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Kassahun H, Van Schepdael A, Ketema G, Adams E. Development and validation of a simple and affordable LC-UV method for identification and assay of selected antimicrobial medicines. J Pharm Biomed Anal 2024; 244:116127. [PMID: 38554556 DOI: 10.1016/j.jpba.2024.116127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/14/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024]
Abstract
Antimicrobials, particularly antibiotics, are among the most common classes of drugs reported as substandard and falsified (SF) in developing countries. Therefore, it is important to develop simple and affordable analytical methods for the quality control of antimicrobial medicines. In this study, a liquid chromatographic method with ultraviolet detection (LC-UV) was developed and validated for the screening and quantification of 13 antimicrobial medicines and one beta-lactamase inhibitor in pharmaceutical formulations. LC separation was carried out on a Kinetex C18 column (150 mm × 4.6 mm, 2.6 µm) with gradient elution. The mobile phase consisted of mixtures of acetonitrile-water-10 mM phosphate buffer pH 3.5 at ratios of 3:92:5, v/v/v for mobile phase A and 50:45:5, v/v/v for mobile phase B with a flow rate of 0.5 mL/min. The screening method was intended for confirmation of the identity of the actives and validated for specificity and robustness, whereas the quantification method (using only a different detection wavelength) was further validated in terms of linearity, accuracy, sensitivity and precision (repeatability, intermediate precision). For all compounds, the method was found to be linear (r2 > 0.999), precise (%RSD < 1%), accurate (% recovery of 98-102%), sensitive, specific and robust. The developed LC method was successfully applied for the identification and assay of 12 antimicrobial samples from Ethiopia. Among the 12 samples analyzed, one (8.3%) product was confirmed to be falsified.
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Affiliation(s)
- Haile Kassahun
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB, 923, Leuven 3000, Belgium; Wollo University, College of Medicine and Health Sciences, Department of Pharmacy P.O. Box 1145, Dessie, , Ethiopia
| | - Ann Van Schepdael
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB, 923, Leuven 3000, Belgium
| | - Gebremariam Ketema
- Wollo University, College of Medicine and Health Sciences, Department of Pharmacy P.O. Box 1145, Dessie, , Ethiopia
| | - Erwin Adams
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB, 923, Leuven 3000, Belgium.
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Tefera Mekasha Y, Nigussie S, Ashagre W, Getahun Feleke M, Wondie A, Mulaw A, Dessalegn B. Evaluating the Knowledge, Practice, and Regulatory Situation of Veterinary Experts Regarding Counterfeit Veterinary Medications in the Selected Districts of Central Gondar Zone, Ethiopia. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2024; 15:91-108. [PMID: 38595914 PMCID: PMC11001539 DOI: 10.2147/vmrr.s450560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
Background The intentional and illegal misrepresentation of fake medications involves falsely indicating their source. These fraudulent medications can include products that contain either accurate or incorrect ingredients, lack proper labeling, have insufficient quantities of ingredients, and are packaged with counterfeit packaging. This unlawful activity has led to treatment failures, the development of antibiotic resistance, adverse effects, and even deaths. Hence, the objective of this study was to assess the knowledge, practice, and regulatory status of veterinary drug experts in the central Gondar zone of Ethiopia regarding counterfeit veterinary medications. Methods From January 2023 to July 2023, a self-administered structured questionnaire was utilized to conduct a cross-sectional study in Central Gondar Zone, Ethiopia. The analysis of the data involved the application of descriptive and chi-square tests. Results The study revealed that the majority of professionals possessed a work experience ranging from 5 to 9 years (23; 56.1%). Additionally, a total of 25 individuals (61.0%) who participated in the research had not undergone any kind of training. It was observed that a significant proportion of participants (82.9%) possessed knowledge about counterfeit veterinary drugs. Only about 63% and 36% of respondents had high knowledge and good practice concerning veterinary counterfeit drugs, respectively. Only 29.3% of participants have reported practices. Furthermore, a poor regulatory level of coordination was detected (85.4%). The study revealed a significant (χ2 =7.6165; p = 0.022) disparity between the respondents' practice levels and training. Respondents' regulatory levels were also significantly associated (p < 0.05) with their sex (χ2 = 13.34; p = 0.001) and work experience (χ2 = 13.64; p = 0.033). The research findings also revealed a noteworthy correlation between practice and regulatory activity (χ2 = 15.0463; p = 0.005). Conclusion The study outlines the necessity of awareness initiatives, with a focus on the significance of veterinary experts' knowledge, practice, and regulatory efforts in addressing the issue of counterfeit veterinary medications.
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Affiliation(s)
- Yesuneh Tefera Mekasha
- Department of Veterinary Pharmacy, Pharmaceutical Quality Assurance, and Regulatory Affairs, University of Gondar, Gondar, Ethiopia
| | - Sete Nigussie
- Department of Veterinary Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Wegayehu Ashagre
- Doctor of Veterinary Medicine, University of Gondar, Gondar, Ethiopia
| | - Melaku Getahun Feleke
- Department of Veterinary Pharmacy, Pharmaceutical Analysis, and Quality Assurance, University of Gondar, Gondar, Ethiopia
| | - Abibo Wondie
- Department of Veterinary Pharmacy, Drug Supply Chain Management, University of Gondar, Gondar, Ethiopia
| | - Asnakew Mulaw
- Department of Veterinary Pathobiology, University of Gondar, Gondar, Ethiopia
| | - Bereket Dessalegn
- Department of Veterinary Pathobiology, University of Gondar, Gondar, Ethiopia
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Tegegne AA, Feissa AB, Godena GH, Tefera Y, Hassen HK, Ozalp Y, Suleman S. Substandard and falsified antimicrobials in selected east African countries: A systematic review. PLoS One 2024; 19:e0295956. [PMID: 38277385 PMCID: PMC10817106 DOI: 10.1371/journal.pone.0295956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/04/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Globally, millions of people have been affected by fraudulent pharmaceutical products, particularly those in developing countries. Although the problem of falsified and substandard drugs is acknowledged, the extent of the issue is ever-changing, has a dynamic nature, and should be quantified and captured in a recent snapshot. OBJECTIVE This systematic review seeks to examine the data that can quantify and provide a current snapshot of the prevalence of SF antimicrobials in selected east Africa countries. METHODS Scientific studies on antimicrobial quality were searched in PubMed, Embase, Scopus, and Google Scholar from 2017 to February 2023. The search strategy focused on scientific articles published in peer-reviewed scientific journals written in English and the studies exclusively done in any of the selected countries of east Africa. The articles were carefully reviewed by two individuals for inclusion independently, first by title followed by abstract and the full-text retrieval. To minimize bias associated with the methodology used for data collection, the quality of the studies was assessed for quality according to the Medicine Quality Assessment Reporting Guidelines (MEDQUARG). The reporting of this systematic review was done following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). RESULTS Fifteen studies that estimated the prevalence of poor-quality antimicrobial medicines in selected four east African countries were included. The overall percentage of samples of antimicrobials that failed at least one quality test was 22.6% (151/669) with each class's prevalence of 17% in antibiotics (73/432), 24% in antimalarial (41/171), and 56% in anthelmintics (37/66). Quality control parameters of API content were the most commonly examined in the included studies, accounting for 14/15 (93%) studies. Fifty (33.1%) of the failing samples failed assay API- content determination, while 26.5% (n = 40) failed the visual inspection and packaging analysis; 19.2% (29) failed dissolution; 14% (n = 21) flawed hardness or friability; 4%(n = 6) failed uniformity, as well as 3.2% (n = 5) failed disintegration test of the quality control parameter. CONCLUSION It was found that this review was general in these selected east African countries and was a catalyst for combating the menace of poor-quality medications that affect millions of lives.
