The issue of cost of medications and indeed healthcare expenditure is especially germane in Nigeria, where the majority of patients pay out of pocket. This report by Sade Oguntola X-rays challenges people with chronic illnesses face due to poor access to foreign exchange.
If you think medicines have become too pricey, you are not alone. Many Nigerians, especially old persons and retired people living with chronic illnesses also think that the cost of medications is unbearable, given the economic situation of the country.
Although the increase in drug prices is obvious, having to search many pharmacies in their various neighbourhoods before getting these drugs have also been a challenge.
Mr Henry Akintola, a civil servant, developed problem urinating and his doctor prescribed a drug to help ensure he could urinate without much difficult. Back in January, a blister pack of the drug was N1, 400 but by June, the only pharmacy selling the medicine charged N3, 400.
Akintola, whose salary has not been paid for six months, declared: “The prices have gone up significantly and it is difficult buying the medicine. But, I really do not have a choice because the other alternative is a surgical operation.”
Chief Emmanuel Adeyinka, President, Diabetes Association of Nigeria, Oyo State Branch, corroborated that cost of medicines for diabetes has also risen. He said: “A particular one that was sold for N3, 000 was changed to N3, 500. We had to invite the drug company to our meeting to explain to members the increase in cost because most of the medicines are imported. In fact, reducing the cost of our medicines is the association’s mandate to our new president.
“Assess to free and subsidised drugs given to persons with HIV, needs to be extended to other persons with diseases like diabetes,” he said.
Although the price of imported medicine is more affected than those manufactured in Nigeria, he stated that access to these medicines for diabetes was not a challenge. because the association buys drugs in bulk.
Meanwhile, Mr Samuel Adegoke, who has been living with hypertension since 2005, complained that the cost of each of his prescribed drugs for the treatment of high blood pressure had increased by 35 per cent.
He, however, changed to a cheaper brand of his medication after the prices were increased early in the year based on the advice of a pharmacist.
“When I started experiencing strange symptoms, I requested to go back to my previous medication. Unfortunately, two of them are no longer available. They said I should wait till next month to get them, even as I started reacting to the new medication,” he stated.
Is access to affordable drug getting worse? The finding of a survey that was undertaken by the Federal Ministry of Health in collaboration with the World Health, Organisation and Health Action International in 2004, is disturbing.
According to the survey, Nigeria is one of the eight countries in the world with exceptionally exorbitant drug prices. Patients also pay between two to 64 times the international reference prices for medicines in various facilities in the public and private sectors of Nigeria.
Private health clinics were shown to charge up to 184 per cent more than the public health facilities and 193 per cent more than private retail pharmacies.
Medicines are unaffordable to the majority of Nigerians (90.2 per cent) who live below the income level of US$ 2 a day, as well as the government worker that earns a minimum wage of US$1.4 per day.
Certainly, medicine prices are important because most Nigerians purchase their medicines out of pocket and it is one of the reasons for poor attendance in hospital for medical care.
The depreciation in the value of Naira, Professor Ayodele Arowojolu, a consultant obstetrics and gynaecologists at the University College Hospital (UCH), Ibadan, said, has left many patients struggling to buy their medications and possibly affect hospital attendance.
“I wouldn’t know what had led to the drop in clientele; whether it is the attitude of health workers, money, availability of facilities, or the fact that many private hospitals are able to satisfy their needs. But I know that the number of the people coming to my clinic had dropped by almost 40 per cent.”
Arowojolu, however, suggested that government should come up with alternative means of ensuring that the cost of medicines is subsidised, as well as encourage and patronise local pharmaceutical companies.
Moreover, the superintendent pharmacist and Managing director, Myriads Pharmaceutical, Eleyele, Ibadan, Mr Lanre Tiamiyu, stated that patients now pay more for their drugs and treatment due to the challenges of accessing funds to stock them.
“For antihypertensives, there has been up to 25 per cent increase in price over a year ago. This increase in prices also cuts across all classes of medicines
“Certainly, the purchasing power of the people is reducing while the cost of medicines is increasing. The situation is unlike abroad, where people have health insurance and as such the cost of their medicines end up being subsidised,” he said.
Professor Akande Tanimola, President, Association of Public Health Physicians of Nigeria, said aside the increase in monies spent on health care, the high cost of drugs could further worsen Nigeria’s health index. Where there is poor adherence to medications because of cost, he said more treatment failure and deaths due to ill health are likely to occur.
“Of course, a major challenge is that people will now go for alternative medicine, which oftentimes, may be dangerous,” he added.
Chairman and Chief Executive Officer, Archy Pharmaceuticals Limited, Lagos, Dr Tony Ihenatu, urged Nigerians to prepare for a looming scarcity of drugs in the country.
He said “I do not know where the country is heading to in the next six months. Be it manufactured or imported ones, the cost of finished pharmaceuticals is not moving at par with the increase in the naira exchange rate.
For example, paracetamol used to sell for N500 per cup. Its cost of production has increased by 200 per cent, meanwhile the cost of its finished product has only increased by 20 per cent. So, a lot of people have stopped its manufacture because the market has not accepted the new price.
“So instead of manufacturing or importing at a loss, everybody wants to keep their money to see the way the country is drifting. Of course, what this means is that there will be scarcity of drugs. The situation is also creating a very big opportunity for fakers to jump into the market. People will accept their products because they will be cheaper.
“The fact that people cannot afford to buy common drugs they need for their health is a danger. Availability of drugs is a national security issue; it should be treated that way,” he warned.