When people get sick in Nigeria, their first stop is the pharmacy.
“Pharmacies and pharmacists play a very important role in front line health care in Nigeria,” pharmacist Emmanuel Ayanjoke, who goes by "Dr. Manny," says of his home country.
He remembers watching his father and his grandfather – both pharmacists – treat patients when he was young. “My dad knew everyone that came into the pharmacy,” he said.
Ayanjoke opened his own pharmacy, Altev Community Pharmacy, in Avondale, in December.
Ayanjoke wants people to feel at home when they visit his pharmacy. He also wants them to understand that pharmacists can do more than fill prescriptions – just as his father and grandfather did.
A change in Ohio law that took effect in 2021 helps him fulfill his mission: Medicaid pharmacists are now recognized as healthcare providers. They can examine the big picture of a patient’s health and medications, treat both acute and chronic issues, and get reimbursed for the time they spend with patients.
“It’s important that any pharmacist or even any medical provider knows their patients and has that relationship first,” said Ayanjoke.
Avondale neighborhood faces worse health outcomes
Altev Community Pharmacy serves Avondale, a neighborhood that is 81% Black, according to the 2020 US. Census, and faces worse than average health outcomes. This is despite being less than a mile from both University of Cincinnati Medical Center and Cincinnati Children’s hospital.
Half of Avondale residents live in poverty, nearly twice Cincinnati’s average. Nearly half have high blood pressure and 17% are uninsured, according to the 2019 American Community Survey.
"I would say a good majority of our patients are Medicaid primarily because of our location," said Ayanjoke. Medicaid, a government program offering health coverage to millions of low-income Americans, plays a crucial role in the U.S. healthcare system.
He chose the location of his pharmacy intentionally, to improve access to care. The most pressing medical issues Ayanjoke sees in Avondale neighbors, many of whom are low-income and elderly, are diabetes, hypertension and mental illness.
Despite the prevalence of health issues, Ayanjoke aims to steer clear of overprescribing, especially for his elderly customers.
“What you have now in the healthcare system is a lot of older adults overmedicated,” he said. “Especially when we look at the more complex patients, they are seeing multiple specialists. And often, all these specialists aren’t really working together.”
The result? Patients who experience adverse effects from medications lead doctors to prescribe more medications, said Ayanjoke, without understanding the full picture of their health.
Every day, 750 Americans aged 65 or older are hospitalized because of severe side effects from their medication, according to the Lown Institute, a nonpartisan think tank.
“That’s why you need a pharmacist who spends that time,” said Ayanjoke, who offers pharmacy counseling through Altev Community Pharmacy. Local pharmacists have the training to sit down with patients, review their medical history, and determine what medications are safe for them.
“You look at your history, look at why you’re taking it, and try to piece two and two together.”
Altev and other independent pharmacies cheaper than chains, Enquirer finds
Ayanjoke not only champions local pharmacies for their personalized care, but also their affordability when compared to chains like Kroger and CVS.
The Enquirer used Altev Community Pharmacy’s website, which allows users to compare medication prices across pharmacies by searching a specific medication and Zip code, to verify.
At Altev, 90 tablets of 20 mg lisinopril, a common medication for high blood pressure, cost $11.48 – slightly more than the city’s health department pharmacies' price of $10.23. Other local pharmacies offered the same supply for between $10 to $12.
However, at Kroger, the same supply cost $21.14, and at CVS, it was $35.55.
For metformin, a medication for Type 2 diabetes, there was a similar trend: a 180-tablet supply of 500 mg was priced under $12 at Altev and other local community pharmacies. At Kroger, it cost $25.30, while CVS charged twice as much as Kroger at $51.99.
Comparing Zoloft, a commonly prescribed drug for depression and anxiety, CVS charged nearly four times the amount that Altev Community Pharmacy charged.
Consumers can also compare prescription prices and access coupons through GoodRx, where dollar amounts vary from those displayed by Altev's website. However, searching for the same drugs reveals that Altev's prices are still lower than Kroger's and CVS Pharmacy's – even after applying GoodRx coupons.
Local pharmacies such as Altev follow a pricing benchmark set by the federal government, which is based on surveys of pharmacies nationwide.
All in all, Ayanjoke wants people to feel comfortable in his pharmacy, the opposite of “that feeling of being in a foreign place” that he says many people have in hospitals and doctors' offices. He believes in the importance of forming personal connections with patients, an ethos passed down from the pharmacists in his family.
“When you know people on that level," he said, "they open up to you.”
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