More Nigerians battle rising cost of health care

By Tumininu Ojelabi Hassan

Nigerians have decried the high cost of healthcare in the county as prices of medications as well as the cost of treatments in government-owned and private-owned hospitals have skyrocketed amid economic hardship occasioned by the removal of fuel subsidy.

Based on findings by our correspondent, most foreign drugs are extremely scarce while the few available ones are ridiculously expensive due to the economic situation, inflation and foreign exchange challenges. An example is the GSK pharmaceutical company which recently announced the company’s shut down of operations in Nigeria due to shortage of foreign exchange.

Following the announcement, the products of GSK like Augmentin, Beecham Ampiclox, Duodart, Cervarix (HPV vaccine for cervical cancer) and Ventolin, are currently out of stock and the slightly available ones are sold at exorbitant prices.

For instance, the price of Augmentin used to be N5000, three weeks ago it was N17,000, presently it is N23,000 (price varies based on location), while Beecham Ampiclox capsule, which was previously N2000 costs about N7000 now. Two months ago, Ventolin inhaler cost an average of N4500 per canister, presently it is sold for N12,000.

Aside the high prices of medications, Nigerian patients have raised concerns over the cost of medical services in the country. Due to the economic crisis, Nigerian hospitals have been forced to review their medical services depending on the location. In some hospitals, patients on ventilator pay as much as N200,000 per day while patients pay about N100,000 for ICU care and N6000 for diet. Oxygen (1-5 kg) costs N120,000 per day, (6- 10 kg) is about N150,000 per day and (11- 15 kg) is about N170,000 per day.

Modupe Ifekoya, a 57-year old hypertensive patient shared her experience since the price of her medication increased from N800 per sachet to N1300 per sachet.

“Since the price of Lotrial 10mg increased from N800 per sachet to N1300 per sachet, buying it has been a struggle but I have no choice because I have to use this drug everyday. The current economic situation is becoming unbearable. We are struggling to make ends meet and we also have to struggle to buy medication to stay alive,” she lamented.

Due to the high cost of medical services, some patients, who shared their experiences with our correspondent, said they had to resort to treating themselves with traditional medicine because they couldn’t afford the orthodox medicine.

In an interview with our correspondent, Dr. Owolabi Lawal, Registrar & Gynecologist in training, Olabisi Onabanjo University Teaching Hospital, Sagamu (OOUTH), said the shift towards traditional medicine as opposed to orthodox medicine can be ascribed to the high cost of medical services in the private health sector and for the public health sector, the stress patients pass through when they visit government-owned hospitals is the reason they avoid government-owned hospitals.

Aside the aforementioned reasons, poverty, education level and ignorance are other reasons contributing to the preference of traditional medicine over the orthodox medicine.

“Why people avoid the private health sector is basically because of the high cost of the services there. With respect to government hospitals, it has to do more with the stress people go through before achieving their aim.

“By and large, the private hospitals cannot totally be blamed because they have to pay their employees, pay for drugs, they have to keep the hospital running and also maintain their standard, as a result of these they have to step up their prices in order to stay afloat. .

“With the current economic situation in Nigeria, the government hospitals can’t keep up. They have to generate income, due to this they had to step up their prices, although it isn’t as bad as the prices in the private sector. A treatment of N3000 is now N7000, but in the private sector it is about N20,000- N25,000. The main reason is the economic situation.

Aside this, ignorance and lack of education is very high on the list of why people avoid the hospital. However, in this part of the country, the level of education is high and the ignorance level is low compared to the northern part of the country, where their level of education is low and their ignorance is skyrocketing.

“For patients here in the west, it’s basically cost. Also, it’s not like they don’t know where to go to, instead they believe so much in traditional medicine, because the sellers of traditional medicine give them one medication to cure ten ailments. They are actually killing them and when they come down with kidney damage, it becomes our case.

“What limits people from accessing healthcare is basically poverty, education level, ignorance and also how they are being attended to. In the northern part of the country, they are solely dependent on the government hospitals because they have just a few private hospitals, they have no choice but poverty, ignorance and lack of education always come into play,” he stated.

Dr. Lawal attributed the high cost of treatment, especially in the private health sector to the selfishness of medical practitioners in the private sector. However, the social workers in the public health sector aren’t relenting towards ensuring patients access healthcare on credit.

“Private hospitals are very selfish. Once a patient presents a case to them, if he has headache, they will treat typhoid. If he has malaria, they will treat sepsis. Everything to extort patients. When the situation gets worse, they refer them to the teaching hospital. When the patients get to us, they would have exhausted their money. Our social workers are working day and night to ensure that patients access health services and pay later and this is only possible if the patient is still alive,” he said.

Another way some private owned hospitals extort patients is through the Widal test, which according to Dr. Lawal is an unnecessary test. He added that in the teaching hospital, carrying out a widal test is prohibited and any doctor guilty of this will be issued a query.

“Widal test is rubbish because everyone is positive. Everybody has a degree of typhoid in their body, but the level differs. However, there are superior tests they can do to suspect what is wrong with the patient, which are more expensive than the Widal test but people have become so accustomed to the Widal test, such that if you don’t want to run the test for them, they will ask for it.

“In my own setting, which is the teaching hospital, if you write the Widal test for a patient, you will be queried. But in the private sector, when a patient complains of just back pain, you will run widal and malaria test,” he added.

To address the issue of drug scarcity and the hike in prices of drugs like Augmentin, he ascribed it to the recent shutdown of GSK Pharmaceutical company, Nigeria. To mitigate the burden of high cost of drugs, he advised medical practitioners to prescribe other effective drugs with lesser prices to patients.

“The issue of scarcity of some drugs is because GSK Pharmaceutical company has ceased operations. When a product is scare, it becomes expensive. But why are people killing themselves on Augmentin, when there are equally good drugs that can do the same thing. As a medical practitioner, when I know a particular drug is now expensive, I will prescribe affordable drugs with the same effect to my patients,” he said.

He further attributed the high cost of medical services in the private sector to the high overhead costs of running a hospital, on the other hand, in the government-owned hospitals, the hike in the cost of running a test is due to the increase in the price of reagents.

“The private sector have to pay a lot of bills, they have to pay their staff, buy consumables, drugs and reagents among other things, while these things are made readily available by the government in the government hospitals. Although, the hospitals purchase some but you can’t compare it to what the private hospital is doing.

“Most private hospitals are trying to stay afloat. In the government hospital, the prices of running tests have increased due to the price of reagents used in carrying out these tests. When they were running malaria tests for N1000, reagents was about N200-N300, but now reagents is about N1500, they had to increase the price of the test.

“Most of these reagents aren’t produced locally, they are imported. In as much as government hospitals aren’t profit-making enterprises, they still have to generate income because they are remitting to the government. It’s not their fault, it is due to the economic situation”.

To ensure the accessibility of quality healthcare, he emphasized the importance of health insurance as well as ensuring a corruption-free society in order to improve the quality of healthcare in the country.

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