The cost of kidney dialysis and transplants in Nigeria has seen a sharp rise over the past year, putting significant financial strain on patients and their families.
Some kidney disease patients like Mrs. Okoli, who requires two dialysis sessions weekly, describe the experience as “unbearable,” while others, like a retired civil servant, depend on their children to raise funds for each session. Another patient recounted how missing dialysis led to severe swelling and shortness of breath, calling it an ordeal he hopes never to face again.
According to findings by Nairametrics, a single dialysis session now costs between N41,000- N60,000, a sharp increase from N35,000 in 2023.
Additionally, kidney transplant surgery is priced at N14 million – N15 million, a significant increase from the previous price of N12,000,000 from last year. This represents a 25% increase.
This surge in healthcare costs is driven by inflation, currency depreciation, and the rising dependence on imported medical supplies, intensifying concerns about the affordability of life-saving treatments for the increasing number of Nigerians affected by kidney disease.
Managing kidney disease in Nigeria has become a financial burden for families, with many unable to afford to receive the required dialysis or transplant treatment necessary for their health.
Rising disease prevalence
Kidney disease is a global health crisis, affecting millions and accounting for significant mortality worldwide. Over the past 30 years, the all-age prevalence and mortality rates of kidney disease have risen by 30% and 40%, respectively.
- Currently, the eighth leading cause of death globally, kidney disease is expected to climb to the fifth position by 2040, making the management of this disease even more critical.The Nigerian Association of Nephrology stated that several studies have shown that approximately 20 million Nigerians are living with chronic kidney diseases.
- The average participant age was 43, with 60% of participants being female and only 4.7% aware of their condition, 10.9% had been screened before.
- Additionally, 5.4% reported having relatives with kidney disease the gap in awareness and care is clear. The North-Central had the highest participation (30.3%), followed by the South-West (23.6%) and South-South (19.5%).
Facility cost disparities
The cost of kidney dialysis in Nigeria is influenced by various factors, with the choice of hospital or clinic being a significant one. Each facility has its own pricing structure, leading to variations in dialysis fees across different locations.
Hemodialysis, the primary treatment for people with severe kidney failure, requires multiple sessions each week.
Nairametrics gathered detailed information on the costs of kidney dialysis and transplants from different medical facilities.
At Zenith Medical and Kidney Center in Abuja, the cost of kidney dialysis varies based on the patient’s condition.
Clean blood dialysis costs N41,000 per session, while bad blood dialysis costs N43,000. For elderly patients or those with high blood pressure, the charge increases to N50,000 per session. Patients must also check their packed cell volume (PCV) before dialysis, which adds to the expenses.
Additionally, there is a consultation fee of N55,000 for three months, which includes N5,000 for registration and N50,000 for consultation. This consultation determines the necessary tests and the appropriate dialysis machine.
The representatives explained that dialysis access costs include a central venous catheter, referred to as a “Neckline,” which costs N261,000. Other access options are the femoro-femoral fistula at N65,000 and the brachiocephalic fistula at N55,000.
These access points are essential for conducting dialysis, and they noted that the central venous catheter offers a more effective dialysis experience compared to the other methods.
Evercare Hospital in Lekki Phase 1 disclosed that “the cost of kidney dialysis is currently N48,000 per session, up from the previous price of 34,000 naira,” reflecting a 41% increase.
The hospital has not yet initiated kidney transplant procedures, with a representative stating, “We are yet to start the kidney transplant procedure, so there is no cost structure for it at the moment.”
Regarding health insurance coverage, the hospital explained that “the availability of insurance for such procedures depends largely on the patient’s company policy,” noting that typically only patients with “the highest level of insurance coverage, such as a platinum scheme,” can receive insurance for kidney procedures.
They also clarified, “There is no instalment payment option; it operates as a pay-as-you-go service.”
At LSUTH, kidney dialysis now costs N60,000 per session, a 9.09% increase from N55,000, a rate set mid-last year, up from an earlier price of N32,000. Additionally, a thoracic access procedure is priced separately at N260,000.
