DOI: https://njcpt.com.ng/101.1.2.28
Abstract
Background: Generic medicines have become the mainstay in low and middle-income countries like Nigeria. The cost of branded pharmaceutical products has necessitated the policy for their usage in public health facilities and all health facilities where the National Health Insurance Scheme policy (NHIS) is applied.
Objective: The study accessed the availability and affordability of generic medicines used to manage hypertension, diabetes and psychosis in Jos and its environs in Nigeria.
Methods: A descriptive, cross-sectional study was done using the WHO/HAI methodology 2008. This was used through an adopted questionnaire to measure the prices of selected Branded and generic incarnates of essential medicines in public and private pharmacies within a particular distance of one hour and three hours drive from the reference hospital (Jos University Teaching Hospital (JUTH) Jos) in a day. The mean prices of the lowest generic and branded were also noted in the principal health facilities and at least five retailed pharmacies nearest them. Data Analysis was done using the IBM SPSS version 20 software to calculate prices of generic and branded antihypertensive and antidiabetic baskets of essential medicines.
Results: It was observed that 68% of branded products were prescribed more in private health facilities, lisinopril, amlodipine and frusemide among the antihypertensive while branded metformin (82%), glimepiride (27%) and glibenclamide (9%) were the most prescribed antidiabetics. The following antihypertensives were found available in private health facilities according to WHO/HAI 2008 (moduretic, methyldopa, vasoprin, propranolol and nifedipine), while (moduretic, methyldopa, vasoprin, amlodipine, frusemide, lisinopril and captopril) where available in public health facilities. Branded insulin, metformin 500mg, pioglitazone 15mg, repaglinide 1mg and sitagliptin 25mg those prices were higher than generic and international reference prices. For the antihypertensives, most generics except Olmesartan 5mg, Hydralazine 20mg, ramipril 5mg, timolol 0.25%, torsemide 5mg and Verapamil 100mg were higher than the international reference prices. For the antipsychotics, most of the international reference price products were higher than their generics and branded; however, carbamazepine 200mg was exceptionally higher (branded).
Conclusion: Access to essential medicines in developing economy like Nigeria are mostly affected by branded products with trade-related intellectual property rights. Generic incarnates of such medicines in the above study showed that branded products were not cost-effective compared to their generic versions in treating hypertension, diabetics and psychosis. Branded products were mostly used in private health facilities, explaining the incremental cost compared to the public health facilities.
Keywords: Access to medicines, generic, branded, hypertension, diabetes and antipsychotics