As essential medication prices surge, Nigerians, already grappling with the high price of food prices and cost of living now face dire health consequences as few Nigerians can afford the rising cost of essential drugs. Community pharmacies in Nigeria are strained under the weight of inflated drug prices, endangering access to healthcare for countless citizens.
At Shatara Pharmacy in Sokoto state, Mr. Mohammed Zayyanu steps out with a sullen look. Zayyanu had gone into the pharmacy with a prescription but left empty-handed.
Recently, he had undergone a laboratory test at the hospital where he was diagnosed with typhoid and malaria.
“The hospital prescribed some drugs which they didn’t have for me to buy in a pharmacy shop. I was shocked when the drug seller told me the prices.
“When I tried to bargain, he said drugs are very expensive now due to the general cost of things. So I left without buying because the money I had on me was not enough.”
Zayyanu worries even more over his daughter’s health who is asthmatic. Ventolin inhalers used by his asthmatic daughter which previously sold for N1,500 have skyrocketed to N10,000.
This means serious implications for her health if he can’t afford it.
“I bought a Ventolin inhaler for my daughter for N1,500 last time but now, I am told the price has skyrocketed to N10,000, generally, the cost of drugs has increased sharply and i am concerned.”
In Shiroro local government area, a hypertensive patient, Usman Musa decried the continuous hike in drug prices saying that this makes it difficult for him to decide between his medications and other basic needs as he grapples with financial constraints.
“Ampiclox Beecham that we used to buy N750, the last time I bought it in January was N9000. Which one are we going for, the food to eat or the medicine to survive?”, he bemoaned.
Nigerians have seen a sharp increase in their cost of living lately
People are paying and spending more to access essential goods and services in the face of little to no increase in their earnings.
On Monday, the 5th of February saw protests in NIger and Kano states as residents protest over the rising cost of food prices and the high cost of living.
The healthcare sector in Nigeria is not an island of itself. Just as has been recorded by every sector of Nigeria’s economy, the healthcare sector also has its fair share of challenges as a result of the inflation in the country.
One of these challenges is the hike in the price of essential drugs in the country. With an already poor healthcare system, this may yet again dampen the country’s health indices.
Most Nigerians are already burdened by the financial burden of out-of-pocket expenditures as only three percent of the over 200 million Nigerians are covered with health insurance.
People are continuously being pushed below the poverty line, making access to healthcare, which is a fundamental human right, a luxury.
They now have to make the difficult choice of rationing their already meagre resources to cater to their well-being.
“Xalatan routine medication which I used to buy for N3,000 has in 1 month increased to N6,000.
“You just have to close your eyes and buy it. If it is not something important, I could have shoved it aside,” a resident of Minna, the Niger state capital, Muhammad Kabir lamented bitterly.
The prices of some drugs
According to the Clinical Pharmacist of Shatara Pharmacy in Sokoto state, Rolland Izuchuwu said some antibiotic drugs like Augmentin 625mg previously sold for N9,000 earlier this year is now N17,000 with some pharmacies selling as high as N18,500.
He said that Amoksiklav (625mg) now sells at N4,000 against the previous price of N2,500, Ciprotab ( 500mg x14 tablets) which sold for N2,000 in 2023 is now between N2,600 and N3,000, Antimalarial-Artemether- Lumefantrine tabs D/S (x6) increased from N900 to N1,500
Some brands like Lonart DS currently sell for N2,500 to N3,000, depending on location.
Izuchukwu said that cough expectorants increased from between N400 and N500 to between N700 and N800 per bottle, depending on the brand while some brands like Menthodex and Beehives Basalm now sell between N1,600 and N3,000.
“Anti-hypertensive drugs such as Methyldopa tablet (x10) are now N600 to N700 as against N450 it was sold before, while the others like Co-micardis, and Exforge comes expensive selling at N12,500 and N21, 500 respectively.
The Clinical Pharmacist said they have no choice but to sell the drugs at the new price or they can prescribe drugs that can be affordable to their patients.
“It is affordable because it was made with the same chemicals as other drugs but by different companies. Different names have different content but the same chemicals. Some of these affordable drugs can’t be compared to the other companies’ drugs because of their strength”, he said.
Enablers
Discussions with health experts reveal that the challenge is also enabled by multiple factors ranging from Nigeria’s over-dependence on the importation of drugs as well as the poor performance of local/international indigenous pharmaceutical companies.
Nigeria imports nearly 70 per cent of all drugs from abroad. For local manufacturers, a bulk of active pharmaceutical ingredients (APIs) are also imported.
This means that the cost of running such indigenous drug manufacturing firms does not save them from rising inflation.
The inflation has made the business environment hostile to not just indigenous manufacturers, but multinationals who are also currently left to contend with the high cost of running their ventures.
“When you look at the products in this shop, 90 per cent of them are produced abroad. In a nutshell, they are bought from abroad in dollars, and you know how expensive the dollar is to the Naira,” says Earnest Onah, the Vice Chairman of patent medicine sellers, in Shiroro local government.
Mrs Igson Mercy of Igson Patient Medicine Store in Sokoto state pointed out that apart from the hurdle encountered in getting foreign exchange, importers of pharmaceutical products also face another challenge of clearing the goods at the ports.
She said they are usually subjected to unwholesome charges at the ports. “In most cases importers source dollars from parallel market at exorbitant and unfavourable exchange rates,”
Mercy explained that after going through these hurdles, importers usually add some amount to the cost of the final product which makes them expensive.
