Runaway medicine prices making Kenyans sicker
A medic displays cancer drugs at a Nyeri hospital on September 26, 2019.Given the sharp rise in the cost of imported medicines, insurers are now urging patients to take cheaper generic drugs to avoid exhausting their covers.
The cost of healthcare in Kenya has shot up sharply as the impact of a heavily weakened shilling raised the overall prices of imported medicines, surgical supplies, and medical equipment by up to an average of 15 per cent, pilling strain on the medical bills of millions of households already scorched by a high-cost living.
The shilling has slipped 18.67 per cent against the dollar since January 2022 alone— significantly affecting the cost of imported items, including drugs. The shilling exchanged at 134.35 units against the dollar on Friday compared to 113.32 on January 3, 2022, meaning importers are spending more on items.
A spot check by Nation showed that prices of key imported medical supplies including lifesaving cancer, hypertension, and kidney ailment medicines have shot up significantly due to the weakened shilling even as vendors continued to send notices to hospitals informing them of revised pricing.
“Most of the medical supplies be it medicines, surgical supplies, or medical equipment are imported and due to currency devaluation and supply chain challenges a number of vendors have sent us notices and revised prices. On average the costs have increased by 12-15 per cent” Mr Rashid Khalani, the CEO of Aga Khan University Hospital, told Nation.
Mr George Onyango, a General Manager at pharmaceutical firm GSK, said the weakening of the shilling has also affected local manufacturers because some of the ingredients used are imported.
“Most of our products are still imported and despite having some local ones, they still require an active pharmaceutical ingredient (API) which we have to get from outside the country. Sometimes, we end up struggling to get products which leads to drug shortages,” he said.
Enquiries among drug suppliers and stockists revealed a gloom with prices of drugs for common ailments going through the roof.
For example, the wholesale price of Lasatan-H, which is a common drug for hypertension and kidney failure patients, has shot up by up to Sh60 a tablet from Sh10 in October last year—dealing a blow to thousands who take it as a lifelong prescription.
This means a patient now requires Sh21,900 annually for a standard dose of a tablet of Lasatan-H per day, up from Sh3,650 previously. For patients with acute conditions, Lasatan–H is prescribed twice a day meaning that they would now require Sh43,800 for the lifelong medication, up from Sh7,300.
The price of Tamoxifen—a common drug used to treat early breast cancer in women who have already been treated with surgery or chemotherapy—has shot up to Sh1,550 a packet that lasts a month, from Sh450 previously. This means a year’s prescription of Tamoxifen now costs a patient some Sh18,600 compared to Sh5,400 previously. Doctors recommend that patients take Tamoxifen for at least five years to avoid the risks of recurrence of breast cancer.
The wholesale price of Gaviscon—a common medication prescribed to manage heartburn, stomach acidity, and indigestion—has increased to an average of Sh550 from Sh317 previously. Similarly, the price of Tacrolimus—a commonly prescribed anti-rejection drug for kidney transplant patients—has shot up to an average of Sh62, rising from Sh28 previously. The cost of insulin—a hormonal drug used to control blood sugar among diabetes patients—has risen to an average of Sh800 compared to Sh500 previously.
The price of test kits for blood sugar levels—commonly known as glucose strips—has also risen from Sh500 to Sh700.
The rise in the prices of medical consumables—which make up to 30 per cent of a patient’s care—is already reflected in the overall cost of healthcare. “We have seen a noticeable increase in healthcare costs over the past year. According to our data, medical inflation has risen by approximately 10 per cent, which is significantly higher than the general inflation rate. This has put a strain on patients’ medical covers, with many struggling to keep up with the rising costs, putting a strain on patients’ medical covers” Ms Njeri Jomo, the chief executive officer of Jubilee Health Insurance, told Nation.
“The effects of rising healthcare costs are not limited to patients alone. Insurers are also feeling the impact, and we have had to increase premiums to keep up with the rising costs,” she added.
Given the sharp rise in the cost of imported medicines, insurers are now urging patients to take cheaper generic drugs to avoid exhausting their covers.
“Patients can make significant savings on their healthcare spend by opting for generic medications rather than brand drugs. A generic drug is a pharmaceutical drug that contains the same chemical substance as a drug that was originally protected by chemical patents. It also has the same effect on the body, safety, and quality as the brand drug,” Ms Jomo said.
It is estimated that the use of branded stands at about 70 per cent in Kenya compared to Tanzania’s 37 per cent and Uganda’s 33 per cent.
“This is a huge contrast from developed countries with estimates showing that generics account for 90 per cent of prescriptions in the US. The high use of branded drugs in Kenya means that half of the medical claims go into drugs at the expense of treating various ailments. On average, generic drugs cost 30 to 80 per cent less than their brand-name counterparts. Patients must therefore always request for generics to optimise their resources,” Ms Jomo said.
“In addition, patients can manage their medical expenses by seeking the most cost-effective treatment options such as telemedicine. For instance, Jubilee Health Insurance has partnered with various companies such as Sasa Doctor, Livia Health, and One- Stop pharmacy to boost access to medical services and ensure patients access quality and affordable medical care,” she added.
The rise in the cost of healthcare comes as a major blow for households—many of which have to rely on out-of-pocket (OOP) expenditure when seeking medical services.
The Kenya Demographic and Health Survey 2022 report released by the KNBS earlier this year shows that an estimated 95 per cent of poor men and women in Kenya don’t have health insurance—illustrating the magnitude of the financial pain whenever they fall ill.
A separate study by the World Bank shows that, despite the State’s efforts to improve financial protection from healthcare use, OOP expenditures continue to make up a significant proportion of the total health spending and drive about one million Kenyans into poverty each year.
The multilateral lender proposes a bigger role for the National Hospital Insurance Fund (NHIF) in Kenya’s healthcare financing transition to help address the OOP health financing challenges.
For instance, the multilateral lender has urged Kenya to enroll more private hospitals under the NHIF and cover medicines to curb OOP expenditures. “Although Kenya has removed user fees for public facilities, public hospitals still operate under the cost-sharing policy, and all levels of private healthcare facilities are still paid for through OOP payments,” the World Bank said in a policy paper.
“To further reduce OOP expenditures in Kenya, it is critical to address the role of the private sector, such as through the inclusion of more health facilities under the NHIF arrangement and coverage of pharmaceuticals,” it added.
The elderly and people affected by chronic conditions are the worst hit by the OOP expenditure that has continued to rise over the years despite increased budgets by the State for healthcare. “This is a concerning trend, as paying at the point of care for services or drugs creates financial barriers and exposes households to catastrophic health spending,” the World Bank said.
Dr Mbau Gitau, who works at Allium Pharmacy in Nairobi’s Eastlands area, urged the government to lower taxes on medicines and allow for purchases through NHIF.
“It is time we promote local manufacturing by ensuring that we produce 100 per cent of the essentials medicines list. The government should also allow patients to buy drugs using the national hospital insurance fund (NHIF),” he said.
