Anxiety as 200% hike, scarcity hit hospitals, essential drug market

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‘A hospital without essential drugs’ is a contradiction in terms. Yet, that is fast defining many public hospitals given the scarcity of vital consumables that are now ravaging the health sector nationwide.

Findings by The Guardian across major public hospitals have shown supply shortages in drug dispensaries that had earlier offered succour to patients, in terms of availability, affordability, and integrity of the products.

With some of the essentials now rarely available at the ‘fortress’, the public is either settling for more expensive pharmacies in town – selling at between 150 to 200 per cent increment – or going home without prescribed drugs.

Doctors and other caregivers are on the edge over drug insecurity, calling on the federal government to immediately declare an emergency in the health sector to save lives.

For instance, at the University of Medical Sciences Teaching Hospital (UNIMEDTH), Akure, Ondo State, the state capital, most of the patients, after leaving the consultation room, were seen heading to the private pharmacies situated opposite the hospital.

According to one of the patients, Favour Afolabi, a middle-aged woman, said, “I brought my father to the hospital. After waiting for over one hour, we saw the doctor, who gave us this prescription. He told us that he was not certain the pharmacy inside the hospital would have them and that we should go outside to purchase them.

“You won’t believe that six drugs were prescribed, and the pharmacy outside the gate gave us a bill of N46,250! Just like that.”

One of the staff members of UNIMEDTH, who works in the pharmacy, stated that they only dispense drugs to customers based on the supply received.

While craving anonymity, he emphasised that when some of the patients present the prescription and are given the ones available, “they will immediately leave when we tell them the (high) cost.” According to him, the patients always claimed that there were other pharmacies where they could get it at a cheaper price.

The cost of drugs in Oyo, including the University Teaching Hospital (UCH), Ibadan, is also out of the reach of many residents. A recent check showed that prices of drugs had increased by as much as 400 per cent.

A lecturer, Tosin Adekunle Adeluwoye, said getting drugs at UCH is difficult.  “About 50 per cent of drugs are purchased from Kunle Ara Pharmacy. Generally, prices of drugs have gone up astronomically.”

But the Public Relations Officer of UCH, Mrs Funmi Adetuyibi, was quick to deny the claim.

She said: “How can you believe such a statement? If there are no drugs, why do we give prescriptions? Come and check the Cash and Carry unit, you will see drugs there. Our patients only go out to buy drugs we don’t have,” Adetuyibi said.

In Abeokuta, the Ogun state capital, many residents have resorted to self-medication as a result of the rising cost of drugs in both public health centres and private hospitals.

The case is not better in Ekiti, where citizens are pleading with the federal government to declare all imported drugs duty-free to enable patients to purchase their drug prescription, this is as they lament the high costs of healthcare at public hospitals in the state.

In Rivers State, the narrative is slightly different. Not only is there scarcity at public hospitals, the government-owned dispensaries are a lot more expensive than private-owned.

For instance, a list of drugs obtained from a patient at the State Apex Hospital showed at least a 100 per cent hike in prices than those sold outside the facility.

A caregiver, Vivian, got a list of six drugs, which include: I.V Lacix 40mg, I.V rocephine 1g, Tinidanole, Tab folic acid, Tab fesolate, Tab Ver.Bc, for over N28,000 at the hospital pharmacy.

She said: “I bought these drugs marked with a red pen (showing her prescription sheet) earlier for N28,000 in the hospital, but when I went outside the hospital, I got all of them for N12,000. Specifically, the one called rocephine, I bought it N12,000 for one at the hospital pharmacy but I bought it N5,000 for one outside.”

The narrative is not any better in Lagos, though the hike in cost is most profound. Gloria, an asthmatic patient, and a student at the University of Lagos visited a pharmacy as usual to purchase four pieces of Ventolin inhalers at N4,000 each. But a canister had increased to N17,000 lately.

Disturbed and worried, she was forced to add N1,000 to the N16,000 she had planned to buy the four pieces.

The head of production at a reputable drug manufacturing company told The Guardian that there is currently about a 150 to 200 per cent increment in the cost of production of drugs from the importation of raw materials to the conversion of those raw materials to finished products.

According to her, 90 per cent of the Active Pharmaceutical Ingredients (APIs), which are raw materials used in drug production, are sourced and imported from outside the country and as such, are affected heavily by inflation.

She noted that Nigeria presently does not have the technology for API production and the prices of APIs abroad have doubled.

“If only we can produce these things in Nigeria, it would be easier and better for us, but we unfortunately don’t and that on its own is a big challenge right now in the industry,” she said.

She added that policies on importation are not favourable and tariffs paid for importation are high.

“All these make it difficult for foreigners to come in and of the few that came around, most of them have gone back.

“We have increased price more than three times, and sourcing for Forex has been difficult. Some of the things we were buying for 600 to 700 per dollar before, have significantly gone to $1,800 although they are gradually coming down now, in Nigeria, when prices of things go up, it hardly goes down,” she said.

Former secretary of the Association of Community Pharmacists Nigeria (ACPN) Lagos chapter, Jonah Okotie, told The Guardian that the surge in price was a result of scarcity and according to him, the fact that some drug producers leaving the country caused panic leading to hoarding and price escalation.

Okotie said: “One of the major reasons some of the drugs also went that high, is the issue of scarcity, some of the drugs were out of circulation. The producers of these medicines left our shores. So, that gave room to the market forces because it is not centrally controlled.

“We are hoping that soon enough the prices of drugs will begin to come down. But for now, it remains the same. For instance, Augmentin that went as high as N50,000 or even more, as of today, is selling for around N15,000.”

Okotie explained that prices of some drugs are already falling due to some intervention, but the price of some vital drugs is yet to come down because they are still scarce.

“But that being said, it is not all the products, because as we are speaking right now, the price of inhalers has not changed. The inhaler that used to go for around N4,000 Naira is still about N15,000 or more because it’s not available. Ampiclox, as we are speaking, is also not available so, it’s not all the products, it’s just a few that are available right now.

“And I’m sure with the government, I know the Minister of Health met with the stakeholders in the pharmaceutical sector, and then the pharmaceutical Society of Nigeria. The Pharmaceutical Society of Nigeria also is doing some things on its end. So, I believe all these concerted efforts will pay out in the long run to ensure that these things work in the favor of the average Nigerian,” Okotie said.

Special Adviser to President Bola Tinubu on Health Matters, Dr Salma Anas-Ibrahim, in an interview with The Guardian, said that the issue of drug security was being addressed as the administration plans on using local production to help cut down the cost of drugs for Nigerians.

“By the time we have local production, it will drastically cut the cost of drugs to the lowest minimum level where most Nigerians can afford because currently, we rely heavily more than 70 per cent on imported drugs,” she said.

From Ijeoma Nwanosike (Lagos), Ann Godwin (Port Harcourt), Ayodele Afolabi (Ekiti), Adewale Momoh (Akure), Rotimi Agboluaje (Oyo), Oluwole Ige (Osun) and Azeez Olorunlomeru (Ogun)