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Affiliation(s)
- Addisu Afrassa Tegegne
- Pharmaceutical Sciences, Pharmaceutical Quality Assurance and Regulatory Affairs, University of Gondar, Gondar, Ethiopia
| | - Anbessa Bekele Feissa
- Pharmaceutical Sciences, School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Gemmechu Hasen Godena
- Pharmaceutical Sciences, School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Yesuneh Tefera
- Pharmaceutical Sciences, Pharmaceutical Quality Assurance and Regulatory Affairs, University of Gondar, Gondar, Ethiopia
| | - Hassen Kebede Hassen
- Ethiopian Agricultural Authority, Veterinary Drug Quality Control and Inspection Directorate, Addis Ababa, Ethiopia
- Department of Pharmaceutical Technology, Near East University, Turkey
| | - Yildiz Ozalp
- Department of Pharmaceutical Technology, Near East University, Turkey
| | - Sultan Suleman
- Pharmaceutical Sciences, School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
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Jaff D. The proliferation of counterfeit and substandard medicines in Iraq and the Kurdistan Region of Iraq (KRI): why does it matter? Med Confl Surviv 2023; 39:352-355. [PMID: 37722407 DOI: 10.1080/13623699.2023.2258327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Affiliation(s)
- Dilshad Jaff
- Maternal and Child Health Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Waffo Tchounga CA, Sacré PY, Ravinetto R, Lieberman M, Hamuli Ciza P, Ngono Mballa R, Ziemons E, Hubert P, Djang’eing’a Marini R. Usefulness of medicine screening tools in the frame of pharmaceutical post-marketing surveillance. PLoS One 2023; 18:e0289865. [PMID: 37566594 PMCID: PMC10420354 DOI: 10.1371/journal.pone.0289865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The negative consequences of Substandard and falsified (SF) medicines are widely documented nowadays and there is still an urgent need to find them in more efficient ways. Several screening tools have been developed for this purpose recently. In this study, three screening tools were used on 292 samples of ciprofloxacin and metronidazole collected in Cameroon. Each sample was then analyzed by HPLC and disintegration tests. Seven additional samples from the nitro-imidazole (secnidazole, ornidazole, tinidazole) and the fluoroquinolone (levofloxacin, ofloxacin, norfloxacin, moxifloxacin) families were analyzed to mimic falsified medicines. Placebo samples that contained only inert excipients were also tested to mimic falsified samples without active pharmaceutical ingredient (API). The three screening tools implemented were: a simplified visual inspection checklist, a low-cost handheld near infrared (NIR) spectrophotometer and paper analytical devices (PADs). Overall, 61.1% of the samples that failed disintegration and assay tests also failed the visual inspection checklist test. For the handheld NIR, one-class classifier models were built to detect the presence of ciprofloxacin and metronidazole, respectively. The APIs were correctly identified in all the samples with sensitivities and specificities of 100%. However, the importance of a representative and up-to-date spectral database was underlined by comparing models built with different calibration set spanning different variability spaces. The PADs were used only on ciprofloxacin samples and detected the API in all samples in which the presence of ciprofloxacin was confirmed by HPLC. However, these PADs were not specific to ciprofloxacin since they reacted like ciprofloxacin to other fluoroquinolone compounds. The advantages and drawbacks of each screening tool were highlighted. They are promising means in the frame of early detection of SF medicines and they can increase the speed of decision about SF medicines in the context of pharmaceutical post-marketing surveillance.
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Affiliation(s)
- Christelle Ange Waffo Tchounga
- Department of Pharmacy, Laboratory of Pharmaceutical Analytical Chemistry, University of Liege (ULiege), CIRM, Liège, Belgium
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Pierre-Yves Sacré
- Department of Pharmacy, University of Liege (ULiege), CIRM, Research Support Unit in Chemometrics, Liège, Belgium
| | - Raffaella Ravinetto
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Marya Lieberman
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, United States of America
| | - Patient Hamuli Ciza
- Faculty of Pharmaceutical Sciences, University of Kinshasa, Lemba, Kinshasa, Democratic Republic of the Congo
| | - Rose Ngono Mballa
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Laboratoire National de Contrôle des Médicaments et Expertise (LANACOME), Yaoundé, Cameroon
| | - Eric Ziemons
- Department of Pharmacy, Laboratory of Pharmaceutical Analytical Chemistry, University of Liege (ULiege), CIRM, Liège, Belgium
| | - Philippe Hubert
- Department of Pharmacy, Laboratory of Pharmaceutical Analytical Chemistry, University of Liege (ULiege), CIRM, Liège, Belgium
| | - Roland Djang’eing’a Marini
- Department of Pharmacy, Laboratory of Pharmaceutical Analytical Chemistry, University of Liege (ULiege), CIRM, Liège, Belgium
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Shedul G, Sanuade OA, Ugwuneji EN, Ojo TM, Vijay A, Ponzing P, Okpe I, Shedul GL, Huffman MD, Ojji D, Hirschhorn LR. Stakeholder perspectives on the demand and supply factors driving substandard and falsified blood pressure lowering medications in Nigeria: a qualitative study. BMJ Open 2022; 12:e063433. [PMID: 36549744 PMCID: PMC9791447 DOI: 10.1136/bmjopen-2022-063433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
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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Affiliation(s)
- Grace Shedul
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Olutobi Adekunle Sanuade
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah, USA
- Robert J Havey Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eugenia N Ugwuneji
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Tunde M Ojo
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Aishwarya Vijay
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Patrick Ponzing
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Inuwa Okpe
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Gabriel Lamkur Shedul
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Mark D Huffman
- Robert J Havey Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Cardiovascular Division and Global Health Center, Washington University in St Louis, St Louis, Missouri, USA
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dike Ojji
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
- Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria
| | - Lisa R Hirschhorn
- Robert J Havey Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Karungamye P. Counterfeit and substandard drugs in Tanzania: A review. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2022. [DOI: 10.1016/j.fsir.2022.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Yasunaga T, Fukuoka T, Yamaguchi A, Ogawa N, Yamamoto H. Microtaggant Technology for Ensuring Traceability of Pharmaceutical Formulations: Potential for Anti-counterfeiting Measures, Distribution and Medication Management. YAKUGAKU ZASSHI 2022; 142:1255-1265. [DOI: 10.1248/yakushi.22-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Toshiya Yasunaga
- Laboratory of Pharmaceutical Engineering, School of Pharmacy, Aichi Gakuin University
| | | | - Akinobu Yamaguchi
- Laboratory of Advanced Science and Technology for Industry, University of Hyogo
| | - Noriko Ogawa
- Laboratory of Pharmaceutical Engineering, School of Pharmacy, Aichi Gakuin University
| | - Hiromitsu Yamamoto
- Laboratory of Pharmaceutical Engineering, School of Pharmacy, Aichi Gakuin University
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Jenkins D, Diallo C, Payne M. Detecting falsified oral contraceptives by visual assessment and diffuse reflectance spectroscopy (350–2500 nm): the need for supplementing traditional pharmacopeia techniques and the public health implications. Heliyon 2022; 8:e10837. [PMID: 36217469 PMCID: PMC9547234 DOI: 10.1016/j.heliyon.2022.e10837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives Substandard and falsified pharmaceuticals can present a major health risk, particularly for low- and middle-income countries. In a Sub-Saharan African market, United States Agency for International Development (USAID) staff found an oral contraceptive product (0.15 mg levonorgestrel/0.03 mg ethinyl estradiol) labeled with a logo (and brand name) visually matching one historically used by USAID but purportedly manufactured by an unauthorized source. Additional assessment was conducted to determine if more evidence of falsification was present to better understand the public health impact. Study design Relative to a control, the suspect sample was assessed visually for tablet features and with United States and International Pharmacopeia methods for levonorgestrel/ethinyl estradiol tablets. Diffuse reflectance spectra (350–2500 nm) were collected to further characterize the sample. Results Although the suspect sample aligned with pharmacopeia tests, visual examination of tablet characteristics and diffuse reflectance spectroscopy (350–2500 nm) assessments supported the tablets were not the same as control samples, confirming the suspect sample was falsified. These results raised concerns for the overall regulatory oversight available for the market with uncertainty regarding the true clinical bioequivalence levels (although adequate dissolution levels were observed). Conclusions Comprehensive characterization of suspect pharmaceuticals from the field can often be required depending on the nature of the sample and can have dramatic implications for understanding the public health risks to the end user within the local market. Simple visual assessment and spectroscopic techniques to screen a sample can help to supplement traditional pharmacopeia approaches. Implications Proper characterization of suspect pharmaceuticals is necessary to best understand their potential public health impact. Situations can occur where traditional pharmacopeial techniques may not adequately characterize a sample. Visual assessments and diffuse reflectance spectroscopy can be supplemented to provide a more holistic analysis.
