning the economic burden of chronic kidney disease for patients in LMICs: The heightened need for a government-driven financial support policy

Cited by 5 publications

References 18 publications

Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria

Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria

Willingness to pay for haemodialysis among patients with chronic kidney disease in Abuja, Nigeria

Cost-effectiveness of sodium-glucose cotransporter 2 inhibitors in the treatment of chronic kidney disease: a systematic review

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