“The fact is that if you import raw materials at higher costs, it will affect the cost of production and consequently the prices along the distribution chain. Those who bear the brunt are the final consumers (the patients),” she stated.
Nigeria’s community pharmacists bear the brunt
Amidst this crisis, Nigeria’s community pharmacies bear the brunt of this, as according to the Chairman of the Pharmaceutical Society of Nigeria (PSN), Niger State chapter, Pharm. Yakubu Maji-Isah, many of them are struggling to stay afloat.
This, he said, is worrisome especially as the pharmacies are the first point of call for many Nigerians in need of healthcare services.
In an interview with ASHENEWS, the Managing Director/Chief Executive, Dallas MediCare Nigeria Limited, Pharm. Dr. Ahmed Ndagi Muhammed described the current market for community pharmacists as chaotic.
“The teeming populace is not able to access quality medicine because of the cost and rising cost of medication. This is in the sense that essential medicines are not readily available and those available are very expensive.”
Also speaking, the chairman of Patent Medicine Sellers, Shiroro local government of Niger state, Mr Gabriel Omoje said “Every time we order pharma products, we most often experience a hike in prices and when we complain, the feedback is mostly on the rise of chemicals and other production materials which in return affects market prices.
“Now, most of the international companies have left our country, for example, GlaxoSmithKline, Snofi-Aventis, P&G, and Equinor, and many of them set to leave, and all these are as a result of the unfavourable business environment, the taxation policy is not friendly for them.”
Implications for public health
Concerns have also heightened that the increase in drug prices could come with grave consequences.
Pharm. Ndagi warned that the health and well-being of many Nigerians will suffer either directly through their inability to access healthcare services at the appropriate time, or indirectly through the activities of quacks in the sector.
“The rise will indirectly mean we are not able to take care of our sick persons because the available medications are not affordable. It gives room to so many organizations seeking to cut corners.
“For example, the possibility of bringing in substandard medicine is high because such parties will lower their prices to meet the range of what people can afford currently.
“Those substandard ones will not do the job and may lead to a rise in disease burden, which will in turn reduce the productivity of Nigerians.
“People will want to reduce the cost of production and by the time you have fraudulent businessmen, they will go and connive with companies that are producing and tell them to produce fake ones for them or even the ones that are already expired may be expired and instead of helping patients, you are causing more havoc by giving substandard medicines to patients,” he said.
Findings by ASHENEWS further reveal that this hike has affected drug availability in most of the medical stores found in Primary Healthcare centres across the country.
“Apart from ACT which is used for the treatment of malaria, we don’t receive any other drugs anymore,” said Zainab Adamu, officer in charge, of Primary Healthcare Centres, Shiroro told our reporter.
Way out
With no definite time frame yet to resolve Nigeria’s inflation problem, the country must look inward to tackle the soaring drug prices.
The Niger PSN chairman opined that the way out is for the Nigerian government to promote local production.
He noted that Nigeria already has the manpower and the expertise to produce its own medicine, “The only strong challenge that is stalling drug production in Nigeria is the issue with the petrochemical industry.
“If our petrochemical refinery stations have been fully in production or utilized, we would have gotten some pharmaceutical byproducts, particularly API’s but that hasn’t been the case,” the PSN chairman in Niger state said.
The next line of action should be from the side of the government, which he suggested should give a waiver to indigenous firms to import pharmaceutical materials.
“This will go a long way in bringing down the cost of health commodities.
“Our pharmaceutical industry has the manpower that could produce all our drugs including vaccines. It’s left for the government to make the environment conducive for pharmaceutical companies.”
Similarly, Pharm. Ndagi added “Most of us are trained to produce medicines but the environment is not conducive in the sense that the government has not given it a priority. It prefers to give individuals rights to import rather than give incentives for local production.
“Rising cost of production and a lack of waiver from government has made production locally more expensive than importing from other countries so people go for the cheaper alternative.”
In his words, “Local production is ultimately the solution to ensure we have medicine and drug security.
“With the rise in refineries that are coming up in the country, the basics required in making these drugs are available in these petrochemical industries. We can harness them to go a long way in bringing about local production.
“If our refineries are working well, local manufacturers could also cut back on importation on APIs, thereby saving production costs.”
“It’s clear that this is on the government, they have the power to moderate all these hikes because the production companies operate under the government Act,” Onah added.
The cornerstone of public health borders on the twin pillars of accessibility and affordability
The Nigerian healthcare sector already has its badge of being inaccessible to the generality of the population oftentimes due to a lack of infrastructure.
This coupled with a shortage of manpower is further complicated by a poor funding system.
Vulnerable populations such as persons with disabilities, the elderly as well as the thousands of Nigerians living in humanitarian crises may face an even greater burden with this hike.
The efficiency of Nigeria’s healthcare system is also put on the line. When people cannot afford to take care of their health needs at the appropriate time, their conditions may worsen, leading to increased cases of emergencies and the number of people requiring treatment for chronic illnesses.
Either way, finances are involved.
In line with the target of sustainable development goal three, the affordability and availability of essential medicines should be the key irrespective of one’s socio-economic status.
By Fadlillah Abdallah (Sokoto), Fatima Zahra Muhammad (Minna), and John Asishana (Sokoto)
