AN elderly man ambles into a pharmacy in the capital city, Harare, lamely holding a prescription for drugs, which he presents to a pharmacist.

He is told the cost of the medication — a cool US$10 or, alternatively, $245 — and slowly shakes his head.

“What if I buy for just one week?” The man asks, calculating the money he had, but the pharmacist stresses that they can only dispense the full allocation of the drugs.

The man slowly shakes his wizened head and walks out of the pharmacy. It is a heart-breaking sight.

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This has become a common sight in the country as the cost of medication — and healthcare in general — continues to spiral out of control, with even those on medical aid forced to downgrade their packages to ensure that the medical cover does not swallow their entire salaries.

The pricing of drugs continues to cause a huge headache for many patients who are forced to pay mostly in US dollars as the bond equivalent is way beyond the reach of many and is often pegged way above the official interbank and parallel market rates to discourage clients from using the local currency.

This is despite the fact that many people earn their salaries in local currency — whose introduction after nearly 10 years of officially using the US dollar — has caused significant instability in the economy and seen prices of both medical consumables and other basic goods shooting through the roof.

Speaking to NewsDay Weekender on the pricing of drugs, Kuda Chapfika of the Pharmaceutical Wholesalers Association said there was too much instability and speculation in the market.

“Currently, there is a lot of instability in terms of pricing due to the fluctuating rates prevailing in the economy,” he said.

Chapfika also noted that the speculation was fuelling the glaring pricing disparities but admitted that wholesalers were forced to price their products in such a way that they would hedge themselves against losses as they were not accessing any foreign currency.

“Some players are being forced to speculate more than others in their pricing, hence the reported price disparities,” he said.

A snap survey by this paper revealed that the prices of the majority of medical drugs on demand were exorbitant, with a week’s supply of simple painkillers ranging from $100 to $120. In some pharmacies, however, the painkillers are going for US$1.

For common cough syrups, one would need to part with an average of US$10, which is an equivalent of $200 in local currency.

Those with chronic afflictions are the worst affected as they have to take their medication everyday, with most having to pay over US$30 for a month’s supply of a single drug, with epileptic drugs like phenobarbitone costing an average of US$9.

Pricing of drugs has remained one of the most contentious and in the absence of a proper regulatory mechanism, some pharmacists have been accused of wantonly putting higher mark-ups on drugs.

There have been reports that businesspeople with exclusive dealership on drugs were making profit margins of over 300% due to the relaxed pricing regulations for medicines in the country.

The scenario has been worsened by the situation in public hospitals which previously catered for many people at a lower price.

Patients have been accessing private medical care including pharmacies during the standoff between government and the doctors who are now slowly going back to work.

Many pensioners, who constitute the majority of patients stalked by terminal illnesses such as hypertension and diabetes, and in some cases HIV, have been hit the hardest by the increased cost of medical care and health products and consumables.

A Harare-based doctor who declined to be named citing professional reasons, said once the cost of medicines shot up, the next thing was default for those whose pockets are not deep enough to continue pumping out money for drugs.

“If people cannot afford medication, the next thing is default. If they default, then there are complications, especially from hypertension and diabetes, which lead to things like strokes, kidney failure, heart failure and blindness,” he said.

Social commentator, Robert Mhishi, said it was possible that many such patients could end up dying quietly as there had no recourse anywhere, and there could be a silent genocide going on in the country.

“Quite clearly, medical care has become a preserve for the rich,” he observed. “But the majority of those requiring constant healthcare are the elderly, many of whose pensions are nothing to write home about.”

He said those under medical cover were not safe given the spiralling cost of medical care and drugs, which has seen a number of clients downgrading their packages.

Earlier this month, one of the biggest healthcare funders in the country, CIMAS Medical Aid, increased its tariffs and introduced new inflation-proof packages to hedge well-heeled clients against the shocks of high medical costs.

In a statement issued in November last year, CIMAS managing director Martin Mushambadope indicated that their standard packages of private hospital, general and basicare would require co-payments.

“We have maintained three standard packages as part of our product offering. Please note that these packages will require co-payments at most healthcare facilities and these co-payments could be significant in some cases,” he said.

For those under the new packages — Healthguard Deluxe, Healthguard Essential and Healthguard Classic — will have wider treatment options without fretting too much.

Specialist physicians are now charging between US$30 and US$50 for consultation as top up for clients on medical aid.

Prohibitive costs of pharmaceutical products in Zimbabwe are pushing many individuals to source their medications from neighbouring countries such as South Africa where they are cheaper.

Although the government has been courting India for the provision of affordable drugs, medical doctors who spoke to NewsDay Weekender said it was imperative for the authorities to invest in its own public health system.

“We get most of our medication from India. So it is a good move to engage Indian companies. However, there is need for foreign currency to buy medicines from India. I am not sure if the government has enough foreign currency to meet that demand. We have our local companies that are struggling. Maybe government should also try to resuscitate these local pharmaceutical manufacturers,” said one local doctor.

“The government should also make sure that public hospitals are well-funded and equipped. Health services can then be offered to everyone at subsidised prices.”

For now, however, the majority of those battling chronic illnesses in particular, would be scratching their heads on how to ensure that they would not be forced to default by circumstances beyond their control.