Prescription and cost consideration at a diabetic clinic in Ibadan, Nigeria: a report

Abstract

Diabetes mellitus is associated with high morbidity and mortality. The high cost of treatment is a major concern to both physicians and patients. This study assessed pattern and cost of drugs prescribed at a diabetic clinic, and identified the commonest reasons militating
against adherence to therapy.The study was a cross-sectional survey. Data was obtained from all prescriptions issued following each days
consultation. Patients were also interviewed using a self-administered questionnaire. Means were compared using t-test and chi2 was used to
test associations. P-value < 0.05 was considered significant statistically. Three hundred and fortynine (349) diabetic patients were seen. There were more females than males (61.9% & 38.1%). About 36% (125) of the patients had no formal education and 12% (42) had only primary education, while 80% were from the low socioeconomic
class. The average number of drugs prescribed/day was 4 with an average cost of medications/day being N183.5 ±150.4 (Nigerian
naira) approx $1.40 (USD). The commonest reasons that militate against adherence to prescribed drugs were the high cost of the drugs
(52.2%) and the large number of drugs to be taken (43.5%). Biguanides (66%) are the commonest oral hypoglycemic agents prescribed,
while ACEIs (53%) were the commonest antihypertensive prescribed. Only 5.4% of patients received statins. The cost of medications
prescribed to diabetic patients in Ibadan, Nigeria is quite high. Every effort at cost reduction through improved prescription of drugs as
generics and rational prescribing is necessary so as to encourage adherence to drug therapy.

Key words: Cost of drugs, diabetes mellitus, drug use indicators, Nigeria, factors