Evaluation of Drug Pricing in Nigeria: A Focus on Affordability and Availability of Essential Medicines in Federal Capital Territory Abuja

Abstract

Critical to the success of a country’s healthcare delivery services is the affordability, availability, and accessibility of essential medicines to the populace irrespective of their income status. The price of medicines is an important determinant of medicines affordability and accessibility. Due to seeming inefficient health insurance programs, medicine financing in Nigeria is generally out-of-pocket. In Nigeria, drug prices are set mostly by market forces, with government tariffs, taxes, and distribution mark-ups accounting for a significant proportion of the final price.The following thematic areas of interest to were the focus in evaluating the current situation of drug pricing:  National Drug Policy and Drug Pricing; National Drug Distribution Guideline and Drug Pricing; National Policy Framework on Drug Revolving Fund and Drug Pricing; Nigerian Pharmaceutical Market and Drug Pricing.The study evaluated drug pricing in Nigeria by comparing the availability and prices of various brands of a chosen set of essential medicines in different parts of the health sector and different types of health facilities in the Federal Capital Territory Abuja to assess the availability and affordability of these medicines.The study design used a questionnaire format data collection tool based on the 2nd edition of the World Health Organization (WHO) and Health Action International manual for measuring medicine prices, availability, affordability, and price components. The survey was carried out within the Federal Capital Territory Abuja at both public and private health facilities, including community pharmacies. A total of 145 facilities were enumerated and 20% were successfully surveyed.  Key data collected included; percentage availability, price of originator brand and generics, price ratio to the international reference price, and the economic effect of current drug prices on the populace.The results showed varied and fantastic outcome, on inferential statistics in comparative analysis; Firstly, for the Public hospital vs Private hospital Medicines’ Prices, there was a significant difference (P<0.05) between the price of medicines in private hospital and the median price of medicines in public hospitals. Also, price of medicines in private hospital was 2.9 times higher than the median price of medicine in public hospital ( p=0.013, t=2.9); Secondly, for the Innovator brand vs Most sold generic brand in community pharmacy,  there was a significant difference between the median price of innovator brands of medicines and the median price of the most sold generics. The median price of the innovator brands was approximately 5 times the median price of the most sold generics (p=0.000291, t=4.689); Thirdly, for the Price of medicines across community pharmacies (innovator brand), there was no significant difference (p>0.05) in the prices of innovator brands across the community pharmacies assessed. (p=0.459); Fourthly, for the Price of medicines across community pharmacies (Most sold generic), there was no significant difference (p>0.05) in the prices of the most sold generic brands of medicines across community pharmacies assessed (P=0.915); Fifthly, for the Price of medicine across public hospitals, there was no significant difference (p>0.05) between the prices of medicines across the public hospitals assessed. (p=0.877).There exists a huge price disparity between public and private health facilities, hence there is an overarching need to regulate drug prices in the health sector so as to ensure affordability and availability of essential medicines and other healthcare commodities. There is poor availability of some essential medicines particularly in the public health pharmacies, it is imperative that appropriate measures be put in place to ensure medicine availability. Improving access to medicines is key to attainment of Universal Health Coverage and Patients’ satisfaction of the healthcare delivery system.

Keywords: Drug Pricing, Essential Medicines, Affordability, Availability, Nigeria, FCT Abuja

DOI: 10.7176/JHMN/97-01

Publication date: January 31^st 2022