In Nigeria, falling sick can be challenging in normal times but seeking treatment is currently a double blow as the financial implication has become increasingly unbearable for many Nigerians.
The cost of basic drugs, such as antibiotics, analgesics, anti-diabetics, and key medications for chronic conditions, has doubled, tripled, or even quadrupled in some instances, leaving many patients struggling to access the healthcare they desperately need.
The alarming rise in drug prices, its impact on healthcare access, and the urgent need for solutions have become overriding to ensure that falling sick does not become a financial death sentence.
Hardest hit by the exponential surge in prices of drugs are the poor, notably those on the minimum wage and below, those without steady sources of income, and particularly those without reliable health insurance, like Idowu Akinyemi, a single mother.
When Idowu, who is living with diabetes, went to purchase her insulin, she was shocked to discover the price had gone up for the second time within a fortnight.
"The last time I purchased my insulin, it was around N3,000, but now when I went to check at the pharmacy, it is over N5,000, almost double," lamented Idowu who noted that with each passing month, the cost of her insulin climbs higher, forcing her to choose between medication and feeding her children.
Dokun Bolarinwa, diagnosed with high blood pressure, said he had been on regular treatment, but noted that the soaring price of his medication was gradually forcing him to default in adherence to the guidelines of his treatment.
"I'm a retired civil servant with no stable income. Over the past few years, I have been managing my condition with family support and goodwill, but these days, things are tough. I'm already skipping certain medications because I cannot afford them, and if care is not taken, I may be forced to abandon treatment altogether.
Ade Ogun who bought a medicated cream for his skin rash was amazed when he discovered the drug had doubled in price a week later.
"I bought a tube of Nixoderm for N500, but when I went back to the the same shop to purchase another one some days later, the price had gone up 100 per cent. It was an unexpected increase," Ade noted.
Funmi Olaoye, a housewife and mother of an ashtmatic child was also concerned about the high cost of drugs. "My son needs medication for his asthma, but I can barely afford half the dose. It's a constant struggle," she lamented.
Among factors contributing to the increase in drug prices are rising production costs, delays in global supply chains and local supply challenges, as well as the declining value of the naira.
400-500% price increase
Findings from a recent survey by SB Morgen showed that over the last four years, the prices of different categories of paracetamol-based analgesics, common cold medicines, such as Actifed, and antibiotics, and antimalarials, rose dramatically.
The report found that between 2022 and 2023, Ampiclox and Amoxil recorded 340 per cent and over 400 per cent increases respectively, while antimalarials such as Lonart DS recorded cost and selling price increases of 110 per cent and 92.3 per cent respectively between 2019 and 2023.
From Vanguard's investigations, the prices of all routine drugs in Nigeria have gone up astronomically. The most affected categories include genuine antibiotics, analgesics, anti-malarials and a number of prescription and specialized drugs.
A random check of prices in some pharmacies and in the open market in Lagos revealed that prices of all the popular genuine brands of antibiotics, including Ciprofloxaxin, Azithromycin, Amoxil, Ampiclox and Augmentin, have gone up by 50 - 150 per cent since the beginning of the new year.
Experts say accessing affordable insulin is crucial for managing diabetes effectively. However, it was gathered that the rising cost of insulin presents a significant challenge for people living with diabetes.
Insulin prices in Nigeria have been steadily increasing in recent times with ranges, depending on the brand, pharmacy, and location.
Findings show that for insulin, from rapid-acting, intermediate-acting or long-acting, the average depending on the type, ranges between N4,000 and N18,000 per cartridge/vial.
A silent rage of people grappling with undiagnosed or inadequately managed chronic diseases, such as cancer, is also underway as chemotherapy drugs have seen a 300 per cent price increase in recent times, pushing them beyond the reach of most patients.
Access to essential medications as anti-depressants is also restricted as they can cost up to N10,500 per month, leaving many resorting to traditional remedies or simply going untreated.
Data from the Global Cancer Observatory show that over 100,000 new cancer cases are diagnosed annually in Nigeria, yet only five per cent of those affected can afford treatment.
Statistics from the World Health Organisation, WHO, backed by the Nigeria Association of Psychiatrists, reveal that an estimated 20 per cent of Nigerians suffer from mental health issues, but access to treatment is severely limited.
The consequences of the price hike are serious, with many Nigerians skipping doses, rationing medication, or even abandoning treatment altogether due to the prohibitive costs.
Women, children hardest hit
Those bearing the brunt more are the vulnerable groups, including children, pregnant women, the elderly, and those with underlying or pre-existing health conditions and those that require regular medication.
Experts say the consequences of this development could be devastating and could lead to undesirable complications, delayed diagnoses, and even preventable deaths.
The lack of insurance coverage is also there. Most health insurance plans in Nigeria do not cover chronic ailments comprehensively. So in most cases, the patient has to pay out of pocket.
Already, worries about affordability of treatment and drugs from delays in treatment or skipping of doses leading to complications, worsening health outcomes, and even becoming common.
Health watchers blame the development on a combination of factors, including depreciation of the naira, global supply chain disruptions, and increased drug production costs.
