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A Nationwide Survey of Parkinson's Disease Medicines Availability and Affordability in Nigeria
Author(s) -
Okubadejo Njideka U.,
Ojo Oluwadamilola O.,
Wahab Kolawole W.,
Abubakar Sani A.,
Obiabo Olugbo Y.,
Salawu Fatai K.,
Nwazor Ernest O.,
Agabi Osigwe P.,
Oshinaike Olajumoke O.
Publication year - 2019
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12682
Subject(s) - medicine , pharmacy , levodopa , parkinson's disease , pharmacology , disease , family medicine
Background and Objectives Limited access to medicines can impact negatively on outcomes in people with Parkinson's disease (PD). The study objectives were to determine the availability and assess the affordability of antiparkinsonian medications in pharmacies across Nigeria. Methods This was a cross‐sectional nationwide study utilizing the World Health Organization/Health Action Initiative methodology. Strategically selected private‐ and public‐sector pharmacies in the six geopolitical zones of Nigeria were surveyed for availability of medicines for management of early and advanced PD. The nine categories were: levodopa/peripheral decarboxylase inhibitors, dopamine receptor agonists, monoamine oxidase type B inhibitors, anticholinergics, catechol‐o‐methyl transferase inhibitors, atypical antipsychotics, antidepressants, antidementia drugs, and miscellaneous (e.g., drugs for orthostatism, urinary incontinence, and sleep disturbance). Unaffordability was defined as paying more than 1 days' wages (>N600 or > US$1.67) for a standard 30‐day supply. Results One hundred twenty‐three pharmacies were surveyed (62 private [50.4%] and 61 public sector [49.6%]; range of 15–25 pharmacies in each geopolitical zone). Private exceeded public‐sector availability across all nine categories of PD medicines ( P < 0.05). The most available medicines were dopamine receptor agonists (68.3%; predominantly ergot‐derived bromocriptine), anticholinergics (56.1%; mainly trihexyphenidyl), and l ‐dopa formulations (48%; mainly 250/25 l ‐dopa/carbidopa). Only two medications (trihexyphenidyl tablets and biperiden injection) were affordable. The average number of day's minimum wages for a 30‐day supply of PD medicines was 41.3 days (range, 1–371). Conclusions PD medicines access is limited in Nigeria. Strategies, including engagement of stakeholders to consider interventions to improve and prioritize PD medicines access, are urgently warranted.