The hidden toll: Assessing the economic burden of pentazocine dependence on sickle cell disease patients in Nsukka local government Area, Enugu State, Nigeria

Background: Pentazocine (PTZ) is commonly prescribed for the management of acute and chronic pain in patients with Sickle Cell Disease (SCD). However, prolonged and unsupervised usage can lead to dependence, posing immediate health risks and contributing to escalated healthcare expenses, decreased productivity, and societal repercussions affecting families and communities. This research aims to evaluate the financial burden incurred by SCD patients frequenting pharmacies due to pentazocine dependence in the Nsukka Local Government Area of Enugu State. Methods: Data regarding patterns of pentazocine utilization and the impact of dependence-related complications on labor force participation were collected using self-reported cost-of-illness instruments across 25 selected pharmacy stores in Nsukka, Enugu State. Direct medical and non-medical costs were estimated by summing the various out-of-pocket expenses, while the indirect cost was evaluated utilizing the human capital theory. All analyses were conducted using Microsoft Excel and IBM Statistical Package for Social Sciences (SPSS®) version 23 software. Results: The average direct cost attributed to pentazocine dependence was estimated at NGN 116,587.71 (USD 143), while the average indirect monetary equivalent of time lost due to dependence or its complications was assessed at NGN 17,415.06 (USD 21.37), resulting in an average cost of pentazocine dependence borne by SCD patients in Nsukka, Enugu State, of 134,002.77 (USD 164.42). The projected annual cost of dependence was estimated at NGN 422,156,564 (USD 517,983.52). Conclusion: The study demonstrated significant financial implications for patients due to pentazocine dependence, constituting 87% of the direct cost and 13% of the indirect cost of the dependence.