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Sng YJ, Kwok D, Goh E, Tan A, Teo J, Chan CL. The Problems with Online Health Product Sales: How can Regulations be Improved? Drug Saf 2024; 47:529-533. [PMID: 38483769 DOI: 10.1007/s40264-024-01414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 05/25/2024]
Abstract
With the rapid proliferation of online businesses, national authorities are facing challenges managing the online supply of illegal health products due to the anonymity of the internet, increasing number of global syndicates, new technologies, and inability to enforce against overseas sellers. This paper describes these challenges and the Health Sciences Authority's regulatory approaches to tackle the online sales of illegal health products. These include partnering with platform administrators to remove illegal online postings, leveraging technological tools and relevant legislation, empowering consumers to make informed decisions, and fostering closer collaborations across different jurisdictions to combat online pharmaceutical crimes.
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Affiliation(s)
- Yi Jing Sng
- Health Sciences Authority, Singapore, Singapore.
| | - Daryl Kwok
- Health Sciences Authority, Singapore, Singapore
| | - Eugene Goh
- Health Sciences Authority, Singapore, Singapore
| | - Annie Tan
- Health Sciences Authority, Singapore, Singapore
| | - Jessica Teo
- Health Sciences Authority, Singapore, Singapore
| | - Cheng Leng Chan
- Health Sciences Authority, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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de Brito I, Saraiva FA, Bruno NDC, da Silva RF, Hino CM, Yoshizaki HTY. Inefficacious drugs against covid-19: analysis of sales, tweets, and search engines. Rev Saude Publica 2024; 58:06. [PMID: 38422280 PMCID: PMC10926985 DOI: 10.11606/s1518-8787.2024058005413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/01/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Assess the correlation between the sales of two drugs with no proven efficacy against covid-19, ivermectin and chloroquine, and other relevant variables, such as Google® searches, number of tweets related to these drugs, number of cases and deaths resulting from covid-19. METHODS The methodology adopted in this study has four stages: data collection, data processing, exploratory data analysis, and correlation analysis. Spearman's method was used to obtain cross-correlations between each pair of variables. RESULTS The results show similar behaviors between variables. Peaks occurred in the same or near periods. The exploratory data analysis showed shortage of chloroquine in the period corresponding to the beginning of advertising for the application of these drugs against covid-19. Both drugs showed a high and statistically significant correlation with the other variables. Also, some of them showed a higher correlation with drug sales when we employed a one-month lag. In the case of chloroquine, this was observed for the number of deaths. In the case of ivermectin, this was observed for the number of tweets, cases, and deaths. CONCLUSIONS The results contribute to decision making in crisis management by governments, industries, and stores. In times of crisis, as observed during the covid-19 pandemic, some variables can help sales forecasting, especially Google® and tweets, which provide a real-time analysis of the situation. Monitoring social media platforms and search engines would allow the determination of drug use by the population and better prediction of potential peaks in the demand for these drugs.