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Pozsgai K, Szűcs G, Kőnig-Péter A, Balázs O, Vajda P, Botz L, Vida RG. Analysis of pharmacovigilance databases for spontaneous reports of adverse drug reactions related to substandard and falsified medical products: A descriptive study. Front Pharmacol 2022; 13:964399. [PMID: 36147337 PMCID: PMC9485933 DOI: 10.3389/fphar.2022.964399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: The public health threat of substandard and falsified medicines has been well known in the last two decades, and several studies focusing on the identification of products affected and preventing consumption have been published. However, the number of these products reaching patients and causing health consequences and adverse drug reactions is not a well-researched area.Objectives: Our aim was to identify and describe the characteristics of cases that are related to adverse drug reactions potentially originating from counterfeit medication using publicly available pharmacovigilance data.Methods: A descriptive study was performed based on pharmacovigilance data retrieved from Individual Case Safety Reports (ICSRs) identified in the European Medicines Agency’s EudraVigilance and FDA Adverse Event Reporting System (FAERS) databases in April 2022 using selected MedDRA preferred terms: counterfeit product administered, product counterfeit, product label counterfeit, product packaging counterfeit, suspected counterfeit product, adulterated product, product tampering, and suspected product tampering. ICSRs were analyzed by age and gender, by year of reporting, region of origin, reporter’s profession, and severity of the outcome. The disproportionality method was used to calculate pharmacovigilance signal measures.Results: A total of 5,253 cases in the FAERS and 1,049 cases in the EudraVigilance database were identified, generally affecting middle-aged men with a mean age of 51.055 (±19.62) in the FAERS and 64.18% of the cases between 18 and 65 years, while the male to female ratios were 1.18 and 1.5. In the FAERS database, we identified 138 signals with 95% confidence interval including sildenafil (n = 314; PRR, 12.99; ROR, 13.04; RRR, 11.97), tadalafil (n = 200; PRR, 11.51; ROR, 11.55; RRR, 10.94), and oxycodone (n = 190; PRR, 2.47; ROR, 2.14; RRR, 2.47). While in the EV data 31, led by vardenafil (n = 16, PRR = 167.19; 101.71–274.84; 95% CI, RRR = 164.66; 100.17–270.66; 95% CI, ROR = 169.47; 103.09–278.60; 95% CI, p < 0.001), entecavir (n = 46, PRR = 161.26, RRR = 154.24, ROR = 163.32, p < 0.001), and tenofovir (n = 20, PRR = 142.10, RRR = 139.42, ROR = 143.74, p < 0.001).Conclusion: The application of pharmacovigilance datasets to identify potential counterfeit medicine ADRs can be a valuable tool in recognition of potential risk groups of consumers and the affected active pharmaceutical ingredients and products. However, the further development and standardization of ADR reporting, pharmacovigilance database analysis, and prospective and real-time collection of potential patients with health consequences are warranted in the future.
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Affiliation(s)
- Kevin Pozsgai
- Department of Pharmaceutics and Central Clinical Pharmacy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Gergő Szűcs
- Department of Pharmaceutics and Central Clinical Pharmacy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Anikó Kőnig-Péter
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Orsolya Balázs
- Department of Pharmaceutics and Central Clinical Pharmacy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Péter Vajda
- Department of Pharmaceutics and Central Clinical Pharmacy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Lajos Botz
- Department of Pharmaceutics and Central Clinical Pharmacy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Róbert György Vida
- Department of Pharmaceutics and Central Clinical Pharmacy, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
- *Correspondence: Róbert György Vida,
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Surveillance for substandard and falsified medicines by local faith-based organizations in 13 low- and middle-income countries using the GPHF Minilab. Sci Rep 2022; 12:13095. [PMID: 35908047 PMCID: PMC9338985 DOI: 10.1038/s41598-022-17123-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022] Open
Abstract
This study evaluates the use of the Global Pharma Health Fund (GPHF) Minilab for medicine quality screening by 16 faith-based drug supply organizations located in 13 low- and middle-income countries. The study period included the year before the COVID-19 pandemic (2019) and the first year of the pandemic (2020). In total 1,919 medicine samples were screened using the GPHF Minilab, and samples showing serious quality deficiencies were subjected to compendial analysis in fully equipped laboratories. Thirty-four (1.8%) of the samples were found not to contain the declared active pharmaceutical ingredient (API), or less than 50% of the declared API, or undeclared APIs, and probably represented falsified products. Fifty-four (2.8%) of the samples were reported as substandard, although the true number of substandard medicines may have been higher due to the limited sensitivity of the GPHF Minilab. The number of probably falsified products increased during the COVID-19 pandemic, especially due to falsified preparations of chloroquine; chloroquine had been incorrectly advocated as treatment for COVID-19. The reports from this project resulted in four international WHO Medical Product Alerts and several national alerts. Within this project, the costs for GPHF Minilab analysis resulted as 25.85 € per sample. Medicine quality screening with the GPHF Minilab is a cost-effective way to contribute to the global surveillance for substandard and falsified medical products.
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Dohou AM, Yémoa AL, Guidan DBA, Ahouandjinou SHS, Amoussa A, Dossou FM, Marini Djang’eing’a R, Dalleur O. Assessment of the Quality of Injectable Antibiotics in Benin. Am J Trop Med Hyg 2022; 107:24-31. [DOI: 10.4269/ajtmh.21-0844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/06/2022] [Indexed: 11/07/2022] Open
Abstract
Substandard and falsified medicines are an enormous threat to global health. Poor quality antibiotic preparations contribute to the development of antimicrobial resistance. In surgery, where the occurrence of healthcare-associated infections is high, healthcare teams need to rely on the quality of antibiotic prophylaxis to prevent infections. We assessed the quality of antibiotics used for surgical infection prophylaxis in Benin. Thirty-three samples were collected from six hospitals located in various departments in Benin. The antibiotics (powders for injection: amoxicillin + clavulanic acid, ampicillin, ceftriaxone; solutions for injection: ciprofloxacin, gentamicin, metronidazole) were assessed using visual inspection, pharmacotechnical tests (including uniformity of mass, pH measure, sterility test, and active pharmaceutical ingredient identification), and assay tests (including a simple analytical method thin layer chromatography) and complex analytical techniques (ultraviolet-visible spectrophotometry, high-performance liquid chromatography—diode-array detection, conductometry). Because the material needed for the methods recommended by the pharmacopeias to assess the dosage of gentamicin was not available, we developed and validated a conductometry method. Results showed that 97% (n = 32) of the samples passed visual inspection; 100% (n = 33) of the samples passed the pharmacotechnical tests, identification of active ingredients, and sterility test; 88% (n = 29) passed the test for percentage of active pharmaceutical ingredients. Overall, 15% of the samples did not pass the quality test (3% on visual inspection and 12% for excess active ingredients). Although most of the samples passed the quality tests, it appears important to perform routine quality control for intravenous medicines.
