Path of Science: International Electronic Scientific Journal

Hypertension and diabetes mellitus are major non-communicable diseases associated with significant morbidity, mortality, and long-term economic burden, particularly in low- and middle-income countries. Medication costs remain a critical determinant of access, adherence, and therapeutic outcomes. This study assessed the cost variation, availability, and affordability of commonly prescribed antihypertensive and antidiabetic medicines in selected states of North-Central Nigeria, comparing generic, branded, and international reference prices.

A cross-sectional descriptive study was conducted across 40 registered pharmacy premises using a pretested, structured questionnaire and a price-collection tool. Researchers analysed medicine prices for generic and branded products and derived international reference prices from the International Medical Products Price Guide and National Health Insurance Scheme price lists. They analysed the data using IBM SPSS version 20 and presented the results as means, standard deviations, and comparative ratios.

Antihypertensive medicines were more widely available than antidiabetic medicines across pharmacy premises (p < 0.05). Branded antihypertensive medicines consistently had higher unit prices than their generic equivalents, while several international reference prices exceeded both local generic and branded prices, reflecting exchange rate volatility. For oral antidiabetic medicines, price differences between branded and generic products were minimal; however, branded insulin preparations were substantially more expensive than generic and international reference prices.

Significant cost variation exists among antihypertensive and antidiabetic medicines in North-Central Nigeria. While generic antihypertensives offer more affordable options, high prices of branded products—particularly insulin—pose challenges to sustained access and adherence. Policy measures promoting generic substitution, price regulation, and local pharmaceutical manufacturing are essential to improve affordability and health outcomes.

1. Kumar, V., Agarwal, S., Saboo, B., & Makkar, B. (2022). RSSDI Guidelines for the management of hypertension in patients with diabetes mellitus. International Journal of Diabetes in Developing Countries, 42(4), 576–605. doi: 10.1007/s13410-022-01143-7

2. Song, Z., Kennedy, P. G., Liew, F. J., & Schilling, J. S. (2016). Fungal endophytes as priority colonisers initiating wood decomposition. Functional Ecology, 31(2), 407–418. doi: 10.1111/1365-2435.12735

3. Venkateswaramurthy, N., Krishnaveni, K., Freeda, M., R., & Kumar, S. R. (2016). Assessment of Potential Drug–Drug Interaction in Stroke Patients. International Journal of Pharmacy and Pharmaceutical Sciences, 8(12), 221. doi: 10.22159/ijpps.2016v8i12.13878

4. Chow, C. K. (2013). Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in High-, Middle-, and Low-Income countries. JAMA, 310(9), 959. doi: 10.1001/jama.2013.184182

5. Ibrahim, M. M. (2018). Hypertension in developing countries: a major challenge for the future. Current Hypertension Reports, 20(5). doi: 10.1007/s11906-018-0839-1

6. Correa‐Gallegos, D., Jiang, D., & Rinkevich, Y. (2021). Fibroblasts as confederates of the immune system. Immunological Reviews, 302(1), 147–162. doi: 10.1111/imr.12972

7. Naseri, K., Aliashrafzadeh, H., Otadi, M., Ebrahimzadeh, F., Badfar, H., & Alipourfard, I. (2022). Human Responses in Public Health emergencies for Infectious disease control: An Overview of controlled topologies for biomedical applications. Contrast Media & Molecular Imaging, (1), 6324462. doi: 10.1155/2022/6324462

8. Balu, S., & Thomasiii, J. (2006). Incremental expenditure of treating hypertension in the United States. American Journal of Hypertension, 19(8), 810–816. doi: 10.1016/j.amjhyper.2005.12.013

9. Trogdon, J. G., Finkelstein, E. A., Feagan, C. W., & Cohen, J. W. (2011). State‐ and Payer‐Specific estimates of annual medical expenditures attributable to obesity. Obesity, 20(1), 214–220. doi: 10.1038/oby.2011.169

10. Wang, J., Shen, J., Wu, Y., Tu, C., Soininen, J., Stegen, J. C., He, J., Liu, X., Zhang, L., & Zhang, E. (2013). Phylogenetic beta diversity in bacterial assemblages across ecosystems: deterministic versus stochastic processes. The ISME Journal, 7(7), 1310–1321. doi: 10.1038/ismej.2013.30

11. Zhang, Q., Wu, X., Fan, Y., Jiang, P., Zhao, Y., Yang, Y., Han, S., Xu, B., Chen, B., Han, J., Sun, M., Zhao, G., Xiao, Z., Hu, Y., & Dai, J. (2021). Single‐cell analysis reveals dynamic changes of neural cells in the developing human spinal cord. EMBO Reports, 22(11), e52728. doi: 10.15252/embr.202152728

12. Feingold, K. R. (2000). Dyslipidemia in Patients with Diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK305900/

13. Ogaji, J. I., & Alawode, A. O. (2014). Capacity utilisation in the pharmaceutical industry in Nigeria. Pharmaceutical Regulatory Affairs Open Access, 3(2). doi: 10.4172/2167-7689.1000121

14. Shahu, A., Herrin, J., Dhruva, S. S., Desai, N. R., Davis, B. R., Krumholz, H. M., & Spatz, E. S. (2019). Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT. Journal of the American Heart Association, 8(15), e012277. doi: 10.1161/jaha.119.012277

15. Mandal, M., Mandal, S., & Das, S. (2007). A critical study on availability and price variation between different brands: Impact on access to medicines. Indian Journal of Pharmaceutical Sciences, 69(1), 160. doi: 10.4103/0250-474x.32139

16. Lee, K. S., Kassab, Y. W., Taha, N. A., & Zainal, Z. A. (2020). Factors impacting pharmaceutical prices and affordability: Narrative review. Pharmacy, 9(1), 1. doi: 10.3390/pharmacy9010001

17. Lotfizadeh, A., Palafox, B., Takallou, A., Balabanova, D., McKee, M., & Murphy, A. (2022). Factors associated with the availability and affordability of essential cardiovascular disease medicines in low- and middle-income countries: A systematic review. PLOS Global Public Health, 2(3), e0000072. doi: 10.1371/journal.pgph.0000072

18. Cooper-DeHoff, R. M., & Elliott, W. J. (2013). Generic drugs for hypertension: Are they really equivalent? Current Hypertension Reports, 15(4), 340–345. doi: 10.1007/s11906-013-0353-4

19. Kotwani, A., Singal, G., & Nanda, A. (2011). A comparative evaluation of the price and quality of some branded versus generic medicines of the same manufacturer in India. Indian Journal of Pharmacology, 43(2), 131. doi: 10.4103/0253-7613.77344

20. Beran, D., Hirsch, I. B., & Yudkin, J. S. (2018). Why are we failing to address insulin access? a national and global perspective. Diabetes Care, 41(6), 1125–1131. doi: 10.2337/dc17-2123

21. World Health Organisation. (2021). The WHO Global Diabetes Compact. Retrieved from https://www.who.int/initiatives/the-who-global-diabetes-compact

22. Fatokun, O. (2020). Fostering local production of essential medicines in Nigeria. Bulletin of the World Health Organisation, 98(7), 507–508. doi: 10.2471/blt.19.249508

23. Woldie, G. A., & Siddig, K. (2019). Macroeconomic and distributional impacts of exchange rate devaluation in Ethiopia: A computable general equilibrium approach. Heliyon, 5(12), e02984. doi: 10.1016/j.heliyon.2019.e02984