...FX drives up cost of medicines
…Govt urged to implement executive order on imported drugs
…Experts pick holes in 2025 health budget
A new report has revealed that Nigerians pay 11.5 times more than the international reference price for the cheapest generic medicines, including antibiotics, forcing many to skip crucial treatments.
The research, an updated analysis of the state of medicine affordability, availability and pricing, found that patented medicines cost more than 25 times than the global minimum in Nigeria.
The analysis incorporated data from 71 surveys across 54 countries and extended the timeline of review to February, 2024, offering fresh insights into the disparities in access to essential medicines, especially how various regions and income groups are affected differently.
The World Health Organisation (WHO) recommends an 80 percent availability of essential medicines, but the public health sector falls short, achieving only 68.3 percent availability compared to 77.4 percent in the private sector.
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The high cost has made treatment of both acute and chronic illnesses unaffordable, requiring patients to pay up to 37 days’ wages to purchase a single course of medicine.
For instance, the treatment of an adult respiratory infection using amoxicillin 250 mg capsules, three dose daily for a week, requires an average of 2·7 days’ private sector wages in about 22 states where the new minimum wage of N70,000 has been implemented.
Diabetes management also poses similar economic burden on patients, as branded drugs cost up to 7·8 days’ wages in some states, in contrast to the 0·5 days’ wages required for the public sector brand drugs in Europe.
Patients can’t afford drugs
Olufemi Fasanmade, a professor of Medicine at the University of Lagos College of Medicine, said many patients cannot afford diabetes treatment on their own because the average cost of medication on a monthly basis now ranges between N50,000 to 150,000.
That maximum is more than double the current minimum wage.
Fasanmade said the cost is higher for managing cardiovascular disease such as hypertension. He explained that over 90 percent of these drugs are imported and tied to various duties and tariffs, forcing up their prices.
“Probably less than five to 10 percent of diabetes drugs are manufactured locally. If a person tells you that he is a cleaner and he earns N40,000, you have to start thinking, what drug can I give that man? You have to prioritise and take out some drugs even though he needs it, and face those that would make him survive. So, those are challenges that patients do have,” the professor said.
Abiola Oduwole, a professor of Paediatric Endocrinology at the Lagos University Teaching Hospital, said many patients are struggling to manage their cost of treatment alongside feeding as insulin now costs about N20,000 per vial.
She explained that more patients are returning to the hospital with diabetic ketoacidosis, a serious complication of diabetes that occurs when one’s body doesn’t have enough insulin.
Insulin is a hormone that allows the body to use glucose or sugar for energy. When there isn’t enough insulin, the body starts to break down fat for energy instead, in a process that produces ketones, which are acids that build up in the blood.
“It has actually gotten worse. But thank God that we have non-governmental organisations that provide free insulin, glucometers and reagent strips, investing in their lives in many ways. But they cannot continue to do this forever and there’s a limit to what they can do. We still need the government to start doing something,” Oduwole told BusinessDay.
She further explained that the influx of fake medications is worsening the situation for patients as they sometimes purchase fake medicines at the same cost as genuine ones without suspecting.
Oduwole further said it can be difficult for doctors to identify these deep fakes that are composed of inadequate active ingredients, urging the National Agency for Food and Drug Administration and Control (NAFDAC) to step up surveillance.
Ebun Bamigboye, clinical director and nephrologist at St. Nicholas Hospital, Lagos Island, in interview earlier with BusinessDay, suggested that the government remove barriers to imports to provide short-term relief to the people.
He pointed out that the process through which drugs are imported and sold within the country only ensures that the pricing stays beyond the reach of most Nigerians.
There are multiple tariffs associated with the importation of drugs into Nigeria, including those from the NAFDAC, Nigeria Customs Service, and the National Drug Law Enforcement Agency (NDLEA).
According to Fasanmade, the federal government’s policy to exempt medical raw materials and equipment from these tariffs needs to be executed swiftly.
“There is an executive order to support patients so that costs of drugs being imported will not go up so much. The order is also trying to support local manufacturing of different drugs but you know that if you give such an order, you can’t start manufacturing drugs the next day. You need to put in place the infrastructure and the framework. So, a lot of the right decisions are being taken but we need to implement them,” he said.
Read also: Antibiotics record 1390% price jump as drugmakers walk away
2025 health budget fails to meet expectations
Meanwhile, analysts have said that the federal government’s proposed N2.48 trillion health sector budget for 2025 is not sufficient to make a significant impact in the country which faces critical healthcare challenges.
The allocation accounts for 5.18 percent of the total N49.7 trillion proposed budget. About N1.23 trillion was allocated in 2024, representing 4.47 percent of the total spending.
Olufemi Babalola, former president, Guild of Medical Directors, said while the N 2.48 trillion allocation is a step forward in recognising the importance of the sector, it cannot address significant health challenges, including high maternal and child mortality rates, insufficient infrastructure and limited access to essential health services.
He observed that about 50 percent of the health budget is dedicated to personnel costs, leaving limited resources for critical investments in infrastructure, medical equipment, essential drugs, and public health programmes.
Babalola emphasised that while paying healthcare workers is vital, the balance between personnel expenditure and developmental spending raises concerns about the system’s overall efficiency and the ability to address pressing healthcare needs effectively.
“While the 2025 health budget reflects a growing commitment to the sector, it also underscores the need for a more robust and balanced approach to funding, one that prioritises both immediate and long-term needs. With the right focus on accountability, efficiency, and investment, Nigeria can take meaningful strides toward addressing its healthcare challenges and building a healthier future for its citizens,” he said.
“Looking ahead, it is crucial to build on this progress by increasing funding to health in subsequent budgets to meet but exceed the WHO’s recommended target. Equally important is ensuring that the funds are utilised transparently and efficiently to deliver the maximum impact,” he further said.
Olayinka Oladimeji, former director, Primary Healthcare Systems Development at the National Primary Health Care Development Agency, said the size of the budget is not as important as specific allocations that will drive real impact, particularly in reducing the burden of out-of-pocket payment for healthcare.
He noted that the real impact will be seen if the government commits significant spending to driving basic healthcare funding, health insurance coverage and vaccination, noting that new antigens are being introduced.
He also observed that the budget is abysmally below the recommended Abuja declaration of at least 15 percent of the total budget for health, urging more investment in the healthcare sector.
Commenting on the budget, Adaobi Onyechi, a public health expert, expressed concerns that the capital spending, which funds infrastructure and medical equipment, may be insufficient for the scale of upgrades needed across the country, especially in underserved rural areas.
The expert urged strong monitoring and accountability frameworks to ensure that the budget makes as much impact as possible.
