Scale development on consumer behavior toward counterfeit drugs in a developing country: A quantitative study exploiting the tools of an evolving paradigm

Background: Although desperate need and drug counterfeiting are linked in developing countries, little research has been carried out to address this link, and there is a lack of proper tools and methodology. This study addresses the need for a new methodological approach by developing a scale to aid in understanding the demand side of drug counterfeiting in a developing country. Methods. The study presents a quantitative, non-representative survey conducted in Sudan. A face-to-face structured interview survey methodology was employed to collect the data from the general population (people in the street) in two phases: pilot (n = 100) and final survey (n = 1003). Data were analyzed by examining means, variances, squared multiple correlations, item-to-total correlations, and the results of an exploratory factor analysis and a confirmatory factor analysis. Results: As an approach to scale purification, internal consistency was examined and improved. The scale was reduced from 44 to 41 items and Cronbach's alpha improved from 0.818 to 0.862. Finally, scale items were assessed. The result was an eleven-factor solution. Convergent and discriminant validity were demonstrated. Conclusion: The results of this study indicate that the "Consumer Behavior Toward Counterfeit Drugs Scale" is a valid, reliable measure with a solid theoretical base. Ultimately, the study offers public health policymakers a valid measurement tool and, consequently, a new methodological approach with which to build a better understanding of the demand side of counterfeit drugs and to develop more effective strategies to combat the problem.This work was supported by the Federal Ministry of Health Sudan.Scopu

Consumer behaviour towards counterfeit drugs in a developing country

Introduction Availability of counterfeit drugs is increasing, especially in developing countries. This fact makes it critical to develop new measures that can help to combat this problem. Objectives This study was designed to examine the influence of certain factors on consumers' behaviour regarding counterfeit drugs. Specifically, this study investigates consumers' intention to purchase counterfeit drugs based on their attitude towards the purchase of counterfeit drugs, subjective norm and motivation. Method This study was conducted in a resource limited setting context. A face-to-face structured interview survey methodology was employed to collect data from 1003 subjects. Data were analysed by maximum likelihood estimation procedures using structural equation modelling. Key findings Out of a total of 11 proposed hypotheses, only four were significant as expected. All hypotheses related to factors affecting attitude were found to be non-significant and, consequently, attitude towards purchase intention was also found to be non-significant. Conclusion The model, which was based on past research and the authors' theoretical considerations, was confirmed. Moreover, using the theory of planned behaviour provided strong contributions towards explaining the demand for counterfeit drugs. This study is among the few, and may indeed be the first, that examines an African country drugs market and provides information and knowledge highly demanded by marketing managers and public health policymakers. It provides an in-depth understanding of Sudanese consumers that can be used in designing more efficient anti-counterfeiting strategies in developing countries.Scopu

General public and community pharmacists perception on counterfeit medicines: A preliminary cross-sectional study in Qatar

Introduction: One major contributing factor to the prevalence of counterfeit medicines in a country is the lack of knowledge and awareness of the society. Information on general public and healthcare professionals awareness and vulnerability towards counterfeit medicines in developing countries is limited. Aim: To assess how the general public and pharmacists perceive counterfeit and substandard medicines and to evaluate their vulnerability level toward counterfeit medicines. Materials and Methods: A cross-sectional study was conducted in Qatar where a prevalidated questionnaire was used to collect information about: a) demographic characteristics, b) attitude, c) subjective norm, d) motivation, and e) behavioural intentions of pharmacists and public regarding counterfeit medicines on a Likert-scale. A total of 190 questionnaires were distributed conveniently to the public and community pharmacists. Chi-square and independent t-tests were used at p-value of 0.05. Results: One hundred ninety questionnaires were distributed to both community pharmacists and public, however, only 167 (87.8%) were collected which resulted in response rate. Most of the results of the survey (41 items) were not significant (p-value>0.05). Only questions about awareness towards counterfeit medicines, its societal consequences, the effect of price affordability and the effect of pressure exerted by relatives and friends on purchase intent of counterfeit medicines gave significant difference between public and pharmacists (p-value 0.05). Conclusion: Overall findings suggested that there is no significant difference between pharmacists and public in the way they perceive counterfeit and substandard medicines. Both of them have the same susceptibility level toward counterfeit medicines. Both pharmacists and public have low-level of knowledge and moderate level of vulnerability to counterfeit and low-quality medicines.This work was supported by the Qatar University Student Grant [grant numbers: QUST-CPH-Fall-14/15-11].Scopu

Counterfeit drug demand: Perceptions of policy makers and community pharmacists in Sudan

Background: The counterfeit drug trade has become widespread and has developed into a substantial threat to both the public's health and the pharmaceutical industry. Objectives: The aim of this study was to seek insights into the determining factors of counterfeit drug purchases among health policy makers and community pharmacists in a developing country. Methods: In-depth qualitative interviews with Sudanese policy makers and community pharmacists were undertaken in 2 Sudanese states, namely Khartoum and Gadaref. A semistructured interview guide was developed by incorporating information from existing literature. A purposive sample of knowledgeable policy makers and community pharmacists was interviewed. Results: Thematic content analysis of the interviews identified 8 major themes: understanding the term " counterfeit drug," presence of counterfeit drugs in the Sudanese market, vulnerability to counterfeit drugs, price-quality inference, awareness of societal consequences of counterfeit drugs, subjective social norms, difference in vulnerability according to demographic characteristics, and education pertaining to counterfeit drugs. Unaffordability of medicines and desperate need were emphasized by both policy makers and community pharmacists as major influencing factors that increased consumers' vulnerability to counterfeit drugs. Conclusions: This study concluded that high prices and the unaffordability of medicines have a major role in increasing vulnerability to counterfeit drugs, in addition to lack of knowledge about counterfeiting and the implications of use of these products. Because very limited studies have been conducted in developing countries to explore perceptions about counterfeit drugs, the present study provides information from which policy makers and key stakeholders in the supply chain can benefit.Scopu