Key result
Demand and supply of substandard blood pressure medications in Nigeria are driven by high out-of-pocket costs, stockouts, limited manufacturing capacity, and under-resourced regulatory systems.
Why the study?
Substandard and falsified BP-lowering medications are a global issue, but qualitative research exploring the factors driving this in Nigeria had not been reported.
Cross-Sectional
The demand and supply of substandard and falsified blood pressure lowering medications in Nigeria are driven by multi-level factors including high out-of-pocket costs, stockouts, and weak regulatory systems, requiring multi-pronged strategies to address.
Answers are grounded in this paper and cite their sources.
Supports targeted policies to address cost and supply barriers in Nigeria; leaves open effects on hypertension outcomes.
OBJECTIVES: Although substandard and falsified (SF) blood pressure (BP) lowering medications are a global problem, qualitative research exploring factors driving this in Nigeria has not been reported. This study provides information on factors driving demand for and supply of low-quality BP lowering medications in Nigeria and potential strategies to address these factors. METHODS: This was a cross-sectional qualitative study. Between August 2020 and September 2020, we conducted 11 in-depth interviews and 7 focus group discussions with administrators of health facilities, major manufacturers and distributors of BP lowering medications, pharmacists, drug regulators, patients and primary care physicians purposively sampled from the Federal Capital Territory, Nigeria. Data were analysed using directed content analysis, with the aid of Dedoose. RESULTS: We found that demand for SF BP lowering medications in Nigeria was driven by high out-of-pocket expenditure and stockouts of quality-assured BP lowering medications. Supply of low-quality BP lowering medications was driven by limited in-country manufacturing capacity, non-adherence to good manufacturing and distribution practices, under-resourced drug regulatory systems, ineffective healthcare facility operations, poor distribution practices, limited number of trained pharmacists and the COVID-19 pandemic which led to stockouts. Central medicine store procurement procedures, active pharmaceutical ingredient quality check and availability of trained pharmacists were existing strategies perceived to lower the risk of supply and demand of SF BP lowering medications. CONCLUSION: Our findings suggest that demand for and supply of SF BP lowering medications in Nigeria are driven by multi-level, interrelated factors. Multi-pronged strategies need to target stakeholders and systems involved in drug production, distribution, prescription, consumption, regulation and pricing.
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Shedul et al. (2022) conducted a cross-sectional in Substandard and falsified blood pressure lowering medications. Factors driving demand and supply of substandard and falsified blood pressure lowering medications was evaluated on Factors driving demand for and supply of low-quality BP lowering medications. Demand and supply of substandard blood pressure medications in Nigeria are driven by high out-of-pocket costs, stockouts, limited manufacturing capacity, and under-resourced regulatory systems.
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