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Affiliation(s)
- Irineu de Brito
- Universidade Estadual Paulista “Júlio de Mesquita Filho”Instituto de Ciência e TecnologiaDepartamento de Engenharia AmbientalSão José dos CamposSPBrasilUniversidade Estadual Paulista “Júlio de Mesquita Filho”. Instituto de Ciência e Tecnologia. Departamento de Engenharia Ambiental. São José dos Campos, SP, Brasil
- Universidade de São PauloEscola PolitécnicaPrograma de Mestrado em Engenharia de Sistemas LogísticosSão PauloSPBrasil Universidade de São Paulo. Escola Politécnica. Programa de Mestrado em Engenharia de Sistemas Logísticos. São Paulo, SP, Brasil
| | - Flaviane Azevedo Saraiva
- Universidade de São PauloEscola PolitécnicaDepartamento de Engenharia de ProduçãoSão PauloSPBrasil Universidade de São Paulo. Escola Politécnica. Departamento de Engenharia de Produção. São Paulo, SP, Brasil
| | - Nathan de Campos Bruno
- Universidade Estadual Paulista “Júlio de Mesquita Filho”Instituto de Ciência e TecnologiaDepartamento de Engenharia AmbientalSão José dos CamposSPBrasilUniversidade Estadual Paulista “Júlio de Mesquita Filho”. Instituto de Ciência e Tecnologia. Departamento de Engenharia Ambiental. São José dos Campos, SP, Brasil
| | - Roberto Fray da Silva
- Universidade de São PauloInstituto de Estudos AvançadosSão PauloSPBrasil Universidade de São Paulo. Instituto de Estudos Avançados. São Paulo, SP, Brasil
| | - Celso Mitsuo Hino
- Universidade de São PauloEscola PolitécnicaDepartamento de Engenharia de ProduçãoSão PauloSPBrasil Universidade de São Paulo. Escola Politécnica. Departamento de Engenharia de Produção. São Paulo, SP, Brasil
| | - Hugo Tsugunobu Yoshida Yoshizaki
- Universidade de São PauloEscola PolitécnicaPrograma de Mestrado em Engenharia de Sistemas LogísticosSão PauloSPBrasil Universidade de São Paulo. Escola Politécnica. Programa de Mestrado em Engenharia de Sistemas Logísticos. São Paulo, SP, Brasil
- Universidade de São PauloEscola PolitécnicaDepartamento de Engenharia de ProduçãoSão PauloSPBrasil Universidade de São Paulo. Escola Politécnica. Departamento de Engenharia de Produção. São Paulo, SP, Brasil
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Oriakhi OJ, Almomani H, Patel N, Donyai P. The characteristics and operations of "online pharmacies" investigated in relation to medicines popularised during the coronavirus pandemic: a cross-sectional study. Front Pharmacol 2024; 15:1346604. [PMID: 38444937 PMCID: PMC10912318 DOI: 10.3389/fphar.2024.1346604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024] Open
Abstract
Aim: To explore the characteristics and operations of online pharmacies in relation to medications that gained widespread popularity and increased demand during the COVID-19 pandemic. Furthermore, to assess and compare practices between legitimate and "rogue" online pharmacies. Methods: Fifteen COVID-19-pandemic-related medications were investigated through a UK-based online search. We systematically assessed the credibility of 116 retrieved online pharmacies using the factors: operational location, range of medicines sold, prescription requirements for Prescription Only Medicines (POMs), information exchange, payment/delivery, user-friendliness, legitimacy. Descriptive analysis was conducted, and legitimacy status (legitimate vs. illegitimate/rogue) was tested against relevant safety indicators using a chi-square test. Results: Out of 116 "online pharmacies," 55 (47%) were confirmed as "rogue," 47 (41%) were verified as legitimate by the General Pharmaceutical Council (GPhC), and 14 (12%) were verified by other bodies but not by the GPhC. A total of 93 declared their "apparent" physical location of operation on the webpage of which 63 (67.7%, n = 93) declared a location that did not match their actual location according to the online pharmacy's server (through their IP address). All 15 medicines analysed were readily available for purchase. A high percentage of online pharmacies offered POMs to the public (93.1%, n = 116). Only 23 out of the 116 online pharmacies assessed required a prescription for providing POMs, with only four of these verified as legitimate by the GPhC register, while most of the legitimate pharmacies (44 out of 47) offered online consultations as an alternative option instead of a prescription. Controlled medicines were offered by 28 online pharmacies 27 of which were deemed as rogue. Rogue online pharmacies were significantly more likely to guarantee refunds for medication, not require prescriptions for POMs, and not require an online consultation to obtain POMs. Discussion: Findings reveal easy access to rogue online pharmacies, posing patient safety risks. We also found legitimate online pharmacies often offer online consultations without requiring prescriptions for POMs, raising concerns about inadequate safety checks. This emphasises the need for improved regulations for both types of online pharmacies, especially during public health crises.
