Patients are groaning over the rising cost of managing diabetes just as media advocates seek federal government (FG) intervention for a zero import tariff on raw materials to encourage local production of drugs for treatment.
The Diabetes Control Media Advocacy Initiative (DICOMA-I) in a statement to mark the 2021 world diabetes day notes that the cost of managing diabetes is seen in the rising cost of drugs and devices and this has continued to be the reason why control is difficult and complications are also on the increase.
According to DICOMA-I in the statement signed by its Trustees Chairperson, Dr. Afoke Isiavwe, and Director of Communication, Mrs. Yinka Shokunbi, “People living with diabetes are among the worst hit by the current inflation in the country as many are unable to take their medications or follow necessary guidelines and routines to keep the disease in check”.
The media advocates also observe, “The Covid-19 Pandemic and the attendant disruption it created, contributed negatively to this, as many breadwinners lost jobs with the economic downturn”.
To buttress the dire situation, Sam Eferaro a senior Journalist and founding member of the media advocacy group notes, “Many of you are aware that I’m diabetic. I was diagnosed over twenty years ago and I’ve been living with it without complications. I’m currently in control, thanks to the Almighty God and my doctor who is also my friend.
“I’m on insulin and some tablets and I don’t miss a dose. Also, I ensure I check my blood sugar level every morning and know what to do, and act promptly if my blood sugar level is high or too low.
“Colleagues, I count myself privileged and extremely lucky because I can afford my medications, monitoring devices, especially the strips, and I also have access to one of Nigeria’s best Endocrinologists. Not everyone with diabetes can be so lucky.
“But all these may change soon (God forbid), going by the rising cost of drugs and dwindling business”, notes Sam.
According to Sam, “Right now, many Nigerians can not afford the rising cost of managing diabetes. Children are even worse off. For their type 1 (T1) diabetes, they must be on insulin which is now beyond the reach of average parents.
A medical doctor to Healthstyleplus that some of her parents now cut costs by reducing the dose of their children’s insulin without medical advice. Some have simply stopped further treatment”, she lamented.
Monthly cost of Managing Diabetes Is an Issue of Concern
Sam’s story draws home the worsening economic situation of the country and how about 5.4 million Nigerians are struggling daily with the rising cost of managing diabetes and surviving the effect of instability in the dollar exchange to Naira which currently stands at between N540 and N565 to $1 in the black market and at about N410/N411 to $1 in the banks. Most of the drugs are brought into the country by multinational pharmaceuticals who source their dollars at fluctuating rates.
According to Sam, “in 2019 I bought insulin at N3,5000 in Ketu. Last year it was around N5,000 and sometimes a bit higher depending on where you are buying. Now it is between N5,5000 and even above N7,000 depending on the location where you are buying.
“Now, it’s a bit difficult for me because, by 2019, a vial could last one month because I took it once daily. However, at a point, my control was poor so the doctor changed my brand and I now have to take it twice-morning and evening. So a vial only lasts between two to three weeks. For some people, a vial will only last two weeks so they would need two vials in a month.
“Now, for the glucometer, the last time I bought one was in 2018 and it was N15,000. What takes money now is the strips, and a packet of a good brand is between N6,500 and N8,000 depending also on where you are making the purchase” lamented Sam.
For many patients on insulin injection, that is not all that sustains them; they still need to take some other medications for high blood pressure (a twin condition).
During an unscheduled visit to the out-patient department of the Lagos University Teaching Hospital (LUTH), our Correspondent on one of the clinic days saw patients who queued in well-arranged seats to see doctors at the Endocrinology clinic.
Some of the patients painfully share their experiennces, compare notes while some also lament their situation.
Esther (other name withheld) has been a patient at the clinic for three years and receiving follow-up treatment for her type 2 diabetes but her 7-year old daughter Ifeoluwa is receiving care for insulin-dependent type 1 diabetes. She told Healthstyleplus, “It is becoming frustrating and depressing to take care of myself and my daughter because of the rising cost of our medications. For my daughter who needs a daily dose of insulin, I now spend at least N6,000 to get her insulin and for my drugs, I spend nothing less than N14,000. You can imagine coughing out almost N20,000 monthly on medication since around May this year. I used to spend about N7,000 for both of us monthly. It is killing me. My salary has not increased in the last four years as a Teacher in a Private School and I am not sure how long I can cope with this condition if the government won’t come to our aid”, lamented Esther.
On the economic implication of managing diabetes, Consultant Endocrinologist Lagos University Teaching Hospital (LUTH) Professor Femi Fasanmade said, “presently on the average, it cost about N10,000 monthly to manage uncomplicated diabetes among my patients. Most of them however also have high cholesterol or high blood pressure which causes the cost to double and if any complications are present, the cost comes even higher still”, said Fasanmade.
He discloses that many children born with diabetes mostly die after a few years of life because many parents are unable to afford the monthly N10,000-15000 naira for insulin and glucose tests for their children.
DICOMA-I warns “the scourge of diabetes is attaining a dangerous dimension in the country as many people can no longer afford their medications and routines to effectively control their condition.
At the Medical and Emergency Ward (EW) of the Lagos State University Teaching Hospital (LASUTH), Healthstyleplus learned that at least three to four of every ten cases brought daily to the emergency room for care are related to the twin of Hypertension and Diabetes complications. At least two to three will end up needing dialysis to stabilize the patient.
“Children living with diabetes (for instance) most of whom must be on regular insulin injection are also badly affected by the situation as many parents either reduce doses or stop administering injections as the cost of insulin, a vital component of diabetes management has risen by over 40% in the last six months. A vial of insulin now costs between N6000 and N12,000 in different parts of the country.”
On the theme of 2021 WDD till 2023: ‘Access to Diabetes Care – If Not Now, When?, DICOMA-I called on FG to introduce a policy of free or subsidized insulin for children and elderly, Implement the existing policies and guidelines for the management of diabetes in Nigeria and to ensure caregivers intensify screening for diabetes and improve awareness and information on the management of the disease.
Fasanmade supported the call for the inclusion of Diabetes under health insurance coverage, free treatment for children, and or, the introduction of subsidy on children’s medications. About 453 m people are estimated to live with diabetes mellitus globally