Efforts to detect fakes with handheld spectrometers appear to be having a positive impact on drug quality in Nigeria according to research by US think-tank the American Enterprise Institute (AEI).
The study found that during analysis of 251 drug samples randomly selected from pharmacies across the capital Lagos, portable Raman spectrometers identified more substandard products than either thin-layer chromatography or visual inspection.
The research suggests that, despite the small sample size, the quality of drugs has improved since the National Agency for Food and Drug Administration and Control (NAFDAC) rolled out the technology in 2009
Authors Roger Bate and Aparna Mathur hypothesise that: “The introduction of spectrometers had a noticeable impact on drug quality and the sales of poor quality drugs since the probability of being caught rose after their introduction.”
Bate told in-Pharmatechnologist.com that: “[The] NAFDAC in Nigeria has shown the rest of the continent what can be done to combat bad quality drugs, particularly counterfeit, on its markets. If other nations followed Nigeria's lead there would be a lowering of fakes on their markets too.”
Cost and quality
The team also looked at the cost of the drugs tested and found that those which passed cost an average of $1.85 more than comparator products that failed QC analysis.
This was 85 per cent higher than the price difference observed between ‘good’ and ‘bad’ drugs during a similar study conducted in Nigeria prior to 2010.
Part of the reason for the increase in price, according to the authors, may again be the improvement in drug quality that the introduction of improved detection technology has brought about.
“The result…suggests that as counterfeits became easier to detect, price differences between genuine and counterfeit drugs became starker and prices became a better signal of quality.”
The researchers also cited an, as yet, unpublished study which took data from a larger sample of countries, years and drugs, as lending further support to the idea that higher prices are an indication of quality.
Branded and Generic
However, while price appears to be an indication of drug quality it does not necessarily follow that lower cost products are not to be trusted in Nigeria according to Bate.
“Most of the good drugs on the market in Nigeria are generics. What we found is that both innovator brands as well as generic brands are faked, often, but not always, being sold at a cheaper price.
“In principle,” he continued “removing those fakes from the market increases the aggregate price of the drugs that remain, but of course the drugs that remain work properly.
“In that sense there is no down side to higher prices, since the cheaper products were not good. But, it's not quite that simple. Regulations increase costs to all producers and hence prices may well rise across the board, including of all the good products too, because of the regulations NAFDAC has put in place.
“On balance this is still the right thing to do. There were over 260 brands of anti-malarials on sale in one survey in Nigeria around 2006. That isn't good competition that is madness, a good portion weren't even registered with NAFDAC and probably a third would have failed quality tests.
“So yes prices will rise and there may be a few people harmed by that, but overall they'll be far more likely to buy good products today than five years ago.”