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Affiliation(s)
- Angèle Modupè Dohou
- Louvain Drug Research Institute, Clinical Pharmacy, Université Catholique de Louvain (UCLouvain), Belgium
- Laboratoire de Chimie Analytique et Analyse des Médicaments, Université d’Abomey Calavi, Bénin
| | - Achille Loconon Yémoa
- Laboratoire de Chimie Analytique et Analyse des Médicaments, Université d’Abomey Calavi, Bénin
| | | | | | - Ahmed Amoussa
- Laboratoire de Chimie Analytique et Analyse des Médicaments, Université d’Abomey Calavi, Bénin
| | - Francis Moïse Dossou
- Service de Chirurgie Générale, Centre Hospitalo-Universitaire Départemental Ouémé-Plateau, Bénin
| | - Roland Marini Djang’eing’a
- Department of Pharmacy, CIRM, Laboratory of Analytical Pharmaceutical Chemistry, University of Liege, Belgium
| | - Olivia Dalleur
- Louvain Drug Research Institute, Clinical Pharmacy, Université Catholique de Louvain (UCLouvain), Belgium
- Pharmacy Department, Cliniques Universitaires Saint-Luc, UCLouvain, Belgium
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13
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Ofori-Parku SS, Park SE. I (Don’t) want to consume counterfeit medicines: exploratory study on the antecedents of consumer attitudes toward counterfeit medicines. BMC Public Health 2022; 22:1094. [PMID: 35650557 PMCID: PMC9158175 DOI: 10.1186/s12889-022-13529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background Substandard and falsified medicine (SFM) sales (an estimated > $200 billion) has become one of the worlds’ fastest growing criminal enterprises. It presents an enormous public health and safety challenge. While the developed world is not precluded from this challenge, studies focus on low-income countries. They emphasize supply chain processes, technological, and legal mechanisms, paying less attention to consumer judgment and decision-making aspects. Methods With attention to the demand side of the counterfeit medicines challenge, this survey of U.S. consumers (n = 427) sheds light on some of the social, psychological, and normative factors that underlie consumers’ attitudes, risk perceptions, and purchase intentions. Results Consumers who (a) self-report that they know about the problem, (b) are older, (c) view counterfeit medicine consumption as ethical, and (d) think their significant others would approve of them using such products are more inclined to perceive lower risks and have favorable purchase intentions. Risk averseness is also inversely related to the predicted outcomes. Perceived benefit of SFMs is a factor but has no effect when risk perception and aversion, attitudes, and subjective norms are factored into the model that predicts purchase intentions. Conclusion The results of this study indicate that consumer knowledge (albeit in an unexpected direction), people’s expectations about what will impress their significant others, their ethical judgments about selling and consuming counterfeits, and their risk-aversion are associated with their decision-making about counterfeit medicines. The study offers insights into a demand-side approach to addressing SFM consumption in the U.S. Implications for public health, consumer safety, and brand advocacy education are discussed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13529-7.
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14
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Hoellein L, Kaale E, Mwalwisi YH, Schulze MH, Vetye-Maler C, Holzgrabe U. Emerging Antimicrobial Drug Resistance in Africa and Latin America: Search for Reasons. Risk Manag Healthc Policy 2022; 15:827-843. [PMID: 35519501 PMCID: PMC9064051 DOI: 10.2147/rmhp.s205077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
Medicine quality and methods for its assessment play a major role in the effectiveness of therapies and the treatment of many infectious diseases. However, poor-quality and/or falsified products are circulating in huge amounts in many low- and middle-income countries and are one of the major reasons why more and more resistant bacteria emerge. The development of resistance is additionally triggered by a plethora of antibiotic medicines which is easily available through pharmacies and unofficial sources. The uncontrolled overuse of these products is a huge problem not only in single countries but worldwide. In this review, we aim to demonstrate the factors which are involved in an emerging resistance development and how strong regulatory authorities, routine quality control by means of proficiency testing, and post-marketing surveillance as well as training personnel and patients can be combined to curb the problem.
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Affiliation(s)
- Ludwig Hoellein
- Institute for Pharmacy and Food Chemistry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Eliangiringa Kaale
- Muhimbili University of Health and Allied Sciences, School of Pharmacy, Dar es Salaam, Tanzania
| | | | - Marco H Schulze
- Georg-August-Universität Göttingen, Institut für Krankenhaushygiene und Infektiologie, Göttingen, Germany
| | | | - Ulrike Holzgrabe
- Institute for Pharmacy and Food Chemistry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
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Schripsema J, Dos Santos Merlim R, Gonçalves Parvan L, Sant'Ana Dos Santos Ribeiro H, Dagnino Schripsema L, Aleixo S, Becht A, Holzgrabe U, Dagnino D. Towards a holistic view of tablet quality, an extensive study on paracetamol tablets with nuclear magnetic resonance using similarity calculations, differential NMR and hierarchical cluster analysis. J Pharm Biomed Anal 2022; 215:114773. [PMID: 35489248 DOI: 10.1016/j.jpba.2022.114773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/03/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
The 1H NMR spectra obtained from 56 different paracetamol tablets were thoroughly investigated to analyse and quantify besides paracetamol, the excipients and eventual minor components present in the formulations. In the NMR spectra the amide-iminol tautomerism of paracetamol was observed, with the iminol form present at a quantity of only 0.80% of the amide form. Furthermore, seventeen different components of the tablets were identified, ranging from major excipients like starch and polyvinylpyrrolidone (PVP) to minor components like different parabens, sorbate and triacetin. The similarity from all spectra in relation to each of the other spectra was calculated and based on the similarity table a hierarchical cluster analysis (HCA) was performed. Each of the components of the DMSO extracts of the tablets was quantified, providing a component table, which also was used for HCA. The quantitative analysis of paracetamol was determined to have a precision of 0.2% using the residual solvent signals as internal standard. The HCA of the similarity data and the component table were compared with the HCAs obtained by analysis of the crude NMR data. This clearly shows the limitations of multivariate data analysis and the strength of similarity calculations combined with differential NMR, especially in relation to the analysis of trace components. In fact, the spectrum is not a series of unrelated variables, but a superposition of a limited number of component spectra, and the quantities of these components were determined.
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Affiliation(s)
- Jan Schripsema
- Grupo Metabolômica, Laboratório de Ciências Quimicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil.
| | - Ronald Dos Santos Merlim
- Grupo Metabolômica, Laboratório de Ciências Quimicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil
| | - Lais Gonçalves Parvan
- Grupo Metabolômica, Laboratório de Ciências Quimicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil
| | - Helen Sant'Ana Dos Santos Ribeiro
- Grupo Metabolômica, Laboratório de Ciências Quimicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil
| | - Leonardo Dagnino Schripsema
- Instituto de Computação, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos, 274, Ilha da Cidade Universitária, Rio de Janeiro, 21941-909, Brazil
| | - Seldon Aleixo
- Grupo Metabolômica, Laboratório de Ciências Quimicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil
| | - Alexander Becht
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Am Hubland, 97074 Würzburg, Germany
| | - Ulrike Holzgrabe
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Am Hubland, 97074 Würzburg, Germany
| | - Denise Dagnino
- Grupo Metabolômica, Laboratório de Biotecnologia, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil
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16
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Islam I, Islam MN. Digital intervention to reduce counterfeit and falsified medicines: A systematic review and future research agenda. JOURNAL OF KING SAUD UNIVERSITY - COMPUTER AND INFORMATION SCIENCES 2022. [DOI: 10.1016/j.jksuci.2022.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Akpobolokemi T, Martinez-Nunez RT, Raimi-Abraham BT. Tackling the global impact of substandard and falsified and unregistered/unlicensed anti-tuberculosis medicines. MEDICINE ACCESS @ POINT OF CARE 2022; 6:23992026211070406. [PMID: 36204519 PMCID: PMC9413333 DOI: 10.1177/23992026211070406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
Substandard and falsified (SF) medicines are a global health challenge with the
World Health Organization (WHO) estimating that 1 in 10 of medicines in low- and
middle-income countries (LMICs) are SF. Antimicrobials (i.e. antimalarials,
antibiotics) are the most commonly reported SF medicines. SF medicines
contribute significantly to the global burden of infectious diseases and
antimicrobial resistance (AMR). This article discusses the challenges associated
with the global impact of SF and unregistered/unlicensed antimicrobials with a
focus on anti-TB medicines. Tuberculosis (TB) is the 13th leading cause of death
worldwide, and is currently the second leading cause of death from a single
infectious agent, ranking after COVID-19 and above HIV/AIDS. Specifically in the
case of TB, poor quality of anti-TB medicines is among the drivers of the
emergence of drug-resistant TB pathogens. In this article, we highlight and
discuss challenges including the emergence of SF associated AMR, patient
mistrust and lack of relevant data. We also present study reports to inform
meaningful change. Recommended solutions involve the adaptation of interventions
from high-income countries (HICs) to LMICS, the need for improvement in the
uptake of medication authentication tools in LMICs, increased stewardship, and
the need for global and regional multidisciplinary legal and policy cooperation,
resulting in improved legal sanctions.
