Abstract
ObjectiveTo assess the availability, price, and affordability of cardiovascular, diabetes, and global medicines in Abuja, Nigeria.MethodsA cross-sectional survey involving 27 private pharmacies, 13 public pharmacies, and 25 private hospital pharmacies in Abuja was conducted using the standardized World Health Organization/Health Action International methodology. The availability percentage for each pharmacy sector and each medicine was analyzed. The median price ratio (MPR) (ratio of the median price to the international reference prices) of the medicines were evaluated accordingly. Affordability was assessed by calculating the number of days’ wages the lowest-paid unskilled government worker required to purchase a month worth of the standard treatment for a chronic condition.ResultsThe availability of cardiovascular (CV) medicines ranged from 28.4% (in private hospital pharmacies) to 59.9% (in private pharmacies). There was mixed variability in the mean availability of Originator Brands (OBs) and Lowest Priced Generics (LPGs) anti-diabetic drugs with the highest availability being OBs 36% and LPGs 40.2%, in private pharmacies and public pharmacies, respectively. The availability of global drugs ranged from 49.7% in private hospitals to 68.8% in private pharmacies. Two cardiovascular and four global medicines had greater than 80% availability across the pharmaceutical sectors. The median price ratio for OBs and LPGs was 9.60 and 1.72 for procurement, it was 8.08 and 2.60 in private pharmacies, 13.56 and 2.66 in public hospitals, and 16.38 and 7.89 in private hospitals. The percentage markup on LPG was 49.4% in public hospitals, 51.4% in private pharmacies, and 323% in private hospitals. Only nine medicines in both public hospitals and private pharmacies and two in the private hospital pharmacies required less than the daily wage of the lowest-paid government worker.ConclusionThe availability of cardiovascular, diabetes, and global medicines was below 80% across the different pharmaceutical sectors in Abuja and the medicines were unaffordable. Although the prices were generally exorbitant, private pharmacies offered the best options in terms of availability, pricing, and affordability of medicines. Therefore, the results of this study emphasize the pertinence of enforcing policies that facilitate the availability, pricing, and affordability of cardiovascular, diabetes, and global medicines.
Highlights
Medicines play an indispensable role in the improvement of health, the preservation of lives, the enhancement of public welfare, the promotion of trust, and participation in healthcare services [1]
Two cardiovascular and four global medicines had greater than 80% availability across the pharmaceutical sectors
The availability of cardiovascular, diabetes, and global medicines was below 80% across the different pharmaceutical sectors in Abuja and the medicines were unaffordable
Summary
Medicines play an indispensable role in the improvement of health, the preservation of lives, the enhancement of public welfare, the promotion of trust, and participation in healthcare services [1]. According to a recent study on access to medicine and affordable treatment for acute and chronic diseases in 36 developing and middle-income countries, the availability of generics in the public sector ranged from 29.4% in Africa to 54.4% in the Americas [9]. This poor availability and affordability of medicines in African countries can be attributed to several factors, including inadequate health financing systems, inefficient medicine supply systems, and out-of-pocket payment for drugs [10]. A recent study on cardiovascular and diabetes drug use in Abuja reported 92.8% out-of-pocket payment from the 1008 prescriptions studied [13]
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