Why Health Professionals, Other Stakeholders must Prioritise Better Patient Outcomes – Okeke

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Why Health Professionals, Other Stakeholders must Prioritise Better Patient Outcomes - Okeke
Pharm. Ike Okeke

Pharm. Ike Okeke is the managing director, Superior Pharmaceuticals Ltd, one of the leading pharmaceutical companies in Nigeria. A top pharmacist, based in Tampa, Florida, USA, he is passionate about impacting patients’ lives through the provision of qualitative pharmaceuticals at affordable rates.  Following his graduation from the University of Nigeria, Nsukka, in 1988, Okeke joined Bristol Myers Squibb as a medical sales rep, which enabled him to travel worldwide and exposed him to pharmaceutical practices in Nigeria and overseas. He relocated to the US in 1991 to pursue his dream in the pharmaceutical sector.

Having been at the centre of pharmaceutical and medical care in the United States for the past 20 years, Okeke decided to bring his expertise and experience back to Nigeria in 2011, by establishing Superior Pharmaceuticals. In this interview with Temitope Obayendo, he examined some burning issues in the Nigerian healthcare sector and recommends strategies for overall improvement and better patient outcomes. Excerpts:

Tell us a little about yourself

My name is Ike Okeke.  I am a pharmacist. I graduated from the University of Nigeria, Nsukka in 1988, before relocating to US in 1991. I decided to return to the country in 2011 to set up Superior Pharmaceuticals in order to provide employment, reduce the prevalence of fake and substandard drugs and provide affordable and quality generic drugs to our citizens. I am married to a pharmacist, Yvonne Okeke, who runs her own pharmaceutical business in the US. Together, we are blessed with four kids.

 As an importer of pharmaceutical products, how would you assess the drug distribution system in Nigeria?

Our drug distribution system is still in its infancy. It could be better. I know a lot of smart and intelligent people are working on it and government has approved regulation on drug distribution in the country. However, we still lack the political will and adequate infrastructure to enforce it.

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The end users still bear the full cost of drugs in the country. When the penetration of the health insurance scheme is high enough, and the barrier to entry is raised, the open drugs markets will wither and diminish. It will open the way for professionals to come in and modernise the system.

Having been in the business for a decade, what do you see as the greatest challenge of pharmaceutical importation in the country?

Pharmaceutical importation continues to evolve. It is highly dependent on regulations promulgated and enforced by NAFDAC.  The GMP fee issue is forcing small players out of the sector, with attendant job losses. Access to capital is a serious issue. High interest rates on loan and no access to forex is a major handicap.

 How can these issues be resolved?

Dependence on importation of pharmaceuticals is not in the best interest of the country. We continue to export jobs which are desperately needed by our youths. I applaud the decision of NAFDAC to ban or refuse to renew license for importation of certain basic drugs in the country. This decision will stimulate local production which can only increase with time.

For local production to take hold, various stakeholders – including state governments or investors – must establish industrial clusters, with good roads, water and electricity.  All an investor needs to do is rent space, bring in machinery and start production.

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Government policies and government agencies should do all in their power to assist these investors to succeed and not cripple them with unnecessary demands and shakedowns.

NAFDAC is doing a great job by fast tracking licensing for local manufacturing. This is a big morale boost and will keep our factories busy and happy.

 Is there any similarity between the Nigerian pharma market and that of the United States?

There are some similarities and also major differences. Both have prescription only medications that can be purchased through prescription from the doctors. Both countries allow doctors to purchase and dispense medications like pharmacies but the difference is that those doctors purchasing and dispensing drugs are subject to inspection by the state board of pharmacy to ensure compliance with pharmacy laws.

Also, both countries use drug distributors and authenticated systems to deliver drugs from manufacturers to distributors and to pharmacies or hospitals. The Nigerian system is still evolving and not well developed. patent medicine vendors are non-existent in the US and there are serious consequences for violating pharmacy laws. Dispensing ampicillin, for example, without a prescription could lead to revocation of your pharmacy permit and license.

What are the lessons the Nigerian government and other stakeholders in the health sector can learn from what obtains in the US pharma market?

The take-home lesson is to be guided by what is in the best interest of the patient, not the doctor or the pharmacist or other stakeholders. The entire healthcare infrastructure exists for the sole benefit of the patient and no one else. Without any sick patients, the entire system would collapse.

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With this in mind, it becomes very easy to put in regulations and policies and strike down behaviours, attitudes and habits that are injurious to the patient and do not maximise patient outcomes.

Adulteration and faking are major problems in pharma importation. How can the situation be changed?

I don’t believe that adulteration is a major problem but it is nonetheless significant problem and very concerning. You have to understand that NAFDAC licenses pharmaceutical companies to import pharmaceuticals and each drug imported into the country is tested by NAFDAC before it is released to the company for sale to the distribution system.

The problem of fake or substandard drugs must be from criminal elements in the society that are not licensed or regulated by NAFDAC. The fake drugs are smuggled through our porous borders and made in clandestine locations nationwide.

To control this menace, citizens must co-operate with NAFDAC and the police. Report all suspicious activity to NAFDAC. No government agency can succeed without the support of the citizens.  The government agencies must earn the trust of the public and the public will reward the agency with useful tips to apprehend these criminal elements.

NAFDAC should use its investigative arm to gather intelligence and make it too costly for this criminal to operate. Our courts must pass judgement that will serve as deterrent. The level of corruption in our society must also go down for these ills to whither.

Education and enforcement are the two basic tools to use in tackling this menace.

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