Behind the Paper: The High Financial Cost of Taking "Too Many" Medicines in Nigeria
Published in Pharmacy & Pharmacology, Public Health, and Economics
When a patient walks into a clinic, receiving a prescription is supposed to be the first step toward healing. But what happens when that single visit ends with a prescription for five, eight, or more than ten different drugs at once? In low- and middle-income countries like Nigeria, where health insurance covers only a fraction of the population and healthcare is paid almost entirely out-of-pocket, taking multiple medications can transform a routine health check into a devastating financial crisis.
Our team set out to investigate this precise dilemma at Offa Specialist Hospital in Kwara State, Nigeria. We wanted to know: how widespread is polypharmacy in a secondary healthcare setting, and what does it actually cost the patients on the receiving end?
The Dual Realities: Prescription Records vs. Daily Survival
To get the full story, we combined two research perspectives: a retrospective review of 2,000 prescriptions and a prospective survey of 100 patients and 50 healthcare professionals.
The Scale of the Problem: Over 37% of reviewed prescriptions met the criteria for polypharmacy (5 or more medications), with 12% involving "excessive polypharmacy" of 10 or more drugs. The average prescription contained 4.8 drugs.
The Cost Barrier: Among surveyed patients, 37% spent over ₦20,000 per month on drugs, with an average expenditure of ₦18,600. For 79% of patients, these costs represented a major financial burden.
Dangerous Compromises: High costs forced 66% of patients to skip doses, reduce medication intake, or delay purchases. Additionally, 78% depended on financial help from family and friends just to pay for their prescriptions.
Bridging the Gap: What Healthcare Providers See
The study revealed an overwhelming consensus among clinicians. Every single healthcare provider surveyed (100%) agreed that polypharmacy drives up treatment costs, and 84% noted that they frequently care for patients taking five or more medications. Crucially, 72% of providers recognized that some prescribed medications could be safely reduced through structured medication reviews.
Our findings underline an urgent need to rethink prescribing habits. Addressing polypharmacy isn't just a clinical goal to avoid adverse drug interactions—it is an economic lifeline for patients navigating out-of-pocket healthcare. Integrating routine medication reviews, strengthening clinical pharmacology collaboration, and expanding universal health coverage are critical steps to ensuring that treating an illness doesn't cause a financial crisis.
For Full Details visit, https://rdcu.be/fCwW2
Health ROI Architect, BioPolicy Strategist, Pharma Economic Futurist and Therapeutics Pioneer
Follow the Topic
-
BMC Health Services Research
An open access, peer-reviewed journal that considers articles on all aspects of health services research, focusing on digital health, governance, policy, system quality and safety, delivery and access, financing and economics, implementing reform, and the workforce.
Related Collections
With Collections, you can get published faster and increase your visibility.
Promise, perception, and practice: workforce capability and technology integration in healthcare
BMC Health Services Research invites submissions on how health workforce professionals interact with, adopt, and shape the implementation of digital health technologies, artificial intelligence (AI), and modern electronic health record (EHR) systems. Whether these technologies deliver value depends not only on the technical specifications but also on how they are implemented, governed, evaluated, and continuously refined within the organizations and workforces in which they operate. Health systems worldwide are committing to technology portfolios at a pace that consistently outstrips the evidence base needed to guide them, leaving technology program leaders without the knowledge they need to make sound investment and deployment decisions. We particularly welcome work that bridges implementation science, clinical informatics, and health services research to generate evidence actionable for health systems managing growing technology portfolios.
Topics of interest include, but are not limited to:
- Adoption and sustained use: digital literacy, training, and effective human–AI collaboration
- Front-line feedback as a signal for monitoring and improving technology performance
- Case studies of AI tools (clinical systems, ambient documentation, EHRs, decision support) with focus on long-term value and sustainment
- Governance, evaluation frameworks, and learning health system models for continuous assessment
- Impacts on care quality, clinician well-being, efficiency, and costs, including unintended effects (e.g., workflow disruption, alert fatigue)
- Ethical, equity, and policy considerations, including evolving AI governance
- Innovative measurement using EHR logs, administrative data, and observational methods
- Development of standardized evaluation frameworks applicable across technologies and settings
We welcome submissions across all article types accepted by BMC Health Services Research, including research articles, systematic reviews, study protocols, database and software articles.
All manuscripts submitted to this journal, including those submitted to collections and special issues, are assessed in line with our editorial policies and the journal’s peer review process. Reviewers and editors are required to declare competing interests and can be excluded from the peer review process if a competing interest exists.
Publishing Model: Open Access
Deadline: Jan 29, 2027
Strengthening health system resilience: from emergency preparedness to response and recovery
Health systems worldwide are increasingly facing the dual challenges of rising health demands and the unpredictability of emergencies. Recent and ongoing polycrises—whether the COVID-19 pandemic, sporadic outbreaks of emerging or reemerging diseases, or increasingly frequent emergencies resulting from natural hazards—have highlighted the urgent and compelling need for enhanced health system preparedness and resilience. Effective emergency preparedness involves not only robust planning and response strategies but also the capability to adapt and recover quickly from disruptions. This Collection aims to explore the multifaceted aspects of strengthening health systems to ensure they can effectively prepare for, respond to, and recover from emergencies and maintain continuity of care.
Addressing the resilience of health systems is crucial for safeguarding public health and ensuring that healthcare providers can deliver effective services during crises. Recent advancements have included the integration of technology in health management, improved supply chain logistics, and enhanced workforce training. Furthermore, frameworks for assessing health system resilience have been developed, offering valuable insights into best practices. However, ongoing research is needed to evaluate the effectiveness of these strategies and to implement innovative solutions that can be adapted to various contexts and crises.
Topics for submission but are not limited to:
- Governance, leadership, and policy approaches for resilient health systems
- Frameworks and metrics for assessing and strengthening health system preparedness and resilience
- Financing mechanisms and economic resilience of health systems in emergencies
- Community engagement and locally led strategies in crisis preparedness, response and recovery
- Workforce training, surge capacity, and capability building for emergency response
- Supply chain management and essential resource security during emergencies
- Digital technologies and data-driven innovations for emergency preparedness, response and recovery
- Health system resilience in underserved, vulnerable, or fragile settings
This Collection supports and amplifies research related to SDG 3: Good Health and Well-being.
All manuscripts submitted to this journal, including those submitted to collections and special issues, are assessed in line with our editorial policies and the journal’s peer review process. Reviewers and editors are required to declare competing interests and can be excluded from the peer review process if a competing interest exists.
Publishing Model: Open Access
Deadline: Mar 19, 2027