An essential antibiotic used to treat a range of infectious diseases, including diarrhoea and typhoid, has been found to be most expensive in Kenya compared to other markets, putting it above the reach of many patients who earn about a third of the price of the recommended dose per day.
The survey of 93 countries found that ‘ciprofloxacin’ costs between Sh225 per dose of 14 days for the generic version and Sh4,950 for the patented drug from Bayer Pharmaceuticals.
Universal health access proponents are now calling on the government to ensure fair pricing of medicines like ciprofloxacin that treat a range of common ailments by among other things having the recommended price printed on the packaging.
Health system
“Most countries have a policy on promoting the purchase and prescription of generic medicines in the public health system [and] there is no reason why a similar policy should not be applied in Kenya,” said Gichinga Ndirangu, the regional coordinator of Health Action International-Africa, the non profit group that conducted the survey.
Although the recommended price of the drug in Kenya is Sh3,375, it sells for as much as Sh4,950 in some chemists. That is about four times the Sh1,275 per dose obtaining in South East Asia, two times the Sh2,700 in Eastern Mediterranean and; one and half times the Sh3,300 in Europe.
Ciprofloxacin treats diseases like urinary tract infections, lower respiratory tract infections, skin structure infections, bone and joint infections, infectious diarrhoea, typhoid fever, sexually transmitted diseases and opportunistic infections in people living with HIV.
Health Action International conducted a survey in 93 countries worldwide and carried a spot check last November in Nairobi to ascertain the full price which a patient would pay for ciprofloxacin.
HAI recommends that essential medicines must be provided for free in public health facilities and systems to ensure transparency in pricing of medicines be put in place.
While Kenya National Drug Policy already encourages prescription of generic drugs by requiring that all prescriptions must be in their generic names, the public has not been adequately sensitised on this leaving pharmacists to profit from the ignorance.
“The governmment should control the price of medicines. The law should require the price of medicines to be printed on the package,” said Kamamia Murichu, the chairman of Kenya Pharmaceuticals Distributors Association.
Emma Wanyonyi of the Consumer Information Network said the survey reveals the why the poor Kenyans earning less than Sh74 a day cannot afford to access ciprofloxacin. On Monday, pharmaceutical manufacturer GlaxoSmithKline slashed prices of antibiotics Zinnat and Augumentin by 30 per cent and 40 per cent respectively in a bid to move volumes in a market where the low pricing of generics is threatening the appeal of patented drugs.
Perennial stockouts
Although antibiotics are offered at government hospitals at subsidized prices, perennial stockouts have meant patients buying the drug in private outlets.
“Stock-outs in government hospitals forces people to turn to private pharmacies where prices are significantly higher. Many will end up going without treatment or taking a lower dose to contain rather than cure the illness,” said Mr Ndirangu.
The cost of medicines in Kenya directly affects the purchasing power of households because most people pay for medical services out of pocket. It means the cost of medicines compete with the household income used to buy food, education and transport.
The most recent data from the Ministry of Health indicates that out-of-pocket expenditure accounts for 53 per cent of the total cost of medical services in Kenya with the remainder being Government, community insurance including harambees, private prepaid health plans and non-profit institutions.
Purchase of antibiotics constitutes over 70 per cent of the average Sh1,500 pocket medical spend by Kenyans in a year driven by community-based respiratory tract infections that have a high occurrence in Kenya.
The cost of medicine is a life or death issue in Kenya where poverty afflicts 60 per cent of the population.
Research by a group of professionals responsible for advising the government on universal health care showed the abject poor make the highest number of hospital visits, a total of 16 every year, but they use the lowest amount of money, Sh1,637 every year to pay for their health care services.
The rich make the lowest number of hospital visits averaging 9.6 and use Sh2,704 on average per visit.
