Dying to Survive: Patients Abandoned As Drug Prices Skyrocket Despite FG Order

Dying to Survive: Patients Abandoned As Drug Prices Skyrocket Despite FG Order

Despite President Bola Tinubu’s ambitious Executive Order in June 2024—designed to eradicate tariffs, excise duties, and VAT on pharmaceutical machinery and raw materials— Nigerians continue to bear the brunt of skyrocketing medicine prices.

The Promise and Its Silence

The Executive Order, announced by Coordinating Minister of Health and Social Welfare, Muhammad Pate, sought to boost local pharmaceutical manufacturing by removing financial barriers. Exemptions applied to key inputs like Active Pharmaceutical Ingredients (APIs), syringes, diagnostic tools and promotional mechanisms including volume guarantees and streamlined regulatory approvals across agencies such as Customs, NAFDAC, SON, and FIRS.NairametricsMondaqBusinessday NG

The Nigeria Customs Service confirmed the policy took effect in March 2025, granting exemptions to manufacturers with valid Tax Identification Numbers.Businessday NG

But for ordinary Nigerians—especially those battling chronic diseases—the order remains a waiver in name only.

Prices Continue to Skyrocket

A May 2025 market survey by The PUNCH reveals devastating increases across essential meds:

• Insulin: +29%, from ₦14,000 → ₦18,000

• Glucometer: +41%, ₦20,500 → ₦29,000

• Metformin: +30%, ₦500 → ₦650

• Amlodipine: +33%, ₦1,800 → ₦2,400

• Exforge: +83%, ₦32,800 → ₦60,000

Antimalarial treatments nearly doubled:

• Coartem: +124%, ₦3,800 → ₦8,500

• Artesunate injection: +56%, ₦1,600 → ₦2,500

• Lokmal tablet: +104%, ₦1,200 → ₦2,450

Only Augmentin and Ventolin inhaler fell in price—by 24% and 12%, respectively.Businessday NGPunch

On Paper, Not in Practice

Ambrose Ezeh, President of the Association of Community Pharmacists of Nigeria, bluntly states:

“If the order is not implemented, then the status quo remains… 75% of drugs are imported. FX rates and energy costs remain sky-high.”Punch

Meanwhile, in Abuja, ACPN’s FCT chairman, Olatunji Aloba, confirms partial benefit:

“Prices are dropping only on new imports. Existing circulation maintains old prices. The process is gradual—but competition and implementation enforcement can bring down costs over time.”Punch

Global Lessons: Tariffs Do Not Guarantee Relief

Eliminating tariffs is a proven tool—but not a guaranteed fix.

• Peru’s 2001 abolition of VAT on oncology and antiretroviral meds yielded minimal retail price changes, largely due to supply-chain markups.PMC

• A study at PMC shows Nigeria’s long-term local production strategy remains hindered by import dependence and policy gaps.PMC

• Globally, the Geneva Network found that import tariffs can add up to 80% to drug costs in developing countries. Eliminating them improves access to medicines and APIs.Geneva Network

African and Global Parallels

• In Sri Lanka, a 1970s national pharma policy featuring generics promotion and a centralized state procurement system slashed drug prices by up to two-thirds.Wikipedia

• In the U.S., initiatives like external reference pricing aim to lower prescription prices—though implementation remains uneven.Stanford Medicine

• Under the Affordable Medicines Facility-malaria (AMFm), donor-sponsored co-payments dramatically increased access to antimalarials across several African countries, Nigeria included.Wikipedia

Why Nigeria Still Struggles

Experts identify multiple breakdowns:

1. Policy Slippage: Executive directives not fully implemented or enforced across the supply chain.

2. Import Dependency: Over 75% of medications or ingredients are imported—subject to FX fluctuations, energy costs, and multiple markups.Punch

3. Global Headwinds: Tariff removal doesn’t counterbalance rising costs from inflation or supply bottlenecks.

4. Healthcare Financing Gaps: Out-of-pocket payment remains dominant; low health insurance coverage (only 3% per Reuters) forces patients to bear full cost.

5. Policy Inconsistencies: New levies—e.g., Free-on-Board (FOB) import charges—could nullify gains from zero-tariff policies.

Voices from the Ground

• Prof. Bala Audu (NMA President): Urges full implementation of the order to ease patient burdens.

• Dr. Tope Osundara (Resident Doctors): Highlights insufficient manufacturing capacity and lack of universal health insurance.

• Abdulwahab Dauda (Diabetics Association): While insulin costs soared from ₦4,000 → ₦20,000, benefits of the tariff removal remain unrealized.

A Lagos mother recounts treating malaria—with tests and drugs costing over ₦19,000—compared to under ₦10,000 last year. Many now rely on herbs or borrow from friends to survive.

What Needs to Be Done?

• Enforce the Executive Order across all agencies (Customs, NAFDAC, FIRS, SON) with clear oversight and accountability.

• Remove counterproductive imposts like FOB charges on essential healthcare supplies.

• Accelerate local production of generics and ARV drugs, drawing from Sri Lanka’s model.

• Expand health insurance coverage to reduce out-of-pocket spending—aligned with the Abuja Declaration calling for 15% health budget allocations.

• Use global blueprints like the WHO’s Medicines Patent Pool to improve access to generic modern medicines.Wikipedia

Conclusion

Tinubu’s 2024 Executive Order carried the potential to lower drug costs and boost local pharma capacity. But as prices climb—literally doubling for drugs like Coartem—Nigerians remain stranded in a crisis without relief.

Comprehensive implementation, transparency, boosted local manufacturing, and equitable healthcare financing are critical—the path to ensuring that life-saving medicines are affordable for all.