Nationwide survey of the availability and affordability of asthma and COPD medicines in Nigeria

Abstract

objective(s) To determine the availability and affordability of asthma and COPD medicines across Nigeria. methods This was a cross-sectional survey conducted in 128 pharmacies (51 in public sector hospitals, 51 private sector community pharmacies and 26 charity or big private hospitals) across the six geopolitical zones of Nigeria using the WHO/Health Action Initiative method. The proportion of pharmacies where medicines were available, the median retail prices of originator and generics and affordability were analysed. A medicine was available if found in ≥ 80% of surveyed pharmacies. Unaffordability was defined as paying> 1 day's wage (> US$1.68) for a standard 30-day supply of the medicine. results The available medicines were oral corticosteroids and oral salbutamol which are not on the WHO Essential Medicine List. Medicines were found more frequently in private than public pharmacies and in the southern than northern zones. Inhalable corticosteroid was not available at any public pharmacy nationwide. None of the EML medicines were affordable. The least number of days' wages for a 30-day supply of any inhalable corticosteroid-containing medication was 3.5 days. conclusions There are very limited availability and affordability of recommended asthma and COPD medicines across Nigeria with disparity across regions. Medicines that were available and affordable are not recommended and are harmful for long-term use. This underpins the need for engagement of all stakeholders for the review of existing policies regarding access to asthma and COPD medicines to improve availability and affordability. keywords medicine, availability, affordability, asthma, chronic obstructive pulmonary disease, Nigeria Sustainable Development Goals (SDGs): SDG 3 (good health and well-being), SDG 17 (partnerships for the goals)

Implementing essential diagnostics-learning from essential medicines: A scoping review

“…The barriers for the implementation of the EML are similar to the EDL barriers reported above, and the main barriers were poor financial access 39,48,78,79,83,[86][87][88][89]104,110,136,[140][141][142][143][144][145][146][147][148][149] , poor geographical access 36,65,74,82,104,143,146,150 and health facility access 73,74,106,[150][151][152] .…”

“…The enabler themes for the EDL implementation are opposite to the EDL barriers mentioned above 113,114,115, 103. The EML enablers are opposite of the EML barriers reported above, and mainly included availability of essential medicines in facilities 34,37,48,[57][58][59]66,87,92,108, , and adequate capacity of facilities to provide care 34,138 .…”

“…The barriers related to the relationship with norms and standards for the EDL implementation included poor availability of diagnosis and management guidelines, noting the unavailability of diabetes guidelines in any surveyed clinics 165 . Other barriers unique to the EML included incompliance to guidelines 50,53,131,149,153,166,168,169 , incompliance to national EMLs 48,68,79,132,145,170 , lack of national EMLs in facilities 128,171 , disconnect between guidelines on treatment protocols 47,75 , disconnect between policy, guidelines and practice 46,167 , and lack of standard operating procedures 135 .…”

Factors associated with uncontrolled asthma among Sudanese adult patients

“…In Nigeria, as of many LMICs, health-service factors such as poor awareness and knowledge among physicians regarding asthma guidelines, suboptimal infrastructure and diagnostic facilities, and non-availability and high cost of asthma medications were associated with poor asthma control. [10,27] In fact, we found that the use of diagnostic tools for asthma diagnosis and management was very low since only 15.7% of patients had undergone peak flow meter measurement and only 12.4% were diagnosed for asthma using spirometry. Lung function assessment is recommended in asthma care and underuse of these tools has been associated with undertreatment of asthma and poor asthma control.…”

Achieving asthma control in low-middle-income countries: Why it is important?

“…More so, limited access to essential asthma medicines, due to non-availability and high cost, contributes to poor medication adherence. [8][9][10] In this issue of the Journal of the Pan African Thoracic Society, Osman et al reported that nearly 85% of patients attending asthma clinics in Sudan were poorly controlled with patient, physician, health system, and social factors contributing to poor asthma control. [5] This figure is comparable to what was reported in AIRNIG and another study.…”