Ebenezer, CJ; (2015) Pharmaceutical Quality and Policy in Nigeria: Stakeholder Perspectives and Validation of the Mobile Authentication Service. Doctoral thesis , UCL (University College London).

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Abstract

Background Medicines that are of poor quality present a challenge to many countries especially the developing countries. Many interventions against medicines counterfeiting are often not evaluated and qualitative fieldwork to find how stakeholders perceive the problem of poor quality medicines is currently lacking. Aims 1) To conduct a systematic review of the literature 2) To validate the Mobile Authentication Service (MAS) 3) To explore stakeholder experiences and perceptions of the current situation of medicines counterfeiting and quality of medicines distributed in Nigeria. Methods 1) A quantitative study involving Short Message Service (SMS) authentication of tagged Glucophage® (metformin) samples, packaging and chemical (Near Infrared spectroscopyand High Performance Liquid Chromatography) analysis of metformin samples, randomly selected from retail outlets in Lagos, Nigeria, 2) A qualitative study involving semi-structured interviews with different stakeholders. Results The results of the SMS authentication agree with that of packaging and chemical analyses. The Glucophage® samples were significantly different in quality from the generic versions in terms of the concentration of active ingredient with a p value of 0.006. This difference in quality was in favour of the innovator brand, Glucophage® and it is similar to the findings from the qualitative interviews where majority of the participants perceived innovator brands better in quality than their generic versions. Majority of the participants felt that the problem of poor quality medicines in Nigeria is decreasing. Increase in cost of medicines, poor dispensing practices, poor phone network, time constraints, consumer trust in medicine sellers, low level of awareness and complacency by the consumers were identified as factors that may be a barrier to the use of MAS. Conclusion MAS seem to be successful in helping consumers authenticate their medicines. However, recommendations arising from this study should be adopted to overcome barriers to its use. Substandard medicines may present a greater challenge than medicines counterfeiting and should therefore not be neglected.

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