Beyond the high drug prices, they warn that left unchecked, the crisis could cripple the already overburdened healthcare system and worsen existing health inequalities.
In a conversation, President of the National Post Graduate Medical College of Nigeria, Professor Akin Osibogun, said scarcity of genuine drugs will likely have significant effects.
"These include poor control of disease conditions due to non-availability of essential medications, such as diabetes, hypertension, and cancer, among others, and this will result in the conditions becoming complicated.
"There will be escalation of costs of making drugs, even more unaffordable by the poor and the underprivileged further widening. There will be increased opportunity for faking of drugs, which may have increased adverse effects on the health of Nigerians and patients may turn to untested alternative treatment modalities." he remarked.
Increased morbidity, mortality, looming
Also reacting, the Chief Medical Director of Lagos State University Teaching Hospital, LASUTH, Prof Adetokunbo Fabamwo, said high cost of drugs was undesirable for the welfare of the average Nigerian.
"Nigerian citizens are already impoverished and cannot even afford to buy food to eat, if they are sick and need to buy drugs; in the near future we will have increased morbidity and mortality. So people will not be able to comply with their drug prescriptions. People will get sicker, and some of them may even die,'' he said.
Also, people with mental health conditions are not also spared, according to a Consultant Psychiatrist at the Federal Neuropsychiatric Hospital, Yaba, Dr Stephen Oluwaniyi.
He said: "As far as management of those who already have mental health conditions is concerned, many of the conditions are what we call chronic disorders, in the sense that they need to continue with maintenance treatment, taking medications in one form or the other., apart from the cost of transporting themselves to the hospital, they have to pay for medication.
"Now, an individual who has been struggling to spend N2,000 per month to obtain medication now requires to pay like N4,000, You know, a time comes that he or she may not be able to get the medication.
''Some of these disorders, once your medications are not consistent, symptoms tend to recur, which means the individual may become further incapacitated, may not be able to experience optimal state of mental health."
He explained that he or she might not be able to continue to work or be productive in one way or the other.
"So, the high cost of drugs is negatively affecting the treatment of people with mental disorders. There's no doubt about that. And again, I want to appeal to the authorities to make sure something is done quickly about this trend of medication costs skyrocketing. And that also points to the need why health insurance in Nigeria has to be robust.
"Some of these individuals with mental health conditions are not even working. So, for such individuals, there should be a way of providing for them, probably making some of these medications more affordable. If possible, free,'' he added.
On his own part, the Medical Director, Federal Medical Centre, Ebute Metta, Lagos, Dr Adedamola Dada, said a lot was needed to be done to address the situation.
"There are drugs available in the country. It's the cost that has increased, in line with most things that are importation-dependent. And as with everything, Nigerians in the drug business are also taking advantage, seeing that there are limited options and little competition.
"The solution is fundamental, we need to start producing our own drugs locally using high-quality APIs to guarantee drug security, and we also need to eliminate or substantially reduce out-of- pocket payments for health care. These are the things the Federal Ministry of Health is doing now - fundamentally tackling the problem, and soon enough, it would yield results,'' he said.
Speaking further, Dada noted that when patients were unable to afford their drugs,their condition does not get treated.
He said: "A healthy nation is a wealthy nation. Personally, however, I am not one for all this noise about the cost of drugs, it's not the only thing whose prices have gone up. I think we should rather exert our efforts and energy at finding a long-term and enduring solution to it, and that's what Ministers Pate and Alausa are doing now.
"We all need to support them, rather than use the problem as an albatross. It's a surmountable problem and I am totally convinced that the approach they are taking on this will fundamentally change the game but like all programmes, it will take time."
It's heart-breaking
But Dr. Aisha Abubakar, a paediatrician lamented: "I see children suffering from preventable illnesses because their parents can't afford medication. It's heartbreaking."
Also worried was Dr. Olufemi Ademola, a pharmacist and pharmacy owner. He said: "We're caught between our oath to help and the reality that many patients can't afford basic drugs."
He revealed that some customers are now buying smaller quantities of drugs as a way of conserving funds and even resorting to buying unregulated street drugs.
Kenechukwu Okoli, another pharmacist is worried about the impact on chronic illnesses, saying "diabetics, hypertensives, even cancer patients say they are forced to choose between medication and other basic needs."
Seun Adegoke, a healthcare economist, emphasized the need for long-term solutions.
"Investing in local drug production and promoting generic alternatives can bring down costs in the long run,'' Adegoke said.
On her part, Faith Solomon, a mental health advocate said: "Mental illness is often misunderstood and stigmatised in Nigeria. Even when people seek help, access to affordable medication remains a major barrier. This leaves many trapped in a cycle of suffering."
Expressing concern for the well-being of Nigerians, health watchers are calling for urgent action to address the issue of high drug prices, even as they urge the government to prioritise healthcare accessibility, intervene in implementing price controls, support local drug production, and strengthen public healthcare infrastructure.
Among solutions proposed include improving access to affordable health insurance, encouraging the use of safe and effective generic drugs to reduce costs, educating communities about the issue and advocating policy changes.
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