Nigerians groan as cost of drugs, medicare soars

Last week, the news that GlaxoSmithKline, GSK, was exiting Nigeria sent shockwaves across the country.

GSK, one of the country’s major pharmaceutical companies, manufactures some of the best-known prescription medicines, vaccines, and consumer healthcare products, including brands like Panadol, Macleans, Andrew Liver Salt, and Amoxil.

Scarcity looms for these essential drugs and others manufactured by GSK even as prices of pharmaceutical drugs, generally, skyrocket in response to the free fall of the naira.

Presently, some drugs have become unaffordable to the average citizen.

A survey, corroborated by some medical doctors and hospital pharmacists, showed that prices of drugs and medical services rose steeply by at least 80 per cent to 150 per cent in the last two months.

For instance, Ciprotab (Fidson), an antibiotic tablet, used to cost an average of N2,300. Today, it goes for between N3,000 and as much as N3,500 in some retail shops.

Ventolin inhaler (by GSK Pharmaceuticals) cost an average of N4,500 per canister two months ago. Today, it goes for between N6,500 and N12,000 in some retail shops. While Augmentin used to cost N5000, today, it costs N17,000.

Some patients who spoke to newsmen said they now resort to traditional medicine since they could no longer afford conventional treatments.

However, a media consultant to the National Agency for Food, Drugs Administration and Control (NAFDAC), Sayo Akintayo told newsmen that it is not in the purview of NAFDAC to determine the price of drugs.

He said: “We don’t have anything to do with the cost of drugs. Yes, we are only concerned with the manufacture, distribution and sale of drugs. So, that has to do with the operations of the companies, given the variables in the economy.

“It is not in the purview of the NAFDAC to determine the price of drugs. We don’t manufacture drugs. What we do is to ensure that whatever is manufactured or produced for the consumption of Nigerians is of good quality and effective, and we ensure that it is safe for human consumption.

”Determining the price of drugs rests with the manufacturers. And quite a number of things come to play when you want to determine that too. You consider your cost of production, and you consider so many other variables, but it is completely out of the control of NAFDAC.”

The National President of the National Association of Resident Doctors, NARD, Dr Emeka Orji believes it was worsened by the current government’s various economic policies released in quick succession, citing the removal of fuel subsidy and the floating of the Naira.

Orji told newsmen in an interview that the prices of products in the country depend on exchange rates, fuel prices and inflation.

According to him, many of the medications and pharmaceutical products being used in the country are either manufactured abroad in whole or in parts, noting they would be affected by the exchange rate.

He suggested the government should increase access to healthcare via a comprehensive healthcare insurance scheme in the country.

“The hardships were caused by the high inflation rate, and it has been there even before this current government came into place, but it was worsened by the various economic policies that were released in quick succession by this government. One of them was the issue of the removal of fuel subsidy and the floating of the Naira.

“Many of the prices of products in this country are dependent on exchange rates and, of course, fuel prices and inflation. You will realise that many of the medications and pharmaceutical products we use in this country are either manufactured abroad in whole or in parts. So those things will be affected by the exchange rate, and because of that, the price of pharmaceutical products has skyrocketed.

“These days, we don’t even know what the price is because if you go today to buy something, they will tell you a high price, and by the time you go tomorrow, the price has further increased.

“So, it is a problem. Most of these pharmaceuticals are currently beyond the reach of ordinary Nigerians. And the government that is talking about palliatives and other measures to cushion the effect, one should expect that they should look the way of medicare and pharmaceuticals.

“What has happened is that many Nigerians cannot afford medical treatment, and they are resorting to unorthodox means, which is dangerous to their health.

“When it comes to the personnel themselves, the health workers, of course, we are all Nigerians, and what is happening is affecting us. In fact, it is affecting us the most because we realise that part of our duties is to live a nomadic kind of life; we are always on the move.

“I am talking about doctors because we receive calls to visit hospitals several times, and sometimes people call you and expect you to come out and attend to their medical needs. So you need to always be moving around and in this era of very high prices of fuel, it has terribly affected our work.

“Incidentally, that has been part of the reason we have been shouting, clamouring that the government should look into this and find a way of coming to our aid and now give a kind of support to help us.

“There is no reason we should not have a comprehensive health insurance scheme in this country. The truth is that as long as we don’t have this, there is no amount of speech or policies that will help Nigerians.

“The current coverage of Nigerians in the health insurance scheme is still less than 10 per cent. And so, out-of-pocket spending for health is the most important cause of the inaccessibility of healthcare services by Nigerians. We in the hospitals used to see these patients come to hospitals, and by the time you write drugs for them, they can not afford it.

