Access to breast cancer medicines in Kwara-Central Senatorial District, Nigeria: availability, prices and affordability

Breast cancer medicines (BCaMs) have significantly improved breast cancer (BCa) prognosis. However, availability, prices and affordability (APA) of BCaMs continue to present major public health challenges, particularly in lowresource settings. This study evaluated APA of BCaMs in Kwara-Central Senatorial District, Nigeria. A multi-centre study was conducted from March to April, 2022 in nine eligible community pharmacies (CPs) and one tertiary hospital pharmacy (UP). World Health Organization/Health Action International methods were adapted to assess APA of 44 BCaMs in stock, using a one-time visit approach. Data were analysed using descriptive and inferential statistics, including Fisher's Exact, Mann-Whitney U, and Kruskal-Wallis Tests. Statistical significance was set at p < 0.05. Only 40.9% of surveyed BCaMs were available. Availability contributions from CPs and UP were 38.6% and 18.2% respectively, with significant difference of p = 0.003. Originator brand, docetaxel 80 mg/4 ml had highest price (NGN 55, 000 [$132.50]), while generic tamoxifen 20 mg tablets had the lowest price (NGN 38 [$ 0.092]). Furthermore, a lowest-paid Nigeria government employee (earning NGN1000 [$2.41] daily) would require more than one day’s wage to purchase 94.4% of the medicines. BCaMs are inadequately available, highly priced, and largely unaffordable in Kwara-Central Senatorial District of Nigeria.