World Diabetes Day: Patients dying, weighed down by high cost of medications
Nigerians suffering from diabetes are facing untold hardship due to the rising cost of medicines and other barriers to accessing comprehensive care in the country, investigations have shown. To mark the World Diabetes Day today, Daily Trust spoke to some patients, who said they have resorted to herbal medicines to manage their conditions. The patients […]
Diabetes
Nigerians suffering from diabetes are facing untold hardship due to the rising cost of medicines and other barriers to accessing comprehensive care in the country, investigations have shown.
To mark the World Diabetes Day today, Daily Trust spoke to some patients, who said they have resorted to herbal medicines to manage their conditions.
The patients and medical experts called on government and other stakeholders to address challenges towards prevention and treatment of the condition. They said this should, among others, include making diabetes treatment free or cheaper.
About the disease
The World Health Organisation (WHO) describes diabetes as a chronic, metabolic disease characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves.
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The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or does not make enough insulin, a hormone that regulates glucose (sugar) in the blood.
According to the National President of the Diabetes Association of Nigeria (DAN), Dr Ejiofor Ugwu, the burden of diabetes in Nigeria is alarming and has assumed an epidemic proportion.
Ugwu, who is also an Associate Professor of Medicine and a Consultant Endocrinologist/Diabetologist, said Nigeria has an adult population of about 80 to 100 million, and that out of the number, roughly 5.7 per cent have diabetes mellitus.
He explained that the type called diabetes mellitus is a chronic medical condition that is characterised by excess glucose in the blood as a result of either quantitative or qualitative lack of insulin.
He said: “This figure represents only one-third of the diabetes cases in Nigeria, because two-thirds of people suffering from diabetes in Nigeria are not yet diagnosed. They don’t even know that they have the condition, because of poor health seeking behaviours in the country, and lack of regular screening and medical check up”.
A consultant endocrinologist in Ilọrin, Dr Ayeni Olawale Charles, said diabetes used to be common among the elderly before, but that type 1, especially, has increased among the youth because of diet and environmental factors.
Pharm. Francis Duru, a former Secretary of the Pharmaceutical Society of Nigeria (PSN), said: “The rate of spread of the disease is very high now when you look at the way people eat. People eat more of carbohydrates which weigh down on their insulin levels. There are so many drugs in the market now that are used to treat diabetes and the costs vary depending on the type and the country of origin. Such drugs like Glucophage are very expensive now, and beyond the reach of the ordinary Nigerian”.
Patients struggle with cost of drugs, services
A diabetic patient, Rose Emmanuel, said she spends over N80,000 monthly to buy insulin and Galvus-Met, saying her ailment grew worse when she was out of job for some months.
According to her: “It is not only the cost of drugs that has gone up; the cost of food now is also very expensive. I had a relapse a few months ago and that is because I could not afford my medication and food, as I was out of job. So, I was just eating what I could afford. The diabetes got worse; I had to deal with diabetic ketoacidosis”.
She added that access to affordable healthcare would help to cushion the financial strain, saying she spends N200,000 on her medications and food monthly.
Adamu Ahmed, 57, has been battling diabetes for over a decade, forcing him to leave his lucrative job at a major hotel in Abuja to relocate to Kano with his family.
Ahmed said many patients like him have succumbed to diabetes because of the living cost crisis, explaining that he can no longer afford food and medication.
He said: “Insulin now costs N15,000 and testing strip is N10,000, PonporSR 500, which is expected to be taken after meal, is over N2, 000. These are supposed to be routine drugs and I do not have the cash flow to cope”.
Speaking on his diets, Ahmed said he no longer eats Basmati rice, recommended for diabetic patients; beans or even acha, believed to be rich in energy and goods for diabetes patients, because of costs. “I eat what I am able to get for the family,” he said.
Sam Kayode, who has been living with diabetes for 10 years, said one of his drugs, which he used to buy at N1,500 now costs over N5, 000.
He called on the government to introduce more research, to help diabetics not to go down with stroke or be killed by heart diseases, which are the major opportunistic illnesses for diabetics.
Another diabetes patient, Sarah Igbinovia, said she had to change to a much cheaper drug like Diabetimi, Hovid product brand of Metformin and Clamid to manage the ailment.
She said until recently, she used to buy the pack of two sachet at N2,000, but it moved up to N4,000 and from there it got to N6,000. Currently, it costs between N11,000 and N12,000, depending on the pharmacy.
On his part, Mr. Usman Abdul, noted that fall in purchasing power has forced many diabetes patients to reduce their drugs, especially diabetes multi-vitamin, such as Biobetic and Biopentin, which now cost N6,000 as against N3,000.
Experts speak on challenges
Medical experts said there are many barriers hampering access to quality care for diabetes in the country.
Dr Ugwu, of the DAN said the country lacks a survey on non-communicable diseases, adding that the survey is supposed to give an accurate data on diabetes prevalence in Nigeria, and is also very important for policy formulations and for national planning.
Secondly, he said the poor health insurance coverage and high out-of-pocket expenditure negatively affects individuals living with diabetes in Nigeria.
“So, the situation we have in our hands right now is a near catastrophe. Most people living with diabetes in Nigeria can no longer afford care. Diabetes is killing a lot of people, they have dropped their medications, not because they don’t want to take them but because they can no longer afford them. Some of them have resorted to alternative options, including prayer houses and native doctors”, he said.
He said there are no revenue sources for Nigerians to match the 400 per cent increase in the cost of medications.
He added that another barrier was that essential medicines for diabetes were becoming very scarce in the country, because most of the companies that were manufacturing and marketing diabetes medications are foreign companies, and many of them have left the country.
“And we have reliable information that more of them are also planning to leave. This portends great danger to the lives of the six to eight million Nigerian people with diabetes,” he said.
He added that there was no national policy on diabetes in the country, and that the Sugar Sweetened Beverages (SSB) tax instituted to discourage people from consuming unhealthy diets like SSB had been stopped.
He lamented that even when the SSB tax was in place, it was not spent on diabetes.
“That money was supposed to be spent on creating awareness about diabetes, conducting diabetes surveys, improving access to diabetes medication, subsidising drugs among others,” he added.
He further said another barrier was inadequate manpower as diabetes specialists are almost non-existent in rural and semi urban areas.
Way forward
Dr. Ugwu recommended that the federal government should, as a matter of urgency, remove all taxations on importation of diabetes medications, supplies and consumables.
He said the Diabetes Association of Nigeria, also strongly recommends a subsidy on diabetes care.
He said in Nigeria, for instance, treatments of tuberculosis, HIV and leprosy are free of charge but that the number of deaths from the three diseases combined is not up to the death rate from diabetes alone.
He said the federal government along with other stakeholders should conduct survey on non- communicable diseases in Nigeria, and also establish a national policy on diabetes.
He called on the federal government to not only resume the collection of SSB tax, but also increase it from N10 per litre to N20 per litre.
“And there should be a legislation to channel the money accruing from such taxation to improving diabetes care in this country,” he said.