…more Nigerians may die from shortage of lifesaving drugs – Medical experts

By AYOOLA OLAOLUWA

A public health crisis is brewing in the country as prices of drugs continued to skyrocket and spiral out of the reach of average Nigerians, Business Hallmark findings can reveal.

Checks revealed that many sick Nigerians who are without the financial muscle to purchase drugs to treat their various ailments have resorted to unorthodox medical practices, particularly the uncontrolled use of local herbs.

A week long survey on the current prices of drugs in selected pharmacies in Lagos showed that prices of essential drugs have recorded between 35% and 100% increase, forcing many patients who could not afford them to go home disappointed or look for alternatives.

Mostly affected by inflation are drugs for malaria, as well as prescription drugs for the treatment of hypertensive, arthritic pains and diabetic. Others include anti-viral and bacterial drugs as well as disinfectants.

Even, prices of anti-malaria drugs provided under the Bill Gates Foundation-led Global Fund Scheme at a subsidised rate are not left out, increasing between 10% and 35%.

For instance, anti-malarial, Artemether Lumefantrine tabs D/S (x6) moved from N450/N500 to N700; Artemether Lumefantrine (x24) jumped from N500 to N800; Camosunate 150mg/50mg (Children Powder), now N700 from N550; Camosunate (Adult) N900, from N650 in February; Coartem- Double strength (80/480) is N1,700 while the single strength Coartem (20/120) is N800; Lonart: double strength (80/480) is now N1,800 from N900 and N1200 in February.

Surgical facemask, which stood at N50 in February 2020 is now N150. It was N500 in July, but the introduction of locally made ones by local tailors crashed the price. Disposable gloves (100 pieces) moved from between N450 and N500 to N1, 500; Amoxicillin Clavulanic Acid (625mg) moved from N100/tablet to N152, and cough expectorant jumped from N250 per bottle to overN450.

Average bottle of blood tonic (per bottle) moved from N400 to over N600, while an anti hypertensive drugs have also gone up. For instance, Aldomet Methyldopa  (satchet/×10) is now N300 from N200; Normoretic is N2,000 per pack (100 tablets)  and N200/250 r0r a satchet of 10  from N150.

Moduretic N2,500 per pack, as against N1700 and N2000; Lozartan Potassium 50mg (×28), from N850 to N2800, depending on the brand and Co-dovan, a premium antihypertensive drug, which used to be sold for N11,000 per pack now goes for N19,000 per.

Anti diabetic drugs have also gone up, daily slipping out of the reach of average Nigerians. According to the Diabetes Association of Nigeria (DAN), an estimated 15.3 million Nigerians are living with diabetes. BH findings revealed that Metformin x14 is now N350 from N250 in March; Humulin is N3,700 per ampoule; Mustard is N4,600 per ampoule, while Actrapid is at least N3,000 per ampoule.

A pack of Insupen brand Sterile Insulin (8 Needles) and PiC Insumed Sterile Pain-free Insulin (8needles) with Syringe that sold for N5,250 and N2,200 respectively in February are now N10,350 and N5,135 respectively. As each pack contains only eight needles, a patient who needs to take 30 daily injections will need 4 packs to complete a monthly dosage.

The prices of other drugs have also gone up. Brustan -N, an anti arthritis/pain killer drug from N350 to N500; Ciprotab, which used to go for N1450, now sells for N1,900; Ibuprofen (Nurofen) 200mg N1560 per sachet, branded ibuprofen 400mg is N2,250 for a pack containing 12 tablets and unbranded Ibuprofen is N500.

Hovid brand of Prednisolone, a drug used to treat lung or inflammatory conditions, such as arthritis and asthma, recorded about 100percentage increase in price. It presently sells for between N350 and N400 per sachet, instead of N150 in April. Likewise, Ventolin inhaler for asthmatic patients is from N1,900, while Seretide inhaler is N5,550.

Further checks revealed that the prices of antibiotics have gone up. For example, a pack of Augmentin goes for between N3,500 and N5,000 depending on the brand, milligram and the number of capsules in the pack or sachet, while unbranded Augmentin is N1,900. In the same vein, Zinnat 500mg price is between N4,500 and N5000.

A sachet of unbranded Ampicillin capsules, which cost N200 a few months ago, depending on the location, now sells for N800 or more, Azithromycin- Zithromax suspension 1g by Pfizer is from N4,950, Zithromax suspension for children is N4,000, Zithromax tablets 250mg is N3950, Zithromax 500mg tablet is N4,800 and unbranded azithromycin 500mg is N2,600 per sachet.

A lifesaving antibiotic used for the treatment of complicated infections, Meropenem, now sells for N27,000 per unit injection as against N18,600.

Likewise, Ketamine injection, an anaesthetic agent used for surgical operations which was less than N2,000 as at February, is now being sold for N10,000.

