Asthma patients in Nigeria face escalating costs

Written By Mark

The price of asthma inhalers has more than doubled amid scarcity and additional costs after GlaxoSmithKline exits the Nigerian market in 2023.

When Gloria Movifulwa learned in March that inhaler prices were rising in Nigeria, she didn’t think much about it.

The following week, when she went out to Ibadan to buy a replacement for her old Ventolin inhaler, Gloria, an asthma patient, was shocked to see that it was not available in many pharmacies, and that the only place that had it sold it for 7,500 naira (5 dollars), more than double the 2,800 naira ($1.86) she had paid months earlier.

The jump in prices – which followed GlaxoSmithKline’s departure from Nigeria – came as a shock to the 24-year-old university student, who earns little money by designing clothes. The cascading effects were worse.

Last month, while alone in her dorm room and preoccupied with thoughts of her economic challenges, Gloria began to hyperventilate and struggle to catch her breath.

Her roommate was far away and there was no one to take her to the hospital. All she had was an Aeroline inhaler, which she explained did not work as quickly as the Ventolin she was now struggling to obtain.


“I was just scared because not only was I alone in my room, but I was also without the medication I needed so badly,” she told Al Jazeera, adding that all she could do was pray until she fell asleep, hoping that she would regain her strength when she woke up.

Scarcity of medicines and high prices have stressed asthma patients like Gloria, ending a chain of events that began in May 2023, when Bola Tinubu was elected president.

During his inauguration, Tinubu announced the lifting of fuel subsidies, resulting in an unprecedented increase in petrol prices. This also affected the cost of various goods and services and contributed to the inflation rate rising to more than 27%. The cumulative economic impacts have been severe, especially for vulnerable groups, including students and low-income people.

The difficulties were compounded when the president’s monetary policies pushed the naira to all-time lows against the dollar, leading to a further downward trend as manufacturers struggled to meet production targets.

Amid the economic downturn – which included exchange rate fluctuations, falling revenues and a general deterioration in Nigeria’s investment climate – a large number of companies exited the country, including international pharmaceuticals.

Among the companies leaving is British company GlaxoSmithKline (GSK), which ceased direct business in Nigeria in August 2023 and moved to a model in which its medicines are distributed through a third party.

“We believe that moving to a third-party distribution model, a strategy we have successfully implemented in other markets, will enable more sustainable access to our medicines and vaccines for patients in Nigeria in line with our global strategy,” said Dan Smith, GSK spokesperson. .

But the Nigerian doctors and patients Al Jazeera spoke to said the departure of GlaxoSmithKline contributed to higher prices and increased scarcity of some medicines. As a major supplier of inhalers, including the type Gloria relies on, the company’s exit was not good news for asthma sufferers.

According to the World Health Organization, asthma cannot be cured but common treatments such as the use of inhalers that deliver medicine to the lungs allow patients to live a normal, active life.

The World Health Organization recommends that people with asthma receive appropriate health care, but in developing countries like Nigeria, the situation is complex. This was exacerbated by the exit of companies such as Glasgow SmithKline.

While asthma inhalers were readily available and affordable when the company was around, many now find the medication out of reach. Although alternative options exist, Nigeria relies largely on imported medicines, which means adding high operational costs to the prices borne by consumers.

For the average patient, an inhaler lasts about two months, depending on use, making it an expensive regular cost in a country where the monthly minimum wage is 30,000 naira (about $20).

The most prominent triggers that aggravate asthma

High rates of asthma

Like Gloria, 21-year-old Joseph Peay also suffers from asthma. The library, archives and information science student was diagnosed with the condition in the middle of last year and has since faced rising prices for inhalers.

The first time he bought a Ventolin inhaler, it sold for 3,500 naira ($2.30), but by his next visit to the pharmacy this year, the price had jumped to 7,500 naira ($5).

While his parents are helping him save money to buy inhalers, especially since prices have skyrocketed, Peay said he is now also giving up some basic items, such as groceries, to save extra money to buy medicine, “just to avoid the risks.”

