Reasons why insured consumers co-pay for medicines at retail pharmacies in Pretoria, South Africa

Background: Costly prescription medicines with existing cheaper alternatives tend to be purchased by medically insured consumers of healthcare. In South Africa medical scheme members pay higher out-of-pocket payments for medicines than those without insurance.Aim: This study explored reasons for co-payments among insured Pretoria medical scheme members purchasing prescription medicines at private retail pharmacies, despite being insured and protected against such payments. Setting: The study took place in retail pharmacies in Pretoria, Gauteng Province, South Africa.Methods: An exploratory qualitative study was performed. Semi-structured interviews were conducted among purposefully sampled medical scheme members (12) and nine key informants (six pharmacists and three regulators ­ one for the pharmaceutical industry, one for medical schemes and one for pharmacists). Three pharmacies (two corporate and one independent) each were identified from high and low socio-economic areas. Scheme members were interviewed immediately after having made a co-payment (eight) or no co-payment (four) from the selected pharmacies. Interviews were recorded, coded and organised into themes.Results: Co-payments were deemed confusing, unpredictable and inconsistent between and within pharmacies. Members blamed schemes for causing co-payments. Six sampled pharmacies rarely stocked the lowest-priced medicines; instead, they dispensed medicines from manufacturers with whom they had a relationship. Corporate pharmacies were favoured compared to independents and brand loyalty superseded cost considerations. Medical scheme members did not understand how medical schemes' function.Conclusion: Unavailability of lowest-priced medicines at pharmacies contributes to co-payments. Consumer education about generics and expedited implementation of National Health Insurance could significantly reduce co-payments

A study of the use of Primolut N Tablet as a contraceptive in the Kumasi Metropolis of Ghana

This study investigated the use of Primolut N tablet which contains norethisterone 5mg popularly called N- tablet by users as a precoital contraceptive by women in the Kumasi metropolis of Ghana. Clients who called at any of the twenty (20) selected Pharmacies in residential areas within the Kumasi metropolis demanding the drug, with or without valid prescriptions were interviewed using a guide. Of the two hundred and twenty (220) users interviewed, 94% demanded the drug for contraception and 6% for menstrual disorders. Sixty one percent of those demanding it for contraception were between the ages 20-25 years. Respondents preferred the use of norethisterone tablets as a contraceptive to other methods because it worked for them and they also found it easy and convenient taking a tablet just before coitus than taking daily oral contraceptive pills. Norethisterone is being used as a pre-coital contraceptive, though the efficacy, safety and reliability of the drug for that purpose is unknown. Until these are known, women must be discouraged from using the drug (Afr J Reprod Health 2011; 15[1]: 65-67)

Essai de mise au point d'un code de la pharmacie au Mali : partie legislative

Du fait de la colonisation (1895-1960) le Mali a ete soumis au plan legislatif et reglementaire a un corpus de textes nombreux et epars se rapportant au secteur de la pharmacie. Il s'agit entre autre de la Loi An XI du 21 Germinal ou Loi du 11 avril 1803; du contenu du livre V du Code de la Sante Publique relatif a l'exercice de la pharmacie; dont certaines dispositions ont ete etendues aux territoires d'Outre-Mer; au Togo et au Cameroun en 1953 ; de l'Arrete de 1955 sur la repartition des officines en AOF ; de la Loi de 1960 portant creation de l'Ordre des pharmaciens dans la federation du Mali etc.. Apres l'accession a la souverainete internationale; le nouvel Etat Malien tout en reconduisant la legislation pharmaceutique issue de l'Etat anciennement tuteur qui n'etait pas contraire a la nouvelle loi fondamentale; a egalement mis en place; conformement aux orientations politiques de l'heure; de nouveaux textes. Dans le cadre de ce travail; nous avons recense l'ensemble des textes legislatifs et reglementaires qui ont ete pris au Mali dans le secteur pharmaceutique et celui des etudes en pharmacie. Nous avons fait l'examen critique de ces textes et procede a la codification de la partie legislative. Le present code est presente en 189 articles repartis en 5 titres disposes en chapitres et en sections

