A. Wouters et A. Kouzis, COST RECOVERY AND IMPROVED DRUG AVAILABILITY IN NIGER - IMPLICATIONS FOR TOTAL PATIENT TREATMENT COSTS, Health economics, 5(1), 1996, pp. 37-59
Using quasi-experimental design methods, this study investigated, for
a cost recovery intervention in Niger, how the total costs of an episo
de of treatment for an acute illness for a typical patient changed whe
n user fees were imposed but accompanied by an improved drug supply. E
pisode costs included both cash and opportunity costs. With few except
ions, the comparisons of both the unadjusted and adjusted patient epis
ode costs showed that patient total episode costs in the intervention
sites increased relative to the control site. The infusion of resource
s in Say and Boboye meant that now patients had essential medicines to
buy, in comparison to Illela where stocks of essential medicines cont
inued to deteriorate. Trends in episode costs within each intervention
district demonstrated that to some extent cost recovery accompanied b
y an improved drug supply did not significantly change the total cost
of an episode of treatment. In Say, this was true for malaria cases, f
emales and the poor. However, in Boboye, reductions in copayments were
offset by a mandatory tax payment paid by both users and non-users.