Pharmacists and regulators’ perceptions and policy-practice gaps within the drug distribution system in South West Nigeria

This study evaluated pharmaceutical stakeholders’ perceptions of Nigeria’s drug distribution system, their awareness of relevant national policies and recommendations for reforms. A cross-sectional survey was conducted among 349 pharmacists (retailers, wholesalers, importers, and manufacturers) and 36 regulators from the Pharmacy Council of Nigeria (PCN) and National Agency for Food and Drug Administration and Control (NAFDAC) in Southwest Nigeria between August 2024 and July 2025. Two semi-structured questionnaires were used to assess perceptions of chaos, contributing factors, and awareness of policies. Data were analysed with descriptive and inferential statistics, and a p-value set at 0.05. Response rates were 93.7% and 86.1% among pharmacists and regulators, respectively. Most respondents were males with a bachelor’s degree. Awareness of the National Drug Policy and National Drug Distribution Guidelines was high among the pharmacists (85.9% and 73.1%) and regulators (90.3% and 71.0%), respectively. Majority of pharmacists (91.4%) and all regulators believed the drug distribution system in Nigeria is chaotic. Contributing factors included poor implementation of existing laws, open drug markets, poor cooperation among stakeholders, and non-professionals in business. Also, 60% of retail pharmacists had patronized open drug markets, citing wider stock and cheaper prices as reasons. This patronage was significantly associated with perceived personal contribution to the chaotic system and lack of National Drug Distribution Guidelines awareness ( p < 0.05). Awareness of National Drug Policy and National Drug Distribution Guidelines was high among stakeholders. There are widespread perceptions of chaos within Nigeria’s drug distribution system, attributed to poor enforcement, open drug markets, and resource limitations. Coordinated multistakeholder reforms are urgently needed to ensure a streamlined drug distribution in Nigeria.