Patients groan as forex scarcity, port congestion shoot up drug prices by over 30%

As Nigeria experiences economic meltdown on account of the COVID-19 global pandemic, the pharmaceutical industry is not spared, as prices of essential medications increase above 30 percent. ADEBAYO FOLORUNSHO-FRANCIS reports

A middle-aged woman, Mrs. Bola Ishola, stood in front of the pharmacy at Ebute Metta Health Centre haggling over prices of the drugs she was prescribed. Her action drew murmurs and grumbles from patients and relatives waiting on the queue.

When our correspondent accosted her as she made to leave the premises, the 50-year-old showed her prescription bill, saying the price of the drugs were beyond her expectations.

Among the drugs prescribed were Amlodipine (for high blood pressure), Myospaz (muscle spasm pain), Indicontin (antihypertensive), healbatic (multivitamin supplement), Ldnil (anticholesterol) and Peptide (arthritis) tablets which totalled N7,270.

For a woman who has been battling arthritis, Ishola said she initially looked forward to getting one or two medicines, but she was shocked to see the assortments of drugs prescribed by the doctor.

When asked why she left the pharmacy without procuring the medication, she said the money she was holding was far below the total she was expected to pay.

“You saw me haggling with the teller, didn’t you? Those medicines are too expensive. Where do I have the money to expend a whole N8,000 on drugs? The pain won’t kill me. My children will buy them for me when they visit,” she fought back.

Another patient who also spoke with our correspondent, a retired apex chief matron at a Lagos State health facility, approached the issue from another point of view.

“I won’t blame the pharmacy owners because I understand that prices of everything in the country, including food, have gone up. These are trying times for everybody.

“After Klovinal and Amoclav were prescribed for my daughter at the hospital, I knew the prices were unlikely to be the same with what I bought some months ago. So, I came prepared.

“As it turned out, I was right. At the clinic, the cost of the drugs was estimated at N2,860 but I ended up spending N3,200 at the pharmacy,” he said.

‘Antimalarial, essential medicines seriously affected’

Findings by PUNCH HealthWise revealed that prices of popular branded pharmaceutical have shot up considerably.

At a registered pharmacy in Oyingbo area of Lagos, a pack of Myospas, which was retailed at N700 now costs N900; while Klovinal, formerly sold for N1,350 now sells for N1,500.

Popular antibiotics were not spared, either. At a pharmacy in Costain, a branded pack of Coartem and Lonart, which were formerly retailed for N1,500 and N1,350 respectively during the COVID-19 lockdown now sell for N1,700 and N1,500 respectively.

When called on the phone, Business Head of Vanguard Pharmacy, Mrs. Osho Adedoyin, stated that almost all the production and wholesale companies had “responded to the forex difficulty,” inflation and COVID-19 pandemic with the price change.

“Notice of price changes keep coming in daily. For instance, a brand of omeprazole for ulcer treatment increased by 100 percent; ciprofloxacin (antibiotics) has spiralled by almost 50 percent from N380 to N580; glucometer for blood sugar test spiked from N6,800 to N8,950; while blood pressure monitors have increased from N24,850 to N28,850.

“Most of the daily medications for hypertension, diabetes as well as malaria drugs and antibiotics increased by between 20 to 30 percent,” she said.

The National Chairman of the Association of Community Pharmacists of Nigeria, Dr. Samuel Adekola, spoke in the same vein, noting that the cost of drugs has gone up by more than 20 to 30 per cent.

Adekola told our correspondent that pharmaceutical importers had been having difficulty sourcing foreign exchange and other import logistics.

“There is little or nothing anybody can do about it, particularly on products that are already established or matured in the market. It has affected antimalarial and other drugs across the line.

“For instance, Lonart antimalarial which we usually got for as low as N800 per pack some months ago is now N1,000 at distributor’s price,” he said.

Pharmacies have no price regulation

On why there was no price regulation among pharmacy owners as PUNCH Healthwise investigations revealed, Adekola explained that price control could only be done with government backing.

The ACPN leader stated that for any control price to be achievable, the government must be involved.

“The whole system is not streamlined; the process of getting products has been distorted.

“Secondly, it also depends on who is getting it. For instance, you cannot expect somebody who is coming all the way from the outskirts of Lagos or in other states to buy the same products and sell them at the same rate.

“The price mechanism is not even something to think about because of the gamut of problems involved. The only way it could be tackled is when the Federal Government is determined and prepared to solve these problems,” he said.

Reduced profit margin

Adekola lamented that the increase in prices of pharmaceuticals also had a negative impact on pharmacies, profit-wise.

“When prices of drugs shoot up like that, it also affects the profitability of individual pharmacy significantly. It takes only a strong business to survive it.

“Presently, about 20 pharmacies have been forced to close business over the negative impact of COVID-19, high inflation rate and economic recession,” he said.

Forex, port congestion fuelling new price regime

Meanwhile, the National Chairman, Association for Pharmaceutical Importers of Nigeria, Nnamdi Obi, said the issue of price increase might not go away soon.

He explained that pharmaceutical importers are affected, just like every other enterprise.

“It is unfortunate that we found ourselves in this mess where a dollar exchanges for almost N500 and the CBN rate of N375.

“Yet, how many Nigerians can even access the CBN exchange rate? That’s why you see many people sourcing their funds through the parallel market to ensure they remain afloat in business.

“But it looks to me like things are going to get worse because, for now, the biggest shipping line, Maersk Line, is no longer coming to Nigeria. It has suspended services to Nigeria for the meantime,” he said.

He explained that vessels now charge over $8,000 (N3,049,600) per 40 feet container coming to freight.

He explained that the freight cost used to be a little over $3,000 (N1,143,600) in the past, and that virtually every shipping line have increased their service charges.

“What this means is that the prices of all pharmaceutical imports, whether finished products or raw materials brought to Nigeria, would hit the roof by next year. The shipping cost has gone up by well over 350 per cent. Sincerely, I don’t even know where we are heading to. I really don’t see any end in sight.

“Prices of drugs and medical supplies are going to increase. There is no doubt about that. It is a consequence of several factors. As of today, over 46 vessels are hovering around on Nigerian sea because of port congestion. It may surprise you to know that importers are also made to pay demurrage for the return of empty containers to the port after delivery of the consignment.

“All these containers you see lining up the major roads or heading to terminals, the importers are made to pay for them. For instance, to move a consignment from Apapa port to any part of Lagos is N1m. And if the container is coming from Tin Can terminal, it is N1.2m,” he said.

The APIN chairman lamented that there was a general discontent among Nigerian importers and entrepreneurs and wondered if the country would ever come out of the economic quagmire.

He emphasised that the pharmaceutical industry cannot be separated from other ailing sectors that have also taken some hits.

“We are not a serious nation at all. Did you know that we have well over 40 agencies at the Lagos port all doing the same thing? This duplication of functions is what is causing port congestion.

“That’s why vessels are still hanging out there on the high sea. These ships know that they cannot return the consignments back to source, hence the need to increase the freight.

“We have too many agencies disrupting what should have otherwise been a smooth process. There are officials from the Nigerian Navy, Nigerian Air Force, Nigerian Police, Nigerian Customs, SON, NDLEA, NAFDAC and all manner of agencies you can think of.

“Let’s do the calculation. When you add the cost of bringing in a 40-feet container from Europe for $8,000 (N3,049,600) with N1.2m cost of delivery, you already have N4,249,600.

“Now, how do you expect an importer of goods to pay this huge amount on shipping logistics after procurement without increasing the prices? Let’s be sincere,” he submitted.

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