Kidney transplant procedure cost
Zenith Medical and Kidney Center stated that the total estimate for the renal transplant surgery package is N14,250,000, a significant increase from the previous price of N12,000,000. This represents a percentage increase of 18.75%.
The total screening costs for tests related to human leukocyte antigen, crossmatching, and donor-specific antigen testing amount to N3,500,000.
Additionally, there are further laboratory costs associated with both the donor and recipient.
“If plasmapheresis is necessary, particularly when the results of the human leukocyte antigen and donor-specific antigen tests are positive, the cost will be N930,000”. The number of sessions required will depend on the patient’s antibody levels, they said.
Post-transplant, the cost of immunosuppressant medications is significant, with a year’s supply of tacrolimus priced at N1,386,000.
Additionally, a three-month supply of valganciclovir costs N405,000. Other medications, including mycophenolate mofetil and prednisolone, lead to a total expense of N2,311,200 for all immunosuppressant treatments over the specified durations.
A nephrologist from Lagos State University Teaching Hospital (LSUTH), who requested anonymity, revealed to Nairametrics that the cost for a kidney transplant here is around N15m. That covers the surgery, medications before the surgery, and some blood tests while the patient is on admission.
However, follow-up care after the surgery is usually free. It’s important to note that each patient is unique, so the cost may vary based on individual needs,” the doctor explained.
When asked about post-transplant expenses, the doctor added, “Post-transplant, patients need to budget around 300,000 thousand naira per month for medications. We usually advise that patients have enough funds to cover at least one year of post-transplant care before they commence the surgical procedure.”
A nephrologist said the most common cause of transplant rejection in Nigeria is a lack of compliance with the post-transplant medication regimens.
“This is often due to financial implications. Patients sometimes cannot afford the necessary post-transplant medications, which leads to complications and rejection,” he said.
Economic burden
- The cost of kidney dialysis in Nigeria must be understood within the broader context of the country’s healthcare system and economy.
- The devaluation of the Naira, coupled with the rise in demand for medical care, has significantly impacted patients’ ability to access treatment.
- Since dialysis is a lifelong commitment for most Kidney disease patients, many families are trapped in a cycle of financial hardship.
Nairametrics spoke to some kidney patients who came for dialysis procedures at LSUTH. For many, affordability and access dictate every decision about their care.
One patient, who preferred to remain anonymous, shared his ordeal:
“I come all the way from Mile 12 for this procedure. It’s more affordable than the private ones around me, and I don’t even trust those because I’ve heard they have power issues.”
A retired civil servant explained how his children must constantly rally to raise funds weekly for his sessions.
“Aside from that, the cost of having to prepare a separate meal from what others at home eat is not easy,” he stated.
Another patient, who simply gave her name as Mrs. Okoli, described the difficulty of keeping up with two dialysis procedures a week.
“The financial strain is unbearable. Each dialysis session costs so much, and I need it twice a week. That’s thousands of naira every month, and honestly, it feels like I’m constantly scrambling to find money just to stay alive,” she stated.
Another patient shared his experience when he couldn’t get his required procedures: “The first thing I notice is the swelling on my legs and face. Then there’s the shortness of breath.
“It was really an ugly experience I don’t pray to have again, but again I thank God for life,” he stated.
Call for urgent reforms
- The soaring cost of kidney dialysis in Nigeria reflects the urgent need for systemic reforms in the country’s healthcare system.
- The Nigerian Senate has called for an expansion of the National Health Insurance Scheme (NHIS) to provide comprehensive coverage for kidney disease patients. This move follows growing concerns over the financial barriers many Nigerians face in accessing life-saving dialysis treatments.
- Led by Senator Abdulaziz Yar’adua (APC-Katsina), the Senate emphasized the importance of ensuring that financial constraints do not hinder access to life-saving care.
- The lawmakers also urged the Federal Ministry of Health to enhance kidney treatment facilities, strengthen infection prevention protocols, and intensify public education on kidney disease prevention.