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Affiliation(s)
- Tamara Akpobolokemi
- Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Rocio Teresa Martinez-Nunez
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King’s College London, Guy’s Hospital, London, UK
| | - Bahijja Tolulope Raimi-Abraham
- Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
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18
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Chatterjee A, Swierstra T, Kuiper M. Dealing with different conceptions of pollution in the Gene Regulation Knowledge Commons. BIOCHIMICA ET BIOPHYSICA ACTA. GENE REGULATORY MECHANISMS 2022; 1865:194779. [PMID: 34971789 DOI: 10.1016/j.bbagrm.2021.194779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
Current research of gene regulatory mechanisms is increasingly dependent on the availability of high-quality information from manually curated databases. Biocurators undertake the task of extracting knowledge claims from scholarly publications, organizing these claims in a meaningful format and making them computable. In doing so, they enhance the value of existing scientific knowledge by making it accessible to the users of their databases. In this capacity, biocurators are well positioned to identify and weed out information that is of insufficient quality. The criteria that define information quality are typically outlined in curation guidelines developed by biocurators. These guidelines have been prudently developed to reflect the needs of the user community the database caters to. The guidelines depict the standard evidence that this community recognizes as sufficient justification for trustworthy data. Additionally, these guidelines determine the process by which data should be organized and maintained to be valuable to users. Following these guidelines, biocurators assess the quality, reliability, and validity of the information they encounter. In this article we explore to what extent different use cases agree with the inclusion criteria that define positive and negative data, implemented by the database. What are the drawbacks to users who have queries that would be well served by results that fall just short of the criteria used by a database? Finally, how can databases (and biocurators) accommodate the needs of such more explorative use cases?
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Affiliation(s)
- Anamika Chatterjee
- Department of Philosophy and Religious Studies, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Tsjalling Swierstra
- Department of Philosophy, Maastricht University, Maastricht, the Netherlands
| | - Martin Kuiper
- Department of Biology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Sakira AK, Ouattara MSMJ, Yabre M, Bande M, Some TI. Contribution to the Detection of Poor Quality Sildenafil Drugs in Burkina Faso Using High-Performance Thin-Layer Chromatography. JOURNAL OF ANALYTICAL METHODS IN CHEMISTRY 2021; 2021:4093859. [PMID: 34691802 PMCID: PMC8528628 DOI: 10.1155/2021/4093859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/18/2021] [Accepted: 09/25/2021] [Indexed: 06/13/2023]
Abstract
In substandard drugs enforcement, there is a need to develop reliable, fast, and inexpensive analytical methods. Due to its very characteristics, HPTLC offers opportunities for the development of methods that meet these requirements. This technique was used to develop and validate a method for the determination of sildenafil in pharmaceutical formulations from the licit and illicit supply chain in Burkina Faso. Taking into account optimization parameters such as measurement wavelength and mobile phase composition, the best elution quality is found at the maximum signals of spots on silica plates at 305 nm, using a mixture of dichloromethane-methanol mixture 9 : 1 (v/v) proportions. The method developed under these conditions was validated using the accuracy profile as a decision tool. The establishment of the response function curves allowed the choice of the polynomial function applied to the peak areas. This mathematical model provides a validity range between 0.4 and 0.6 mg/mL. The application of the developed and validated method to collected samples allowed the detection of two substandard drugs and confirmed the poor quality of drugs in the illicit market. More data using this approach in a variety of drug molecules could lead to the establishment of databases of counterfeit drugs in Burkina Faso.
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Affiliation(s)
- Abdoul Karim Sakira
- Laboratoire de Toxicologie, Environnement et Santé (LATES), Ecole Doctorale des Sciences de La Santé (ED2S), Université Joseph KI-ZERBO, 03 BP 7021 03, Ouagadougou, Burkina Faso
| | - Mitéhélé Sandrine Marie Josiane Ouattara
- Laboratoire de Toxicologie, Environnement et Santé (LATES), Ecole Doctorale des Sciences de La Santé (ED2S), Université Joseph KI-ZERBO, 03 BP 7021 03, Ouagadougou, Burkina Faso
| | - Moussa Yabre
- Laboratoire de Toxicologie, Environnement et Santé (LATES), Ecole Doctorale des Sciences de La Santé (ED2S), Université Joseph KI-ZERBO, 03 BP 7021 03, Ouagadougou, Burkina Faso
| | - Moumouni Bande
- Laboratoire de Toxicologie, Environnement et Santé (LATES), Ecole Doctorale des Sciences de La Santé (ED2S), Université Joseph KI-ZERBO, 03 BP 7021 03, Ouagadougou, Burkina Faso
| | - Touridomon Issa Some
- Laboratoire de Toxicologie, Environnement et Santé (LATES), Ecole Doctorale des Sciences de La Santé (ED2S), Université Joseph KI-ZERBO, 03 BP 7021 03, Ouagadougou, Burkina Faso
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20
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Sweileh WM. Substandard and falsified medical products: bibliometric analysis and mapping of scientific research. Global Health 2021; 17:114. [PMID: 34556126 PMCID: PMC8460181 DOI: 10.1186/s12992-021-00766-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objective Substandard and falsified (SF) medical products are a global public health threat. The presence and spread of SF drugs negatively affect (1) patients’ safety and health outcomes, (2) national economy, (3) public trust in the healthcare system, and (4) the international fight against serious health challenges such as malaria and antimicrobial resistance. The objective of the current study was to investigate and provide a snapshot analysis of the evolution and developmental patterns of global research publications on SF products. Methods A bibliometric approach was adopted using terms such as fake, falsified, counterfeit, substandard, and others. No language restriction was made. The study period was from 1900 up to 2020. The search strategy was validated and implemented using Scopus database. Results The search strategy retrieved 978 documents authored by 2861 researchers from 100 different countries and published in 421 different journals. The retrieved documents received 11,237 citations (11.5 citations per document) with an H-index of 53. The 978 documents retrieved from Scopus were published from 1961 to 2020, giving an average of 16.6 publications per year. The present study indicated that research on SF medical products: (a) has experienced a steep growth from 2001 to 2012 followed by a steady-state growth; (b) was disseminated in a wide range of journals, mainly in the fields of the pharmaceutical industry, analytical chemistry, public health, infectious diseases, and internal medicine; (c) was published by scholars with diverse and distant geographical backgrounds; (d) was mainly produced in the United States, United Kingdom, and Germany; (d) has fragmented research networks and a limited number of researchers per network; (e) has limited cross-country collaboration except for that between the US and the UK in one hand and countries in the Mekong region in the other hand; (f) emphasized on medications related to malaria and sexual stimulants; and (g) received relatively inadequate funding. Conclusions Research on SF medical products is important and should remain a priority to ensure good quality of medications. Research activity in the field needs to be encouraged in world regions such as Africa and the Middle East where drug regulations are unsatisfactory and cross-border trade of illegal medications is common. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-021-00766-5.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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21
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McManus D, Naughton BD. A systematic review of substandard, falsified, unlicensed and unregistered medicine sampling studies: a focus on context, prevalence, and quality. BMJ Glob Health 2021; 5:bmjgh-2020-002393. [PMID: 32859648 PMCID: PMC7454198 DOI: 10.1136/bmjgh-2020-002393] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 02/06/2023] Open
Abstract
Substandard and falsified (SF) medicines are a global issue contributing to antimicrobial resistance and causing economic and humanitarian harm. To direct law enforcement efficiently, halt the spread of SF medicines and antimicrobial resistance, academics, NGOs and government organisations use medicine quality sampling studies to estimate the prevalence of the problem. A systematic review of medicine quality studies was conducted to estimate how the methodological quality of these studies and SF prevalence has changed between 2013 and 2018. We also aimed to critique medicine sampling study methodologies, and the systematic review process which generates prevalence estimates. Based on 33 studies, the overall estimated median (Q1-Q3) prevalence of SF medicines appears to have remained high at 25% (7.7%-34%) compared with 28.5% in 2013. Furthermore, the methodological quality of prevalence studies has improved over the last 25 years. Definitive conclusions regarding the prevalence of SF medicines cannot be drawn due to the variability in sample sizes, consistency of design methods, and a lack of information concerning contextual factors affecting medicine quality studies. We contend that studies which present cumulative average prevalence figures are useful in a broad sense but could be improved to create more reliable estimates. We propose that medicine quality studies record the context of the study environment to allow systematic reviewers to compare like with like. Although, the academic rigour of medicine quality studies is improving, medicine sampling study limitations still exist. These limitations inhibit the accurate estimation of SF medicine prevalence which is needed to support detailed policy changes.
