Ogbodo Ozioma Favour discusses how rising cost of diabetes treatment is pushing poor Nigerians to alternatives that worsen their conditions.
Diabetes is one of the non-communicable diseases that leads to deaths in Nigeria annually. At least 11.2 million persons are living with the condition, public health experts who conducted a local study on its prevalence in the country have said.
Though there is limited comprehensive data on mortality causes in Nigeria, the International Diabetes Federation (IDF) Diabetes Atlas estimates that 48,375 people aged 20-79 died from diabetes in Nigeria in 2021. This represents 4.5% of diabetes-related deaths occurring in people under 60.
Global statistics from IDF underscore the prevalence of diabetes, with over 3 in 4 affected individuals residing in low and middle-income countries. Projections indicate a significant rise in diabetes cases, reaching 643 million by 2030 and 783 million by 2045. IDF’s 2021 data further highlights the increasing diabetic population in Nigeria, projected to reach 8,000 by 2045.
But despite the gravity of this health challenge which requires daily intake of medication, many Nigerians have ditched their medicines due to the high cost.
According to price analysis by African Health Report (AHR), Metformin, a diabetic prescription medicine which is a compulsory intake for type 2 diabetes patients to help control blood sugar is N8000. This drug used to be sold at N2400 in 2022, indicating a rise of over three hundred percent.
The price survey revealed that other medicines are equally highly priced, with Glucovance 500mg at N7,649, while an anti diabetic used to lower the blood sugar level, Diamicron MR (Gliclazide) costs N8,650.
Galvus Met is sold at N51,000 and Natrol Cinnamon, Chromium and Biotin sold at N21,550 respectively.
Rising Inflation Kick Diabetes Medicines Out of Reach
In a country where the minimum wage is N30,000 and health insurance is practically unavailable to the majority, these prices mean that the majority of diabetes patients in Nigeria cannot afford the medicines they need to keep their condition under control. This constraint forces patients to compromise on prescribed doses or skip medications due to unaffordability.
Mr Galadima Gbako, a pensioner who resides in the Federal Capital Territory (FCT), told African Health Report (AHR) that he is a type 2 diabetes patient and though he is registered under NHIS, it doesn’t cover his medication.
He said he mostly uses Metformin and Liraglutide alongside a combination of herbs because he cannot afford regular purchase of the drugs due to its high cost.
“Most times I forget to take my drugs for week until when I start to feel uneasy and I quickly revert to it,” he stated.
He added that he recently purchased Metformin at N8,000 but since he boils and ferments herbs that are brought from the village for him, he’s hardly faithful with his other medication.
Communication specialist, Mr. Anselm Okolo, who resides in Abuja, is a border line diabetic patient. He also recounts to AHR, the skyrocketing cost of staying on diabetes drugs with his current income as he has only relies on drugs, not herbs or mixtures of herbs and drugs, to keep it under control.
He said, “It’s been quite a challenge keeping up with the cost of the coterie of routine drugs I need daily to be maintain a good condition of health. On the average, I spend around N45,000 early this year, for the three drugs prescribed for me.
”Financially, the money to pay for the drugs and avoiding buying a fake one has always been a problem. Now, with the diminishing value of the naira, I spend twice what I used to spend monthly. I am talking about N80,000 a month, how many Nigerians can afford to do so? At my level, it’s quite a huge challenge, considering what it will be for people earning minimum wage.”
Poverty Leading to Health Complications in Treatment of Diabetes
The growing of cost of treatment has led to health complication, especially as most of the expenses are paid by patients and families who are also grappling with all round inflation on food items, transportation, housing and others.
In Nigeria, the national annual direct costs of diabetes was estimated in the range of $1.071 billion to $1.639 billion per year, says IDF.
With 71 million people living in poverty, according to data from the National Bureau of Statistics (NBS), the hike in price of diabetes drugs have forced patients suffering from the ailments to alternate their prescribed dose or in some cases, skip the medications completely as they cannot keep up with the cost.
Many patients mix their drugs with herbs which may lead to health complications, as highlighted by Mr Gbako.
‘Suicide Mission’
The Director of a Non-Governmental Organisation (NGO), Diabetes Control Media Advocacy Initiative (DICOMAI), Mr Sam Eferaro, who is diabetes patient and an expert in the field, told AHR that many Nigerians have now gone on a ‘suicide mission.’
”Many Nigerians can no longer control their conditions. Some have, without medical advise, reduced the dosage of their medications while some have stopped taking any medication altogether. This is suicidal because diabetes has no known cure and one needs to be on a daily medication in addition to appropriate diets and exercises to be in control. Not being in control could result in several complications ranging from blindness, cardiovascular issues to lower limb amputation, among several others. You also need self monitoring to know whether or not you are in control.”
He added his voice to the cry over the rising cost of managing diabetes in Nigeria, saying,
“I bought Ambulatory Care Unit (ACU) Check strip for blood sugar monitoring yesterday from the cheapest pharmacy in Sango Ota at N9,500. It’s far higher in several other places and not many people can afford it. Of course, one still has to buy insulin and other tablets. Sometimes I spend close to N50,000 in a month to be able to achieve control.”
A nurse, Miss Favour Clement, also emphasised the danger associated with mixing herbs with medication.
”There’s usually a side effect to it because most times the composition in the herbals may be contraindicated to that of the drugs and we might have a reaction that can be harmful to the patients. Since not much research has been done on the herbs, it is not advisable to combine it with drugs. You either choose one at separate times.
”Even certain drugs we don’t administer together because of the possible adverse effect it may produce,” she stated.
The high cost of diabetes treatment is leading people to embrace risky alternatives that may cause complications to their conditions, thereby posing a public health threat to the country’s system.