An octogenarian encountered at Boluke Pharmacy in Agege, Lagos, Pa. Rufus Oguntade said he now depends on his children for survival as his pension is no longer enough to buy his drugs.

“Before, I could buy all my blood pressure medications for the month with just N5,500. But now, I spend N18,000. Yet, I still have to buy drugs for other ailments”, said Pa Oguntade.

A pharmacist with a retail outlet in Ikeja, Pharm. Emenike Orji, complained that the rising cost of drugs may force many drug stores out of business.

“We are recording losses every day as drugs are now left on the shelves unsold. Nigerians are going for cheaper brands or local herbs because prices of drugs are rising daily. The expensive brands are now scarce, and where you get them, they are very expensive because importers could no longer get enough foreign exchange to bring them in anymore.

“As things stand now, we no longer stock major and expensive brands as they gather dust on our shelves and at the same time tie down our funds”, Orji said.

A pharmacist who spoke to the BH on the matter blamed the hike on several factors, including shortage/high cost of foreign exchange, the shutdown of global borders which negatively affected the movements of goods and services, as well as the rising cost of production.

“At the beginning of this year, we were buying a dollar for between N358 and N365. We now buy at the rates of N465/N470.

“We have not even talked of haulage and local transposition. Unless the Federal Government intervenes, the situation could get out of hand”, declared the pharmacist who did not want his identity revealed.

He said the situation could go from bad to worse before the end of the year as manufacturers and importers of drugs fear that a majority of them may shut down their manufacturing plants as they have no forex to purchase the much needed raw materials.

Meanwhile, owing to the spike in the prices of drugs, poor Nigerians are dropping off their medication, resorting to ‘Agbo’ (local herbs), with health experts warning of serious complications and even death.

Worried by this development, medical experts have predicted more deaths and outbreak of preventable diseases. Some health stakeholders who spoke with our correspondent blamed the development on several factors, including the Covid-19 pandemic which ravaged the entire supply chain and slowed down imports; scarcity of foreign exchange to manufacturers to produce and import needed drugs, as well as the imposition of Value Added Tax (VAT) on pharmaceutical products by the Federal Government, among other challenges.

According to Dr. Olawale Dalley, the prognosis is very bad. “As more Nigerians find it difficult to access affordable medicare, they will embrace unwholesome medical practices.

“We have heard of quack nurses procuring abortions for their clients for as little as N1,000. Some will even go to local health practitioners such as ‘Oko Oloyun’ and their likes.

“Also, many women who could not afford proper but expensive medicare have lost their lives while trying to deliver in faith homes. These unwholesome drugs are also kidney and liver killers. They are poison to the body if not properly regulated. The situation is that bad. If current conditions persist, many lives are bound to be lost”, Dr. Dalley warned.

Some manufacturers who spoke with BH urged the Federal Government to quickly intervene before the situation totally gets out of hand.

The operators noted that, despite the availability of the N100billion Healthcare Intervention Fund, the scarcity in foreign exchange is posing a challenge to the effective utilization of the funds by the pharmaceutical industry.

They appealed to the Central Bank of Nigeria (CBN), to make a special allocation for all those who are beneficiaries of the facility to be given forex to import what is needed to boost their operations so that they could meet the repayment obligation.

President of the Pharmaceutical Society of Nigeria, Mr. Sam Ohuabunwa, noted that the requirements for accessing the facility are such that cannot be easily met. He urged the CBN to look into the provision of foreign exchange for manufacturers and also grant a two-year moratorium as against the one year that is stated in the guideline for accessing the facility.

“Instead of one-year they can give two-year moratorium and extend the repayment further down the line. I am also aware that a couple of the beneficiaries have been able to apply for the fund to effect what they wanted to do with it.

“Most of them used the fund on capacity expanding plants, getting new equipment, starting new processes and procedures and expanding manufacturing both in terms of the type of area and other value addition.

“However, because of shortage of foreign exchange, many are running a risk of losing a substantial value of this money and are losing on two sides – inflation and depreciation of the naira.”

Also speaking, the Chairman of the Pharmaceutical Sector of the Manufacturer Association of Nigeria (MAN), Dr. Fidelis Ayebae, called for reversal of polices that could hamper the growth of the pharmaceutical industry and the manufacturing sector at large.

“Policy summersault such as the imposing of value added tax on local pharmaceutical manufacturers whilst allowing duty free importation of finished products makes the local industry less competitive.

“In an era where Covid-19 has ravaged the entire supply chain, slowed down imports, where access to forex has become terrible and we are also talking of the AfCTA coming up next year, they have made us uncompetitive.

“One of the examples of government policy summersault that is not helping manufacturers and pharmaceutical companies is VAT,” said Ayebae, who is also the chairman/chief executive officer of Fidson Pharmaceutical.