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Affiliation(s)
- Dominic McManus
- School of Pharmacy (Formerly of), University College London, London, UK
| | - Bernard David Naughton
- Saïd Business School, University of Oxford, Oxford, UK .,Pharmacy Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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22
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Eiben H, Hala L, Slipchuk V. The current state of the pharmaceutical market of Ukraine, quality assurance and falfication of medicines. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e64723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of our article was the study of the current state of the pharmaceutical market of Ukraine in the context of the quality assurance of medicines and preventing the spread of falsified medicines (FM), the identification of the main problems in the field of circulation of medicines and the ways to solve them. It is established that the dynamic development of the pharmaceutical market and its high profitability cause problem of drug quality, increasing threats to the spread of FM in circulation and require the implementation of effective mechanisms for regulation of quality and safety of medicines. Analysis the annual official statistics of the State Service of Ukraine on Medicines and Drug Control for the period of 2008–2019 on the number of detected FM in circulation showed a steady trend of increasing FM and insufficient implementation of effective measures to combat them. The creation of effective quality assurance system of drugs and preventing the spread of FM need to improve the organization of state control of drug quality, strengthening criminal liability for falsification of drugs and optimization of the system of their detection.
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Dos Santos Ribeiro HS, Dagnino D, Schripsema J. Rapid and accurate verification of drug identity, purity and quality by 1H-NMR using similarity calculations and differential NMR. J Pharm Biomed Anal 2021; 199:114040. [PMID: 33836463 DOI: 10.1016/j.jpba.2021.114040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/24/2021] [Accepted: 03/23/2021] [Indexed: 12/24/2022]
Abstract
The illegal trade in counterfeit and fake drugs is a worldwide multi-billion dollar industry, not only generating enormous economic losses, but health problems for the general population, through direct toxicity, treatment failure and the increased generation of antibiotic resistance. Techniques for high-throughput testing of suspect medicines are needed to face the challenges of the problem. In this study we show that with nuclear magnetic resonance spectroscopy (NMR) drug compliance can be verified in a few minutes, providing data on drug identity, purity and quality without the necessity to develop a specific methodology and using a direct extraction with deuterated solvent. The evaluation of the data is facilitated by similarity calculations and differential NMR spectroscopy. The viability and limitations of this method were assessed, with the application on five different drugs, namely sertraline hydrochloride, alprazolam, vitamin D3, enalapril maleate and paracetamol, in which the individual dosage quantity of the active ingredient ranged from 750 mg down to 0.25 mg. The appropriate sample weight, solvent and internal standard were determined for each drug and quantification was carried out by choosing the most adequate NMR signals for each compound and the internal standard. With the method the accuracy of the quantification is somewhat sacrificed for increased speed in the analysis, but the measurements offer excellent precision and offer the possibility of external calibration. Spectral similarity calculations and differential NMR spectroscopy were used to compare different generic brands and detect eventual undeclared constituents and contaminants. In one brand of alprazolam tablets the undeclared constituent tristearin was found, while in paracetamol tablets the contaminant para-aminophenol was found at a level above the allowed by the legislation. The applicability and limitations of the method are discussed.
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Affiliation(s)
- Helen Sant'Ana Dos Santos Ribeiro
- Grupo Metabolômica, Laboratório de Ciências Químicas, Universidade Estadual do Norte Fluminense, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil
| | - Denise Dagnino
- Grupo Metabolômica, Laboratório de Biotecnologia, Universidade Estadual do Norte Fluminense, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil.
| | - Jan Schripsema
- Grupo Metabolômica, Laboratório de Ciências Químicas, Universidade Estadual do Norte Fluminense, Av. Alberto Lamego, 2000, Campos dos Goytacazes, 28013-602, Brazil.
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Rahman MS, Yoshida N, Tsuboi H, Maeda E, Ibarra AVV, Zin T, Akimoto Y, Tanimoto T, Kimura K. Patient safety and public health concerns: poor dissolution rate of pioglitazone tablets obtained from China, Myanmar and internet sites. BMC Pharmacol Toxicol 2021; 22:12. [PMID: 33653417 PMCID: PMC7923830 DOI: 10.1186/s40360-021-00478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 02/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Poor quality medicines have serious implications for public health. The aim of this study was to explore the quality of the antidiabetic pioglitazone, using samples collected in China and Myanmar, and samples purchased online. Methods In this cross-sectional study, we examined samples (n = 163) collected from hospitals in Shanghai, China in 2012 (n = 44), products purchased via the internet and imported into Japan in 2013 (n = 59), and samples purchased in shops in Yangon, Myanmar in 2015 (n = 60). Collected samples were subjected to visual inspection, authenticity investigation and quality testing (potency, content uniformity and dissolution test) by high-performance liquid chromatography. Samples were rated as compliant or non-compliant based on the relevant pharmacopoeial acceptance criteria. Results Visual inspection of all samples revealed compliant products. However, responses from manufacturers during authenticity investigation were poor. Among the n = 44 samples from China, one was non-compliant in the potency test. Among the n = 59 samples personally imported into Japan, 38% of generic samples were found to be non-compliant. In Myanmar, 13.3% of samples were non-compliant. Non-compliant samples predominantly failed in the dissolution test. All non-compliant samples were generic. Conclusions Despite the apparent satisfactory outcome on the samples from China, pioglitazone samples collected in Myanmar and purchased online for personal import into Japan included many substandard products, which failed quality assessment predominantly because of poor dissolution. Internet providers did not comply with Japanese regulations in various respects. Supplementary Information The online version contains supplementary material available at 10.1186/s40360-021-00478-x.
