Self-medication under uncertainty: Insights on drug quality and consumer behavior in Burkina Faso

How does drug quality affect self-medication behavior? We address this question in the context of Burkina Faso, where self-medication with antibiotics is widespread. Using chemical quality tests, we find that one in three antibiotics on the market is substandard or falsified, posing significant health risks. While consumers are broadly aware of the prevalence of poor-quality drugs, they struggle to assess quality based on observable cues such as price or packaging. To identify causal effects, we conduct a novel lab-in-the-field experiment that varies the probability of purchasing effective medicine. We find that self-medication increases as drug quality becomes more certain. These results suggest that market-level interventions to improve drug quality may unintentionally increase inappropriate antibiotic use, with implications for health policy and antimicrobial resistance.