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The silent epidemic of substandard and falsified medicines in low- and middle-income countries: heed lessons from the tragic deaths of children in Indonesia

MohanaSundaram A, Padhi BK, Mohanty A, Shrestha S, Sah R

Int J Surg, 2023 Mar 01;109(3):523-525.
PMID: 36906790 DOI: 10.1097/JS9.0000000000000059
Matched MeSH terms: Counterfeit Drugs*
Counterfeit drug demand: perceptions of policy makers and community pharmacists in Sudan

Alfadl AA, Hassali MA, Ibrahim MI

Res Social Adm Pharm, 2013 May-Jun;9(3):302-10.
PMID: 22835708 DOI: 10.1016/j.sapharm.2012.05.002

The counterfeit drug trade has become widespread and has developed into a substantial threat to both the public's health and the pharmaceutical industry.

Matched MeSH terms: Counterfeit Drugs*
Near-infrared spectroscopy (NIRS) and chemometric analysis of Malaysian and UK paracetamol tablets: a spectral database study

Said MM, Gibbons S, Moffat AC, Zloh M

Int J Pharm, 2011 Aug 30;415(1-2):102-9.
PMID: 21645600 DOI: 10.1016/j.ijpharm.2011.05.057

The influx of medicines from different sources into healthcare systems of developing countries presents a challenge to monitor their origin and quality. The absence of a repository of reference samples or spectra prevents the analysis of tablets by direct comparison. A set of paracetamol tablets purchased in Malaysian pharmacies were compared to a similar set of sample purchased in the UK using near-infrared spectroscopy (NIRS). Additional samples of products containing ibuprofen or paracetamol in combination with other actives were added to the study as negative controls. NIR spectra of the samples were acquired and compared by using multivariate modeling and classification algorithms (PCA/SIMCA) and stored in a spectral database. All analysed paracetamol samples contained the purported active ingredient with only 1 out of 20 batches excluded from the 95% confidence interval, while the negative controls were clearly classified as outliers of the set. Although the substandard products were not detected in the purchased sample set, our results indicated variability in the quality of the Malaysian tablets. A database of spectra was created and search methods were evaluated for correct identification of tablets. The approach presented here can be further developed as a method for identifying substandard pharmaceutical products.

Matched MeSH terms: Counterfeit Drugs/analysis; Counterfeit Drugs/chemistry*
Perceived Prevalence, Awareness and Attitude towards Counterfeit Medicines among Community Pharmacists of Kathmandu Valley: A Descriptive Cross-sectional Study

Kafle S, Jha N, Bhandary S, Ravi Shankar P

JNMA J Nepal Med Assoc, 2024 Jun 30;62(275):427-432.
PMID: 39369416 DOI: 10.31729/jnma.8651

INTRODUCTION: Counterfeit medicines are a significant problem globally. In a developing country like Nepal, community pharmacists play an important role in dispensing medicines. The study was done to assess community pharmacists' perceived prevalence, awareness and attitude towards counterfeit medicines in Kathmandu valley. Methods: A cross-sectional study design was used. Data was collected conveniently from Kathmandu, Bhaktapur, and Lalitpur districts in March 2022 after obtaining ethical clearance from Nepal Health Research Council (reference no. 2200) and taking written informed consent from Community Pharmacists. Results: Among the 343 pharmacists who participated, 250 (72.89%) were from Kathmandu, 57 (16.62%) were from Lalitpur, and 36 (10.50%) from Bhaktapur. Most 252 (73.47%) were aged between 20 to 30 years, 222 (64.72%) were male, 239 (69.68%) had done a Diploma in Pharmacy, 201 (58.60%) had working experience of more than 5 years and 342 (99.71%) had done their education in Nepal. Their median perceived prevalence of counterfeit drugs was 10.00% but only 2.30% had clear knowledge of such practice. 332 (96.79%) believed that actions should be taken against community pharmacists dispensing counterfeit drugs, 325 (94.75%) believed that pharmacists who dispense counterfeit medicines are unprofessional; 338 (98.54%) stated that there should be strong law against counterfeit medicine sales.
CONCLUSIONS: Median perceived prevalence of counterfeit medicines was 10.00% but only 2.30% were aware of counterfeit medicine dispensing. Out of 343 pharmacists, 332 (96.79%) mentioned that action should be taken against those pharmacists knowingly dispensing counterfeit medicines and 338 (98.54%) stated that there should be strong law against counterfeit medicines.

Matched MeSH terms: Counterfeit Drugs*