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Affiliation(s)
- Mohammad Sofiqur Rahman
- Medi-Quality Security Institute, Graduate School of Medical Sciences, Kanazawa University, 920-1192, Kanazawa, Japan.
| | - Naoko Yoshida
- Department of Clinical Pharmacy and Healthcare Sciences, Kanazawa University, 920-1192, Kanazawa, Japan
| | - Hirohito Tsuboi
- Department of Clinical Pharmacy and Healthcare Sciences, Kanazawa University, 920-1192, Kanazawa, Japan
| | - Erina Maeda
- Department of Clinical Pharmacy and Healthcare Sciences, Kanazawa University, 920-1192, Kanazawa, Japan
| | | | - Theingi Zin
- Department of Food and Drug Administration (FDA), Ministry of Health and Sports, Naypyidaw, Myanmar
| | - Yoshio Akimoto
- Medi-Quality Security Institute, Graduate School of Medical Sciences, Kanazawa University, 920-1192, Kanazawa, Japan
| | - Tsuyoshi Tanimoto
- Pharmaceutical and Medical Device Regulatory Science Society of Japan, 150-0002, Osaka, Japan
| | - Kazuko Kimura
- Medi-Quality Security Institute, Graduate School of Medical Sciences, Kanazawa University, 920-1192, Kanazawa, Japan
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25
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Sakuda M, Yoshida N, Koide T, Keila T, Kimura K, Tsuboi H. Clarification of the internal structure and factors of poor dissolution of substandard roxithromycin tablets by near-infrared chemical imaging. Int J Pharm 2021; 596:120232. [PMID: 33484929 PMCID: PMC7910273 DOI: 10.1016/j.ijpharm.2021.120232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022]
Abstract
The spread of substandard and falsified medicines has become a global problem, especially in low- and middle-income countries (LMICs). Previously, we found that some tablets containing the same active ingredient had large differences in their dissolution even though their contents were comparable. In this study, we investigated the poor dissolution of roxithromycin tablets using near-infrared chemical imaging (NIR-CI) to visualize the internal tablet structure. Roxithromycin tablets collected in LMICs and the pioneer product Rulid® as a reference were cut to a flat surface for analysis. NIR spectral data were normalized, and a principal component analysis was performed to create a tablet internal structure image. For Rulid®, the differences between the spectra with high and low scores were small, and well-defined aggregation of ingredients was not observed. However, large differences in the scores were found for roxithromycin tablets manufactured in some LMICs, and non-uniformity of ingredient distribution and aggregation were observed. Additionally, some pharmaceutical excipients, such as starch or magnesium stearate, were found in certain aggregates by comparing NIR spectra. The NIR-CI results showed some excipients existed as large aggregates, which indicated that the ingredients were not evenly mixed in the roxithromycin tablet, and this contributed to its poor dissolution.
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Affiliation(s)
- Mirai Sakuda
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-1192, Japan
| | - Naoko Yoshida
- AI Hospital/Macro Signal Dynamics Research and Development Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-1192, Japan.
| | - Tatsuo Koide
- Division of Drugs, National Institute of Health Sciences, Kawasaki 210-9501, Japan
| | - Tep Keila
- National Health Product Quality Control Center, Ministry of Health, Phnom Penh 12110, Cambodia
| | - Kazuko Kimura
- Medi-Quality Security Institute, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-1192, Japan
| | - Hirohito Tsuboi
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-1192, Japan
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26
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Bakker-'t Hart IME, Ohana D, Venhuis BJ. Current challenges in the detection and analysis of falsified medicines. J Pharm Biomed Anal 2021; 197:113948. [PMID: 33582458 DOI: 10.1016/j.jpba.2021.113948] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
Falsified medicines affect public health all around the globe. Complex distribution routes, illegal online webshops and reuse of packaging materials make them hard to detect. In order to tackle this problem, detection methods for the recognition of suspicious medicines and subsequent confirmation of falsification by analytical techniques is required. In this review, we focus on the developments and challenges that existed in the last five years (2015-2020) in the detection and analysis of falsified medicines. These challenges might have not been solved yet or arisen with new types of falsifications, new analytical techniques or detection strategies. Detection of suspicious medicines starts with visual inspection of packaging materials. However, re-use of packaging materials and high-quality imitations complicate visual inspection. Recent developments in the analysis of packaging by microscopic and spectroscopic techniques such as optical microscopy, X-ray fluorescence, infrared spectroscopy and Raman spectroscopy or microscopy, in combination with multivariate analysis show promising results in the detection of falsified medicines. An ongoing big challenge in the analysis of falsified medicines is the affordability of analytical devices. Yet, recent reports showed that lower cost devices, such as Counterfeit Drug Indicator or Counterfeit Detection device version 3 show promising use in the detection of falsified medicines. Furthermore, combining the outcomes of different low-cost analytical techniques, such as Minilab, colorimetry and Counterfeit Drug Indicator significantly increased selectivity and sensitivity in the detection of falsified medicines. Also, recent developments make it possible to link a low-cost technique, such as TLC, to mobile phones. Proper training of personnel has shown room for improvement and remains a challenge, even for relatively simple techniques. With an increased use of analytical fingerprints, an upcoming challenge is the accessibility of the growing pool of data. There is also the need of validated reference libraries on both national and international levels. Developments of the last few years bring us a step closer in the fight against falsified medicines, however challenges remain in the worldwide accessibility of affordable, easily operable and sensitive techniques.
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Affiliation(s)
- Ingrid M E Bakker-'t Hart
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands
| | - Dana Ohana
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands
| | - Bastiaan J Venhuis
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands.
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27
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Tesfaye W, Abrha S, Sinnollareddy M, Arnold B, Brown A, Matthew C, Oguoma VM, Peterson GM, Thomas J. How Do We Combat Bogus Medicines in the Age of the COVID-19 Pandemic? Am J Trop Med Hyg 2020; 103:1360-1363. [PMID: 32815510 PMCID: PMC7543841 DOI: 10.4269/ajtmh.20-0903] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/08/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has brought concurrent challenges. The increased incidence of fake and falsified product distribution is one of these problems with tremendous impact, especially in low- and middle-income countries. Up to a tenth of medicines including antibiotics and antimalarial drugs in the African market are considered falsified. Pandemics make this worse by creating an ecosystem of confusion, distraction, and vulnerability stemming from the pandemic as health systems become more stressed and the workload of individuals increased. These environments create opportunities for substandard and falsified medicines to be more easily introduced into the marketplace by unscrupulous operators. In this work we discuss some of the challenges with fake or falsified product distribution in the context of COVID-19 and proposed strategies to best manage this problem.
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Affiliation(s)
- Wubshet Tesfaye
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Solomon Abrha
- University of Canberra, Canberra, Australia
- Mekelle University, Mek’ele, Ethiopia
| | | | - Bruce Arnold
- Canberra Law School, University of Canberra, Canberra, Australia
| | - Andrew Brown
- IntraHealth International, Durham, North Carolina
| | | | - Victor M. Oguoma
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Gregory M. Peterson
- University of Canberra, Canberra, Australia
- University of Tasmania, Hobart, Australia
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28
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Hodges S, Garnett E. The ghost in the data: Evidence gaps and the problem of fake drugs in global health research. Glob Public Health 2020; 15:1103-1118. [PMID: 32228359 PMCID: PMC7446034 DOI: 10.1080/17441692.2020.1744678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 02/09/2020] [Indexed: 10/31/2022]
Abstract
For the past several decades, global health research and policy have raised the alarm about the growing threat of counterfeit and low-quality drugs (henceforth 'fakes'). These high-profile and regularly-repeated claims about 'fake drugs' pepper scholarly publications, grey literature, and popular writing. We reviewed much of this work and found that it shares two characteristics that sit awkwardly alongside one another. First, it asserts that fake drugs constitute an urgent threat to lives. Second, it reports trouble with 'gaps' in the evidence on which their claims are based; that data is weaker and less conclusive than anticipated. Given the ubiquity of and urgency with these claims are made, we found this juxtaposition perplexing. To understand this juxtaposition better, we undertook a close reading of the strategies authors employed to negotiate and overcome data and evidence 'gaps' and asked questions about the cultures of scholarly publishing in global health research. We argue that a scholarly commitment to studying fakes despite--rather than because of-the evidence functions to support the continuation of similar research. It also works against asking different questions-for instance regarding the lack of easy access to pharmacological data that might make it possible to know fakes differently.