Poor Knowledge on New Malaria Treatment Guidelines among Drug Dispensers in Private Pharmacies in Tanzania: the Need for Involving the Private Sector in Policy Preparations and Implementation

Objective: To assess the knowledge of dispensers in private pharmacies on new malaria treatment guidelines which involved switching from chloroquine (CQ) to sulfadoxine pyrimethamine (SP) and from SP to artemether-lumefantrine. Methods: A structured questionnaire was used for data collection and the questions focused on whether the subjects were involved in the preparation or implementation of the guidelines or had undertaken any training on how to dispense new antimalarial medicines as recommended in the introduced new treatment guidelines. Results: The study revealed that none of the participants had been involved in the preparation of the treatment guidelines; nor had they undertaken any training on their implementation. As many as 49of the visited private pharmacies were found to continue stocking and selling CQ tablets and injections. Only 30 and 7knew the correct dose regimen of SP and ALU respectively and none of them knew the condition of taking ALU with a fatty meal for improved absorption. Conclusion: Lack of involvement of the pharmaceutical personnel working in the private pharmacies; from the preparation of new malaria treatment guidelines to their implementation; contributed to their poor knowledge and skill on how to correctly dispense the medicines

Aspects of microbial contamination of tablets dispensed in hospitals and community pharmacies in Benin City, Nigeria

PURPOSE: A research was carried out to investigate the incidence of microflora in tablets dispensed from large container packages used in hospitals and community pharmacies. It was designed to provide baseline data on the common biodegrading microorganisms associated with tablets in retail containers and to highlight the health implications of such observations and roles for pharmacists in self medication phenomenon in Nigeria. METHODS: The protocol for the study involved structured selection of representative named tablets from some public hospitals and community pharmacies within Benin metropolis. Constitutive microorganisms were elaborated and enumerated using standard microbiological protocols. RESULTS: Our results showed that all the tablets sampled had some form of microbial growth. However; aerobic mesophilic bacteria and fungi observed were within standard numerical limits. It was additionally observed that ascorbic acid and folic acid tablets; particularly from the community pharmacies failed the exclusive criteria for Enterobactereacea and Staphylococci. Tablets from public hospitals in general have lower incidence of exclusive microbial contamination; compared with community pharmacies. CONCLUSION: Tablets packed in large containers in retail pharmacies in Benin City are often contaminated with microbial growth. This has possible adverse consequences for those who obtain drugs stored in large containers

The role of drug delivery sytems in health care: the case of self-medication

Up to 80 per cent of illness episodes are first defined; diagnosed and treated at the household-level. In the developing world especially; approximately half the population has no access to public health services. It is obvious then that other sources of care will be used. We examined the availability of proprietary drugs in communities; and the extent and reasons for their use in the treatment of childhood malaria on the Kenyan Coast. Retail outlets are extensively used as the first tier of health care for illnesses considered to be mild or mundane. However; the wide range; types and formulations of over-the-counter (OTC) drugs including antimalarials available in these retail outlets constitute a major health hazard. Yet; both users and proprietors of retail outlets know little or nothing about the drugs and thus use or sell them inapproprietely. Even; children are treated promptly by purchase of OTC drugs. The policy implications of these findings are discussed

Analyse du processus d'approvisionnement en medicaments dans le circuit de distribution public au Burkina Faso : enquete realisee aupres de 96 structures

Etude menee sous forme d'enquete dans 96 structures sanitaires et pharmaceutiques afin de degager les obstacles lies au deroulement efficace du cycle d'approvisionnement en medicaments. Apres un rappel sur la situation pharmaceutique nationale; l'auteur decrit la methodologie; expose ses resultats et commentaires. L'analyse revele des problemes a toutes les etapes du processus. Il termine en proposant des bases de solutions aux problemes souleves