Kenyans could be buying expensive medicines to treat some chronic diseases, yet cheaper alternatives are available at less than Sh100 for a monthly dose.
This is one conclusion by researchers who established that a decision by drug manufacturer Novartis to drastically reduce the prices of 14 key medicines to less than Sh100 for each monthly dose has failed to make a major impact.
The uptake has been slow and many Kenyans still buy more expensive alternatives at higher prices from private chemists.
"The results highlight the poor uptake of affordably priced medications, despite efforts to ensure availability," says Dr Imran Manji, in a commentary accompanying the Lancet article, co-authored with Sonak Pastakia of the Purdue University College of Pharmacy in Indiana, USA.
Dr Manji is a principal pharmacist at Moi Teaching and Referral Hospital, Eldoret.
The Novartis Access programme was launched in Kenya in 2016, targeting noncommunicable diseases such as cardiovascular diseases, type 2 diabetes and respiratory illnesses.
It was expected to improve access, and dramatically increase public demand for cheap medicines. The discounted medicines are only available in public and mission health facilities.
The researches analysed 127 health facilities in eight counties and 571 patients over 15 months. Their results, published recently in the Lancet Journal, show the programme significantly increased the uptake of only two medications (Amlodipine and Metformin).
There was little awareness of cheap drugs, even in health facilities, and many patients continued to buy more expensive medicines from private chemists.
Dr Manji explains that many patients are not used to regularly buying a month's worth of drugs; many buy only 1–2 weeks' worth because of insufficient cash on hand.
"This type of flexibility was not possible in Novartis's $1 per month model and might have further reduced uptake," he says.
Manji also says many targeted patients only access services from rural dispensaries, which are not equipped to treat NCDs. He notes there are also some medicines that cost less than the Sh100 for a monthly dose, although these may not be Novartis products.
"Although US$1 a month represents a discount for medications such as amlodipine, other even cheaper alternatives like hydrochlorothiazide typically cost less than $0·30 per month and might be preferred by patients and their providers as a first-line option," he says.
Other researchers say 15 months is too early for such a project to have made a significant impact. The project's medicines are procured through the Mission for Essential Drugs and Supplies, while most counties now procure through the Kenya Medical Supplies Authority.
"It is our hope that the evidence generated by this study will inform Novartis' efforts to improve their program going forward," says study lead author Peter Rockers from Boston University.
(Edited by F'Orieny)