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Affiliation(s)
- Sarah Hodges
- Department of History, University of Warwick, Coventry, UK
| | - Emma Garnett
- School of Population Health and Environmental Sciences, King’s College London, London, UK
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29
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Rahman MS, Yoshida N, Tsuboi H, Sokchamroeun U, Keila T, Sovannarith T, Kiet HB, Dararath E, Akimoto Y, Tanimoto T, Kimura K. A Cross-Sectional Investigation of the Quality of Selected Medicines for Noncommunicable Diseases in Private Community Drug Outlets in Cambodia during 2011-2013. Am J Trop Med Hyg 2020; 101:1018-1026. [PMID: 31516106 PMCID: PMC6838583 DOI: 10.4269/ajtmh.19-0247] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although the issue of substandard and falsified medicines is quite well known, most research has focused on medicines used to treat communicable diseases, and relatively little research has been carried out on the quality of medicines for noncommunicable diseases (NCDs). This study was designed to assess the quality of seven widely used medicines for NCDs in Cambodia during 2011–2013. Medicines were collected from private community drug outlets in Phnom Penh (urban area), by stratified random sampling and in Battambang, Kandal, Kampong Speu, and Takeo (rural areas) by convenience sampling. Samples were subsequently analyzed by visual inspection, authenticity investigation, and pharmacopoeial analysis by high-performance liquid chromatography. Various discrepancies were observed in visual inspection of packages and medicines. Of 372 tablet/capsule samples from 64 manufacturers in 16 countries, the manufacturers confirmed 107 (28.8%) as authentic; the authenticity of other samples could not be verified. Three hundred sixty-four (97.8%) samples were registered in Cambodia. Among all samples, 23.4% (95% CI 19.2–28.0) were noncompliant in one or more of the quality tests: 12.9% (95% CI 9.7–16.7) contained an amount of active pharmaceutical ingredient outside the permitted range, including some showing extreme deviations, 14% (95% CI 10.6–17.9) failed because of content variation, and 10.8% (95% CI 7.8–14.4) failed to meet pharmacopoeial reference ranges in dissolution tests. Pharmaceutical quality appeared to be unrelated to storage conditions. Although no sample was obviously falsified, there is a high prevalence of substandard medicines for NCDs in Cambodia, indicating the need for focused regulatory action, including collaborative initiatives with manufacturers.
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Affiliation(s)
- Mohammad Sofiqur Rahman
- Medi-Quality Security Institute, Kanazawa University, Kanazawa, Japan.,Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | - Naoko Yoshida
- Department of Clinical Pharmacy and Healthcare Sciences, Kanazawa University, Kanazawa, Japan
| | - Hirohito Tsuboi
- Department of Clinical Pharmacy and Healthcare Sciences, Kanazawa University, Kanazawa, Japan
| | - Uy Sokchamroeun
- National Health Product Quality Control Center, Ministry of Health, Phnom Penh, Cambodia
| | - Tep Keila
- National Health Product Quality Control Center, Ministry of Health, Phnom Penh, Cambodia
| | - Tey Sovannarith
- National Health Product Quality Control Center, Ministry of Health, Phnom Penh, Cambodia
| | - Heng Bun Kiet
- Department of Drugs and Food, Ministry of Health, Phnom Penh, Cambodia
| | - Eav Dararath
- Department of Drugs and Food, Ministry of Health, Phnom Penh, Cambodia
| | - Yoshio Akimoto
- Medi-Quality Security Institute, Kanazawa University, Kanazawa, Japan
| | - Tsuyoshi Tanimoto
- Pharmaceutical and Medical Device Regulatory Science Society of Japan, Osaka, Japan
| | - Kazuko Kimura
- Medi-Quality Security Institute, Kanazawa University, Kanazawa, Japan
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30
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Zhang H, Hua D, Huang C, Samal SK, Xiong R, Sauvage F, Braeckmans K, Remaut K, De Smedt SC. Materials and Technologies to Combat Counterfeiting of Pharmaceuticals: Current and Future Problem Tackling. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e1905486. [PMID: 32009266 DOI: 10.1002/adma.201905486] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/25/2019] [Indexed: 05/28/2023]
Abstract
The globalization of drug trade leads to the expansion of pharmaceutical counterfeiting. The immense threat of low quality drugs to millions of patients is considered to be an under-addressed global health challenge. Analytical authentication technologies are the most effective methods to identify active pharmaceutical ingredients and impurities. However, most of these analytical testing techniques are expensive and need skilled personnel. To combat counterfeiting of drugs, the package of an increasing number of drugs is being protected through advanced package labeling technologies. Though, package labeling is only effective if the drugs are not repackaged. Therefore "in-drug labeling," instead of "drug package labeling," may become powerful tools to protect drugs. This review aims to overview how advanced micro- and nanomaterials might become interesting markers for the labeling of tablets and capsules. Clearly, how well such identifiers can be integrated into "solid drugs" without compromising drug safety and efficacy remains a challenge. Also, incorporation of tags has so far only been reported for the protection of solid drug dosage forms. No doubts that in-drug labeling technologies for "liquid drugs," like injectables which contain expensive peptides, monoclonal antibodies, vaccines, dermal fillers, could help to protect them from counterfeiting as well.
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Affiliation(s)
- Heyang Zhang
- Joint Laboratory of Advanced Biomedical Technology (NFU-UGent), College of Chemical Engineering, Nanjing Forestry University, 210037, Nanjing, P. R. China
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
| | - Dawei Hua
- Joint Laboratory of Advanced Biomedical Technology (NFU-UGent), College of Chemical Engineering, Nanjing Forestry University, 210037, Nanjing, P. R. China
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
| | - Chaobo Huang
- Joint Laboratory of Advanced Biomedical Technology (NFU-UGent), College of Chemical Engineering, Nanjing Forestry University, 210037, Nanjing, P. R. China
| | - Sangram Keshari Samal
- Laboratory of Biomaterials and Regenerative Medicine for Advanced Therapies, Indian Council of Medical Research-Regional Medical Research Center, 751023, Bhubaneswar, India
| | - Ranhua Xiong
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
| | - Félix Sauvage
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
| | - Kevin Braeckmans
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
| | - Katrien Remaut
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
| | - Stefaan C De Smedt
- Joint Laboratory of Advanced Biomedical Technology (NFU-UGent), College of Chemical Engineering, Nanjing Forestry University, 210037, Nanjing, P. R. China
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
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31
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Peña-Acevedo L, Zuluaga AF, Aristizabal-Solis A. A counterfeit multivitamin product inducing severe bleeding disorders in humans. Clin Toxicol (Phila) 2020; 58:846-848. [PMID: 31922430 DOI: 10.1080/15563650.2019.1703999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Context: During a period of 6 months, 36 people reported to health authorities in the Department of Antioquia, Colombia, presenting episodes of bleeding in varying magnitude and locations in the body and alterations in coagulation tests, after having taken a falsified dietary supplement. The identification of the first four cases were to the cell-phone line at the Drug and Poison Research Information Center (CIEMTO). The successive presentation of cases with similar manifestations, taking the same product, served to suspect a possible common link.Case details: All of the patients needed hospitalization, the administration of blood products and / or vitamin K to reverse the clinical manifestations, and to stop the oral consumption of the falsified supplement. For each patient there was a full recovery of coagulation and improvement of haemorrhagic manifestations after the first week of management. The Food and Drug administration of Colombia (INVIMA), withdrew the product from the market, alerted the medical community and the general public and conducted an investigation that finally showed warfarin as a the main contaminant in the dietary supplement.Conclusion: This cases series emphasize the importance of the Poison Control Center to detect promptly potential new exposure of hazards to hundreds of products to the population, some of them fraudulent.
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Affiliation(s)
- Lina Peña-Acevedo
- CIEMTO [drug and poison research and information center] at Integrated Laboratory of Specialized Medicine (LIME), Facultad de Medicina-IPS Universitaria, Universidad de Antioquia, Medellín, Colombia
| | - Andres F Zuluaga
- CIEMTO [drug and poison research and information center] at Integrated Laboratory of Specialized Medicine (LIME), Facultad de Medicina-IPS Universitaria, Universidad de Antioquia, Medellín, Colombia
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32
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Nguyen TAH, Pham TNM, Le TB, Le DC, Tran TTP, Nguyen TQH, Nguyen TKT, Hauser PC, Mai TD. Cost-effective capillary electrophoresis with contactless conductivity detection for quality control of beta-lactam antibiotics. J Chromatogr A 2019; 1605:360356. [DOI: 10.1016/j.chroma.2019.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/06/2019] [Accepted: 07/06/2019] [Indexed: 01/16/2023]
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