The Nigerian Chest Society says that as of 2019, 15 million Nigerians had asthma, while a nationwide study put the number at 13 million, one of the highest rates in Africa. With less accurate data in Nigeria, because people in rural areas have limited access to quality healthcare or medical tracking, the number could be even higher.

On World Asthma Day in 2023, the President of the Asthma Society of Nigeria, University College Hospital (UCH) Chapter, Professor Olusoji Ige, said over 10 million Nigerians suffer from asthma and about 3-quarters of them are at risk of death due to poor asthma control.

Mrs. Tinubu, President of the University of Ibadan Asthma Club, who prefers to be identified only by name, said there are several factors responsible for asthma. However, she noted that an ill-equipped health care system makes the condition worse over time.

Meanwhile, in Ibadan, some enterprising young Nigerians are trying to help bridge existing health gaps.

Temitope Omosibi, a graduate student in psychology, told Al Jazeera that after an encounter with an asthma patient in 2023, he understood how serious the condition was and wanted to do something to help.

That’s when he launched a campaign at the University of Ibadan to help at least some patients access interventions. The campaign helps provide different types of inhalers to those who need them. Last year, 40 inhalers were distributed, and this year an additional 60 devices were distributed for free, all purchased with money from Omosebi himself.

“The campaign is important because it addresses self-care medications for asthma patients which have become very expensive recently,” Omosebi said. “Our focus is particularly on university students, and on individuals in low socioeconomic communities and hopefully soon, due to the well-known financial challenges.” Between these groups of people.

All inhalers are expensive

Olapitan Odunola, a physician and leader at The Health City, a technology-enabled platform focused on preventive services and education, lamented the scarcity and cost of GSK products since the company exited the Nigerian market.

Especially for asthma patients who rely on GSK inhalers, the new conditions are uncomfortable and even alternative medications are out of reach for most patients, she said.

“All inhalers are generally very expensive,” O’Donola said.

O’Donola added that limited access to these devices may worsen healthcare outcomes for asthma patients. Since the condition is long-term, it was also feared that it could lead to more deaths, especially in cases where someone has an asthma attack.

Finding solutions

In January, the value of medicines imported into Nigeria was estimated at 900 billion naira ($606 million), demonstrating heavy reliance on imported medicines.

In February, the federal government announced a $240 million investment in local pharmaceutical manufacturing.

Nigeria’s Minister of Health and Social Welfare, Professor Muhammad Butt, met representatives and CEOs of pharmaceutical companies in Nigeria last year and said the government was concerned about the high cost of medicines and finding solutions to the crisis.

“The Federal Ministry of Health and Social Welfare is working on policy measures that may address rising drug prices especially for the most vulnerable Nigerians,” he said on social platform X in November.

Until that happens, Gloria said she will continue to use Aeroline, which, at 6,500 naira ($4.30), is slightly cheaper than Ventolin, to help her treat her asthma and manage costs. Although it doesn’t suit her well, she feels the lower price makes a difference and allows her supplies to last longer.

GlaxoSmithKline, GSK, exited the Nigerian market in August 2023 after 51 years in the country (Screengrab/ Reuters)

Swelling of the respiratory tract

Asthma is a disease that causes the respiratory tract to swell and narrow, making it difficult to breathe. It affects adults and children. Genes and environmental factors play a role in its infection, and it requires making lifestyle changes, especially avoiding asthma attack triggers.

An asthma attack occurs as a result of inflammation in the respiratory tract, which leads to swelling of its lining. This leads to narrowing of these airways and thus reducing the air that a person can inhale, and the affected person then faces difficulties in breathing.

Although the mechanism of asthma is not completely clear, it is believed that it is a combination of a role played by heredity and genes and a role played by environmental factors such as dust or animal hair. It is also believed that allergies may play a major role in asthma, as it is noted that many people who have a history of suffering from one of the Allergic diseases such as hay fever and atopic dermatitis “eczema” suffer from asthma.