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Affiliation(s)
| | | | - Nilesh Patel
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Parastou Donyai
- Department of Pharmacy, Faculty of Life Science & Medicine, King’s College London, London, United Kingdom
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Vanhee C, Jacobs B, Kamugisha A, Canfyn M, Van Der Meersch H, Ceyssens B, Deconinck E, Van Hoorde K, Willocx M. Substandard and falsified ivermectin tablets obtained for self-medication during the COVID-19 pandemic as a source of potential harm. Drug Test Anal 2023. [PMID: 38043940 DOI: 10.1002/dta.3618] [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: 10/11/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023]
Abstract
In 2019, a global viral pandemic, due to the SARS-CoV-2 virus, broke out. Soon after, the search for a vaccine and/or antiviral medicine began. One of the candidate antiviral medicines tested was ivermectin. Although several health authorities warned the public against the use of this medicine outside clinical trials, the drug was widely used at the end of 2020 and in 2021. Simultaneously, several reports started to emerge demonstrating serious adverse effects after self-medicating with ivermectin. It stands to reason that the self-administration of substandard or falsified (SF) medicines bearing harmful quality deficiencies have contributed to this phenomenon. In order to have a better view on the nature of these harmful quality deficiencies, SF ivermectin samples, intercepted in large quantities by the Belgian regulatory agencies during the period 2021-2022, were analyzed in our official medicines control laboratory. None of the samples (n = 19) were compliant to the quality criteria applicable to medicinal products. These SF products either suffered from a systematic underdosing of the active pharmaceutical ingredient or were severely contaminated with bacteria, two of which were contaminated with known pathogens that cause gastrointestinal illness upon oral intake. In addition to the direct risks of self-medicating with such a product, the improper usage and dosage of ivermectin medication might also facilitate ivermectin tolerance or resistance in parasites. This may have detrimental consequences on a global scale, certainly as the number of newly developed active pharmaceutical ingredients that can safely be used to combat parasites is rather scarce.
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Affiliation(s)
- Celine Vanhee
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Bram Jacobs
- Service of Foodborne Pathogen, Scientific Direction of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Angélique Kamugisha
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Michael Canfyn
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | | | - Bart Ceyssens
- Federal Agency for Medicine and Health Care Products, Brussels, Belgium
| | - Eric Deconinck
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Koenraad Van Hoorde
- Service of Foodborne Pathogen, Scientific Direction of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Marie Willocx
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
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Ortiz-Prado E, Izquierdo-Condoy JS, Mora C, Vasconez-Gonzalez J, Fernandez-Naranjo R. Poor regulation, desperation, and misinformation, a countrywide analysis of self-medication and prescription patterns in Ecuador during the COVID-19 pandemic. Res Social Adm Pharm 2023; 19:1579-1589. [PMID: 37659922 DOI: 10.1016/j.sapharm.2023.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND The rapid spread of the SARS-CoV-2 virus during the early phase of the pandemic led to an unprecedented global health crisis. Various factors have influenced self-medication practices among the general population and unsubstantiated prescribing practices among healthcare professionals. OBJECTIVE This study aimed to describe trends in the purchase and sale of medicines during the COVID-19 pandemic period (2020-2022) in Ecuador, by comparing them with pre-pandemic periods. METHODS In this study, a cross-sectional design was employed to conduct a comprehensive analysis of 28 pharmacological groups, categorized according to the Anatomical Therapeutic Chemical Classification (ATC). Utilizing an integrated drug consumption database, the study examined physician prescribing data, medicine usage, and spending levels in Ecuador during the COVID-19 pandemic. The analysis involved computing absolute differences in monthly resolution, calculating excessive expenditure in comparison to previous yearly averages, and using Defined Daily Dose (DDD) methodology for internationally comparable results. Furthermore, a correlation analysis was performed to investigate potential associations between prescribed and consumed medicines and the number of new cases and deaths. RESULTS In Ecuador, the average yearly expenditure among these groups prior to the pandemic (2017-2019) amounted to $150,646,206 USD, whereas during 2020 and 2021, the same groups represented a total expenditure of $228,327,210, reflecting a significant increase. The excess expenditure during this period reached 51.4%, equivalent to $77,681,004 USD. Notably, 13% of this expenditure consisted of Over the Counter (OTC) Medicines. The study also identified a remarkable surge in sales of ivermectin, which increased by 2,057%, and hydroxychloroquine, which increased by 171%, as measured by DDD. CONCLUSIONS This study highlights the substantial consumption of medicines by the population in Ecuador during the pandemic. It is concerning that many medications were sold without proven therapeutic indications, indicating that misinformation and desperation may have led to improper prescribing by physicians and patients resorting to ineffective drugs. Moreover, since the sale of these therapeutic drugs requires a prescription, poor regulation, and a lack of control within pharmacies likely contributed to such practices.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador.
