Lagos — For patients in Nigeria, the outrageous cost of life-saving drugs is a daily burden. Several people are now forced to take a risk with their health by extending or missing doses, settling for less potent substitutes, resorting to self-medication or traditional healers, or stopping medication entirely.
For those battling chronic ailments such as diabetes, high blood pressure or cancer, the affordability crisis has pushed essential medications and treatment out of reach for many Nigerians and strained the public healthcare system.
Experts are worried that a significant number of patients who are not taking their medications as prescribed, stand to develop complications and incur even more expensive interventions later.
Some patients, who spoke with Vanguard bemoaned the negative effects that rising drug costs are having on their well-being, financial situation, and survival.
Ngozi Uchenna, a petty trader, was concerned about her 10-year-old daughter's persistent cough. At the neighbourhood health centre in Ikeja, Lagos, she was visibly worried at the high cost of the prescribed cough mixture. "I cannot afford the drugs, so I'm taking my child back home," she stated.
James Akor, who had been coping with sporadic coughs and chest pains, said he resorted to taking herbal mixtures because the hospital treatment bills were outrageous.
"One of the drugs the doctor said I shoud buy costs N120,000 and I will need to buy it two or three times every month. Another drug is about N55,000. Where will I get the money? I don't have it," he lamented.
'I can't afford N1.2m for one drug'
Dayo A. who was diagnosed with prostate cancer in 2023, has not purchased any of the drugs prescribed for him.
He lamented: "The cancer was detected mid-stage, I am only on palliative treatment. One of the drugs prescribed for me was Lupron Depot. The doctor said I should take it once every six months, but it cost N1,200,000.
"I am self-employed and not on health insurance, so I could not afford it. I was placed on another drug, Zoladex, but one vial costs about N750,000, which was also unaffordable for me."
For Olu F., a father of three, who noted that paying his hospital bills is a nightmare, said: "I'm a civil servant with a heart problem. Actually, I'm on a basic health insurance plan, but it does not cover the full cost of treatment for my condition, so I'm paying out of pocket.
"I'm usually sacrificing one for the other. It is either I buy my drugs and not pay for one other need or I skip my medication. Either way, it's not in my favour."
Kate B. who is diabetic also has a sad story; and many older adults like her are particularly impacted by the rising costs of diabetes drugs, rationing their medication just to make it last.
Hers is a plight of being forced to choose between buying medicine and putting food on the table.
A market survey by Vanguard in Lagos revealed that the prices of common medications such as painkillers, antibiotics, anti-hypertensives and anti-diabetics have been increasing steadily since the beginning of the year.
Hardest hit are prescription drugs, the cost of some of which runs into millions of naira in some instances.
Causes of high cost of drugs
At the pharmacies, it was gathered that in addition to the naira devaluation, price adjustments by drug manufacturers, government regulations, taxes, availability and demand for specific medications are factors driving price increases.
Towards the attainment of the United Nations Sustainable Development Goal, SDG3, and Universal Health Coverage, UHC, the Federal Government assented to the 2014 National Health Bill aimed at providing increased access to basic health care for the vulnerable population.
But even this has failed because many Nigerians still pay out of pocket for medical expenses, pushing more families into experiencing burgeoning health expenditures.
With hospital care gradually becoming financially out of reach, Nigerians are turning to cheaper but largely untested options such as home remedies, herbal medicines, among others.
But experts are worried by this development. The consensus was that out of pocket expenditures will prevail until the gaps in financing essential health care services, particularly preventive health services, is addressed.
Worry over traditional, herbal medicine
A general practitioner at a General Hospital in Lagos, Dr Femi Akintunde, cautioned that though traditional medicine practices and herbal treatments are prevalent and offer familiarity and cultural relevance, their effectiveness can vary significantly.
"When treatment costs become too high, people are forced to seek affordable and untested alternatives. Although traditional medicine practices and herbal treatments are widely used in Nigeria, their effectiveness can be unpredictable," Akintunde warned.
Further he said: "While going to the pharmacy is okay for consultations for minor ailments and over-the-counter medications, relying on them for serious conditions can be risky due to limitations in diagnosis.
"Though public clinics offer affordable care, they may face resource limitations and longer wait times. The bottom line is that the inability to access proper diagnosis and treatment from qualified professionals can worsen health outcomes."
Roadblocks to good healthcare
Another consultant medical practitioner, Dr. Bola Akinlolu, identified three major roadblocks to receiving good healthcare in Nigeria today: exorbitant costs for medications and treatment, long distances to reach medical facilities, and sometimes dismissive attitudes from healthcare providers.
Akinlolu emphasised that high cost remained the most critical hurdle, saying without health insurance or the ability to pay out-of-pocket, necessary treatment or medication might be out of reach.
"Of these, the issue of high cost is the most significant, because even if the patient succeeds in getting to the healthcare facility, and there are health workers to attend to them, there is little that can be done if such patient is not covered by health insurance, and cannot pay the treatment bill out of pocket or cannot afford to buy the required drugs," he remarked.
Titilola Lawal, a registered nurse and midwife at a Lagos government hospital, blames skyrocketing medication prices as a key reason patients struggle to stick with their treatment plans.
While acknowledging that side effects could also make treatment compliance difficult, Lawal argued that cost was the biggest hurdle.
"Several factors can affect medication adherence but nowadays, high cost is number one. Medications in general are expensive, but some prescriptions, especially 'orphan drugs' for chronic illnesses like cancer, heart disease, and diabetes, can cost millions of naira," she said.
Lawal explained that even with health insurance, the cost of these drugs could be overwhelming, leading patients to skip doses or ration their medication.
She added that some patients might even start treatment but abandon it halfway when the costs become unbearable.
She expressed particular concern for patients on multiple medication, saying managing such regimens could be challenging, and that high costs could increase the risk of accidentally skipped doses or medication errors.
Tolu Adetola, a pharmacist also regretted the development, warning that delay is dangerous.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
"When people delay seeking medical attention, their condition can worsen and become more difficult to treat. This can lead to complications, increased healthcare costs, and even death.
"Worse still, if people with infectious diseases don't seek medical attention, they can unknowingly spread the illness to others. This can be a particular risk for vulnerable populations.
"The rising costs of medical treatments and drug prices, exacerbated by the weakening value of the naira against foreign currencies, are negatively impacting families.
"Many households struggle to manage their healthcare expenses, which in turn affect their allocation of funds for necessities such as food and transportation.
"The general lack of reliable health insurance coverage by significant number of Nigerians further complicates the situation. Even where insurance is available, insurance companies are grappling with higher costs due to expensive medications," Adetola said.
Catastrophic health expenditure
Launched in 2005, Nigeria's National Health Insurance Scheme, NHIS, aimed to make healthcare affordable and accessible.
However, many Nigerians still face out-of-pocket medical expenses, risking financial hardship due to high costs. "What most Nigerians are facing today as a result of the economic downturn is catastrophic health expenditure.
"This is the health care payment beyond a certain fraction, that incurs negative economic consequences, ranging from sacrifice of basic goods and services, depletion of savings by individuals and families, to loss of income, and productivity, as well as disruption of welfare and living standards.
"Narrowing economic status gap across households, and increasing the depth of insurance are crucial mechanisms to reduce the probability of incurring catastrophic health expenditures in Nigeria," he stressed.
