HEALTH: Cost of Medicare Forces Nigerians to Herbal Treatment

As the prices of drugs continue to soar, many Nigerians are opting for cheaper traditional herbal concoctions to meet their healthcare needs without caring so much about the possible negative implications. Because of this, falling sick can be challenging in normal times but seeking treatment is currently a double blow as the financial implication has become increasingly unbearable for many Nigerians.

The cost of basic drugs, such as antibiotics, analgesics, anti-diabetics, and key medications for chronic conditions, has doubled, tripled, or even quadrupled in some instances, leaving many patients struggling to access the healthcare they desperately need. Hardest hit by the exponential surge in prices of drugs are the poor, notably those on the minimum wage and below, those without steady sources of income, and particularly those without reliable health insurance. Nigeria’s healthcare system is one of the worst in the world, ranking 163 out of 191, according to the World Health Organization (WHO).

In a recent report by Vanguard newspaper, a Nigerian Dokun Bolarinwa, diagnosed with high blood pressure, said he had been on regular treatment, but noted that the soaring price of his medication was gradually forcing him to default in adherence to the guidelines of his treatment.
“I’m a retired civil servant with no stable income. Over the past few years, I have been managing my condition with family support and goodwill, but these days, things are tough. I’m already skipping certain medications because I cannot afford them, and if care is not taken, I may be forced to abandon treatment altogether.
Among factors contributing to the increase in drug prices are rising production costs, delays in global supply chains and local supply challenges, as well as the declining value of the naira.
Findings from a recent survey by SB Morgan showed that over the last four years, the prices of different categories of paracetamol-based analgesics, common cold medicines, such as Actifed, and antibiotics, and anti-malarials, rose dramatically.

The report found that between 2022 and 2023, Ampiclox and Amoxil recorded 340 per cent and over 400 per cent increases respectively, while anti-malarials such as Lonart DS recorded cost and selling price increases of 110 per cent and 92.3 per cent respectively between 2019 and 2023.
A silent rage of people grappling with undiagnosed or inadequately managed chronic diseases, such as cancer, is also underway as chemotherapy drugs have seen a 300 per cent price increase in recent times, pushing them beyond the reach of most patients. Data from the Global Cancer Observatory show that over 100,000 new cancer cases are diagnosed annually in Nigeria, yet only five per cent of those affected can afford treatment.
Those bearing the brunt of rising medicare more are the vulnerable groups, including children, pregnant women, the elderly, and those with underlying or pre-existing health conditions and those that require regular medication. Experts say the consequences of this development could be devastating and could lead to undesirable complications, delayed diagnoses, and even preventable deaths. Health watchers blame the development on a combination of factors, including depreciation of the naira, global supply chain disruptions, and increased drug production costs. Beyond the high drug prices, they warn that left unchecked, the crisis could cripple the already overburdened healthcare system and worsen existing health inequalities.

Reacting, the Chief Medical Director of Lagos State University Teaching Hospital, LASUTH, Prof Adetokunbo Fabamwo, said high cost of drugs was undesirable for the welfare of the average Nigerian.
“Nigerian citizens are already impoverished and cannot even afford to buy food to eat, if they are sick and need to buy drugs; in the near future we will have increased morbidity and mortality. So people will not be able to comply with their drug prescriptions. People will get sicker, and some of them may even die,’’ he said.
On his own part, the Medical Director, Federal Medical Centre, Ebute Metta, Lagos, Dr Adedamola Dada, said a lot was needed to be done to address the situation.
“There are drugs available in the country. It’s the cost that has increased, in line with most things that are importation-dependent. And as with everything, Nigerians in the drug business are also taking advantage, seeing that there are limited options and little competition.
“The solution is fundamental, we need to start producing our own drugs locally using high-quality APIs to guarantee drug security, and we also need to eliminate or substantially reduce out-of- pocket payments for health care. These are the things the Federal Ministry of Health is doing now – fundamentally tackling the problem, and soon enough, it would yield results,’’ he said. Speaking further, Dada noted that when patients were unable to afford their drugs, their condition does not get treated. He said: “A healthy nation is a wealthy nation. Personally, however, I am not one for all this noise about the cost of drugs, it’s not the only thing whose prices have gone up. I think we should rather exert our efforts and energy at finding a long-term and enduring solution to it.”

The frightening scenario has forced many Nigerians to seek for alternative means of treatment, thus relying on herbal concoctions. Alluding to this trend, the federal government recently stated that 81.6 percent of the country’s population of over 200 million, up from 70 percent in 2018, were relying on traditional medicine as their primary form of healthcare.
The National Bureau of Statistics (NBS) said in 2022 that over 133 million Nigerians were living in multidimensional poverty due to a lack of access to health, education, and living standards, alongside unemployment and shocks.
The devaluation of the naira and exits of several pharmaceutical manufacturers including GlaxoSmithKline (GSK), a UK-based pharmaceutical company, has pushed up the prices of many essential drugs in recent months and put them out of reach for many citizen, particularly low-income earners who are already squeezed by the growing high inflation and poverty in the country.
For example, the price of Actifed Action tablet skyrocketed from N4,000 before the exit of GSK to N13,000, and that of GSK Ampiclox jumped from N900 to N15,000. In addition, the price of Voltaren pain relief cream rose from below N5,000 to N12,000; Ventolin inhaler, from N3,000 to N15,000; Augmentin 1g tablet, from N4,000 to N43,000; and Avamys nasal spray, from N4,000 to N21 000.
The surge in drug prices is driving the growing demand for traditional herbal medicines, which are preferred due to their affordability and perceived effectiveness.
Traditional medicine vendors are in many strategic locations such as motor parks and markets with herbs promising cures for various forms of illnesses at affordable rates.
Ogbonna Eyinnaya, a resident in the Bwari Area Council of Abuja, attested to the popularity of traditional herbs in Bwari. He said affordability remains a major factor driving demand, especially when compared to the cost of drugs.

Gift Adejoh, an Abuja-based resident, said she recently inquired about the price of Actifed, a product of GSK, from a local pharmacy store to deal with her allergies, but was forced to take another alternative due to the high cost. “I did not believe it when the sales attendant told me N11,500. I got this product for less than N4, 000 two years ago or so. I simply bought another drug, then combined it with some natural remedies and I got better after all,” she said.

Herbal remedies have a deep-rooted culture in Nigeria, especially in more traditional communities, but the drugs have become more popular in recent years even among Western-educated Nigerians. Herbal shops and itinerant vendors promising a cure for all forms of illnesses, from common flu to diseases such as cancer and diabetes, are a common sight on the streets and markets. Herbal vendors advertise their concoctions from loudspeakers atop old cars, while others push herbal mixture-filled prams and carts through the streets.
Herbalists say sales have soared and demand has increased from cash-strapped customers. “The number of customers has increased four-fold because every day we attend to people from varying social backgrounds,” said Abubakar Khalid, a herbalist in Kano’s Yakasai neighbourhood.
With fewer manufacturers and distributors due to the exits of major pharmaceutical companies, healthcare experts predict decreased competition, leading to a continued surge in prices for essential and generic drugs. They suggest that developing traditional medicine to complement orthodox practices could provide relief to Nigerians squeezed by high inflation and rising drug costs.

With additional reports from: Vanguard & BusinessDay