| | - Juan S Izquierdo-Condoy
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador
| | - Carla Mora
- Medical Department, Quifatex, Quito, 170138, Ecuador
| | - Jorge Vasconez-Gonzalez
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador
| | - Raúl Fernandez-Naranjo
- One Health Research Group, Faculty of Medicine, Universidad de Las Américas, Quito, 170125, Ecuador
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Perlis RH, Lunz Trujillo K, Green J, Safarpour A, Druckman JN, Santillana M, Ognyanova K, Lazer D. Misinformation, Trust, and Use of Ivermectin and Hydroxychloroquine for COVID-19. JAMA HEALTH FORUM 2023; 4:e233257. [PMID: 37773507 PMCID: PMC10542734 DOI: 10.1001/jamahealthforum.2023.3257] [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: 02/17/2023] [Accepted: 07/24/2023] [Indexed: 10/01/2023] Open
Abstract
Importance The COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. Objective To quantify the prevalence of non-evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists. Design, Setting, and Participants This single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection. Main Outcome and Measure Self-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources. Results A total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non-evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non-evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non-evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non-evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13). Conclusions and Relevance In this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non-evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors.
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Affiliation(s)
- Roy H. Perlis
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Associate Editor, JAMA Network Open
| | - Kristin Lunz Trujillo
- Department of Political Science, Northeastern University, Boston, Massachusetts
- John F. Kennedy School of Government and Department of Government, Harvard University, Cambridge, Massachusetts
| | - Jon Green
- Department of Political Science, Northeastern University, Boston, Massachusetts
| | - Alauna Safarpour
- Department of Political Science, Northeastern University, Boston, Massachusetts
- John F. Kennedy School of Government and Department of Government, Harvard University, Cambridge, Massachusetts
| | - James N. Druckman
- Department of Political Science, Northwestern University, Evanston, Illinois
| | - Mauricio Santillana
- Department of Political Science, Northeastern University, Boston, Massachusetts
| | - Katherine Ognyanova
- Department of Communication, School of Communication and Information, Rutgers University, New Brunswick, New Jersey
| | - David Lazer
- Department of Political Science, Northeastern University, Boston, Massachusetts
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Fittler M, Rozmer Z, Fittler A. Rampant online marketing of teeth whitening products: Evaluation of online information, labelling accuracy and quantitative analysis of high peroxide content gels. Heliyon 2023; 9:e19463. [PMID: 37809774 PMCID: PMC10558595 DOI: 10.1016/j.heliyon.2023.e19463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/23/2023] [Accepted: 08/23/2023] [Indexed: 10/10/2023] Open
Abstract
Background /Purpose: Online vendors seize the advantage of the high demand on home-use, do-it-yourself dental bleaching products. The study aims to present the uncontrolled online market of dental products and provide evidence of consumer safety risks associated with the utilization of high peroxide content bleaching products without dentist's supervision, and also to identify misleading and insufficient information on content and compromised product quality. Materials and methods A complex risk-based methodology was used including website content evaluation focusing on ingredients, precautionary statements and directions for use provided by online retailers. Bleaching products were test procured in which packaging and labels were documented and assessed. Quality control was performed using the permanganometric method per the official European Pharmacopoeia. Results One (16.7%) of six test procured peroxide gels was not delivered. Another arrived without enclosed description or instructions. The ingredient list was incomplete or missing for all (100%) online products, however, it was listed on the label or in enclosed documentation in four out of five (80%) samples. Precautionary statements were scarcely (16.7%) disclosed online, contrarily, safety claims were emphasized by most (83.3%) websites. Contraindications and adverse effects were mentioned in the majority (80%) of the delivered product labels. One sample contained no active principle, in two sample' peroxide content exceeded the label's claim by 5.2-9.0% while in another two it was below the concentration indicated on the labels by 79.9-80.7%. Conclusions Dissimilarity in regulations elicits an opportunity for consumers to purchase inappropriately labeled, questionable quality, high peroxide content dental products without information regarding ingredients, application and risks. The uncontrolled market, easy access and unsupervised application of high peroxide-content teeth whiteners imply patient safety issues.