“You want to operate on them, they can’t pay for the surgery. We see it happen. Many of them discharge themselves against medical advice because they cannot afford treatment. And that is part of the challenges we face as doctors because sometimes you see yourself even having to pay for your patients. It can be that bad.

“Government should also find a way to increase funding. Yes, we know it is not something that the government can do alone; we need both public and private sector participation to increase healthcare funding. We always say that the annual budget for health is abysmally poor. It is not even up to 15 per cent that is expected based on the Abuja declaration of 2021.

“The 2023 annual budget for health is less than seven per cent, and it has been like that for years. Only when the government increases healthcare infrastructure funding will the personnel be there and other necessities required to deliver a standard healthcare delivery system in Nigeria.

“Government should also find a way of regulating trado-medical people. I can tell you that medical practice is regulated much more than the trado-medical. This is very dangerous because many of these concoctions they give patients do result in kidney and liver failure and other failures of organs occasioned by those concoctions.”

Meanwhile, some patients who spoke to DAILY POST said they have resorted to traditional medicine since they could no longer afford conventional treatments.

Also, some citizens who are on routine drugs, are now on drug holidays.

The worst hit are Nigerians treating chronic conditions like cancer.

Mr Gregory Ani, who told newsmen that he had been on diabetes drugs for over a decade, said he could no longer afford the treatment.

“I am losing faith. Before now, with N3,000, I could buy my two weeks of routine drugs. These days I need nothing less than N10,000 to do two weeks of treatment.

“I have decided to ration it. I only take it when I notice any strange feeling,” he said.

Stakeholders in the pharmaceutical industry fear that many drug companies may fold up due to the inability to access foreign exchange and the cost of diesel, among others.

A pharmacist at Save Health Pharmacy in Port Harcourt, Giginna Mathias, told our correspondent that the free fall of the Naira contributed to the problem.

“The worst part is that people are not patronising us like before.

“Some drugs are even off the shelf because you can’t buy what you know you cannot sell. It is not good for business,” he lamented.

The economic situation for Ekot Bassey, a Sales Representative at a leading Pharmaceutical company in Ogun State, is frustrating.

Bassey told newsmen that drug prices keep increasing daily.

He said, “Inflation is affecting our sales because people are no longer buying drugs”.

On his part, a Consultant Psychiatrist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki and National Publicity Secretary of the Association of Psychiatrists in Nigeria, Dr Okwudili Obayi, told newsmen that the economic hardship has affected patients in many ways, including their access to care.

Obayi noted that only those who don’t have options now consider the need to come to the hospital, disclosing that the number of people willing to see doctors when sick have reduced.

The health expert blamed corruption for the crisis in the health sector, insisting that the government should curb corruption in the country, starting with the politicians.

“Generally, once there is hardship, it affects everybody. One is that it reduces quickened care, whether from orthodox or unorthodox means, because even the unorthodox, even the prayer houses, are not free.

“They are not free in the sense that you need to transport yourself to the place. So, it has affected medicare generally.

“Generally, the number of people coming to see doctors has reduced, but not quite. The reduction is more when you now tell people that they need admission. They fear they will not be able to afford the services. It is a very big challenge. Even when you give an appointment to patients, some will tell you they don’t have transport money.

“Every doctor would like to give appropriate patient care, but it is not hundred percent free, even with NHIS. How many Nigerians are on NHIS? Only a few. So, it has drastically affected people seeking care and being able to receive adequate care as prescribed by the healthcare provider.

“Then, for the few that come to the hospital, the price of drugs and all the things used for treatment has increased in the market and equally in the hospital. And some hospitals can no longer afford to pay their workers, especially private hospitals; they will either increase their charges to patients or sack some people and, of course, sacking some people will affect the workload of the people available.

“That is partly why the NARD went on strike. Part of their demand is that many health workers have left the country because of the difficulties and better pay outside. And they are not replaced. They are asking the government to employ and replace them. So, because few people are working, whether in the private or public setting, that will affect their output on the part of their patients.

“Invariably, economic hardship affects patients in many ways. It affects their access to care. Only those who don’t have options now consider the need to come to the hospital. It affects them that even when they come to the hospital or they choose to go to patent medicine dealers to buy drugs on their own, whatever they were buying before, say at N10, is now tripled or far higher. So, generally, the patient feels sick more, which is too bad. It is also affecting the productivity of the country.

“My advice for the government is to sincerely and squarely face anti-corruption; the bane of everything is corruption. It is corruption that has led some people into hardship. It is corruption that led to the story about subsidy, whether we did not have subsidy in the past or something like that.

“It is corruption that leads people to think they can pay people anything they like or not replace workers when they are retiring or leaving, essential workers, for that matter.

“My friendly advice is, let us get it right by curbing corruption, and it has to start with the politicians, the leaders who appear to be more corrupt than the ordinary citizens.”