Assessment of Medicine Pricing and Affordability at Community Pharmacies in Gombe, Gombe State, North East Nigeria

Medicines are among the most significant household healthcare expenditures in Nigeria, and high prices in community pharmacies often lead to incomplete treatment, purchase of substandard alternatives, or outright non-purchase of essential drugs. This study assessed medicine pricing practices and affordability at community pharmacies in Gombe, Gombe State, North East Nigeria. A cross-sectional survey of 25 community pharmacies was conducted, with pricing data collected for 30 tracer medicines from the Nigerian essential medicines list. Prices were compared against the WHO reference International Medical Products Price Guide and assessed against the affordability threshold relative to the daily wages of a low-income government worker. Findings revealed that 22 of the 30 tracer medicines were priced above the international reference price, with an average markup of 67 percent. Affordability analysis indicated that a three-day course of amoxicillin would require 1.4 days of wages for a minimum wage earner, rendering it unaffordable for many in the lower economic bracket. Price variability between pharmacies for the same drug was substantial, ranging up to 150 percent for some antimalarials. The study recommends government price regulation for essential medicines, expansion of the National Health Insurance Scheme to cover outpatient prescriptions, and transparency mechanisms for medicine pricing in Gombe State pharmacies. Keywords: medicine pricing, affordability, community pharmacy, Gombe State, essential medicines