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Affiliation(s)
- Márton Fittler
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Rozmer
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - András Fittler
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
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Catalani V, Townshend HD, Prilutskaya M, Chilcott RP, Metastasio A, Banayoti H, McSweeney T, Corazza O. Illicit COVID-19 products online: A mixed-method approach for identifying and preventing online health risks. PLoS One 2023; 18:e0287231. [PMID: 37327233 PMCID: PMC10275425 DOI: 10.1371/journal.pone.0287231] [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: 09/26/2022] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Abstract
AIMS The COVID-19 pandemic triggered a demand for vaccines, cures, and the need of related documentation for travel, work and other purposes. Our project aimed to identify the illicit availability of such products across the Dark Web Markets (DWMs). METHODS A retrospective search for COVID-19 related products was carried out across 118 DWMs since the start of the pandemic (March 2020-October 2021). Data on vendors as well as advertised goods such as asking price, marketplace, listed date were collected and further validated through additional searches on the open web to verify the information relating to specific marketplaces. Both quantitative and qualitative methods were used for data analysis. RESULTS Forty-two listings of unlicenced COVID-19 cures and vaccination certificates were identified across 8 marketplaces sold by 25 vendors with significant variation in prices. The listings were found to be geographically specific and followed the progression of the pandemic in terms of availability. Correlations between vendor portfolios of COVID-19 products and variety of goods of other illicit nature such as illegal weaponry, medication/drugs of abuse also emerged from our analysis. CONCLUSION This study is one of the first attempts to identify the availability of unlicenced COVID-19 products on DWMs. The easy accessibility to vaccines, fake test certificates and hypothetical/illegal cures poses serious health risks to (potential) buyers due to the uncontrolled nature of such products. It also exposes buyers to an unwanted contact with vendors selling a variety of other dangerous illicit goods. Further monitoring and regulatory responses should be implemented to protect the health and safety of citizens especially at times of global crisis.
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Affiliation(s)
- Valeria Catalani
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | | | - Mariya Prilutskaya
- Department of Personalised Medicine, Pavlodar Branch of Semey Medical University, Pavlodar, Kazakhstan
| | - Robert P. Chilcott
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Antonio Metastasio
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | | | - Tim McSweeney
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
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Limbu YB, Huhmann BA. Illicit Online Pharmacies: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095748. [PMID: 37174265 PMCID: PMC10178756 DOI: 10.3390/ijerph20095748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/27/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
This scoping review presents the extent and nature of the body of literature on illicit online pharmacies (IOPs) and identifies research gaps. Using the five-step framework developed by Arksey and O'Malley, we searched PubMed, Web of Science, EMBASE, CINAHL, Science Direct and PsycInfo to retrieve relevant studies published in English in peer-reviewed journals. The search strategy identified forty-three articles that met the inclusion criteria. Ten themes were identified and categorized into five clusters: patient risk, healthcare providers, marketing and supply chain, public health and society, and policy and regulation. Research into these clusters has evolved over time and has focused increasingly on issues related to specific drugs rather than the overall phenomenon. Data collection has been dominated by convenience sampling, online searches, content analysis and surveys. Data analysis remains primarily descriptive. Gaps within the extant literature suggest an agenda for future research into regulation and enforcement; public health awareness and education; healthcare services; risks to patients and public health; patient-, price- and product-related issues; website design; social media promotion; and supply chains and logistics. We conclude that IOPs are vastly understudied and suggest an urgent need for further empirical and conclusive research.
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Affiliation(s)
- Yam B Limbu
- Feliciano School of Business, Montclair State University, 1 Normal Ave., Montclair, NJ 07043, USA
| | - Bruce A Huhmann
- Department of Marketing, Virginia Commonwealth University, Richmond, VA 23284, USA
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Almomani H, Patel N, Donyai P. News Media Coverage of the Problem of Purchasing Fake Prescription Medicines on the Internet: Thematic Analysis. JMIR Form Res 2023; 7:e45147. [PMID: 36943354 PMCID: PMC10131998 DOI: 10.2196/45147] [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: 12/21/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND More people are turning to internet pharmacies to purchase their prescription medicines. This kind of purchase is associated with serious risks, including the risk of buying fake medicines, which are widely available on the internet. This underresearched issue has been highlighted by many newspaper articles in the past few years. Newspapers can play an important role in shaping public perceptions of the risks associated with purchasing prescription medicines on the internet. Thus, it is important to understand how the news media present this issue. OBJECTIVE This study aimed to explore newspaper coverage of the problem of purchasing fake prescription medicines on the internet. METHODS Newspaper articles were retrieved from the ProQuest electronic database using search terms related to the topic of buying fake prescription medicines on the internet. The search was limited to articles published between April 2019 and March 2022 to retrieve relevant articles in this fast-developing field. Articles were included if they were published in English and focused on prescription medicines. Thematic analysis was employed to analyze the articles, and the Theory of Planned Behavior framework was used as a conceptual lens to develop the coding of themes. RESULTS A total of 106 articles were included and analyzed using thematic analysis. We identified 4 superordinate themes that represent newspaper coverage of the topic of buying prescription medicines on the internet. These themes are (1) the risks of purchasing medicines on the internet (eg, health risks and product quality concerns, financial risks, lack of accountability, risk of purchasing stolen medicines), (2) benefits that entice consumers to make the purchase (eg, convenience and quick purchase, lower cost, privacy of the purchase), (3) social influencing factors of the purchase (influencers, health care providers), and (4) facilitators of the purchase (eg, medicines shortages, pandemic disease such as COVID-19, social media, search engines, accessibility, low risk perception). CONCLUSIONS This theory-based study explored the news media coverage of the problem of fake prescription medicines being purchased on the internet by highlighting the complexity of personal beliefs and the range of external circumstances that could influence people to make these purchases. Further research is needed in this area to identify the factors that lead people to buy prescription medicines on the internet. Identifying these factors could enable the development of interventions to dissuade people from purchasing medicines from unsafe sources on the internet, thus protecting consumers from unsafe or illegal medicines.
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Affiliation(s)
- Hamzeh Almomani
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Nilesh Patel
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Parastou Donyai
- Department of Pharmacy and Forensic Science, King's College London, London, United Kingdom
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11
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Mavragani A, Patel N, Donyai P. Reasons That Lead People to End Up Buying Fake Medicines on the Internet: Qualitative Interview Study. JMIR Form Res 2023; 7:e42887. [PMID: 36795460 PMCID: PMC9982721 DOI: 10.2196/42887] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/28/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Many people in the United Kingdom are turning to the internet to obtain prescription-only medicines (POMs). This introduces substantial concerns for patient safety, particularly owing to the risk of buying fake medicines. To help reduce the risks to patient safety, it is important to understand why people buy POMs on the web in the first place. OBJECTIVE This study aimed to identify why people in the United Kingdom purchase medicines, specifically POMs, from the internet, and their perceptions of risks posed by the availability of fake medicines on the web. METHODS Semistructured interviews were conducted with adults from the United Kingdom who had previously purchased medicines on the web. Purposive sampling was adopted using various methods to achieve diversity in participants' experiences and demographics. The recruitment was continued until data saturation was reached. Thematic analysis was employed, with the theory of planned behavior acting as a framework to develop the coding of themes. RESULTS A total of 20 participants were interviewed. Participants had bought various types of POMs or medicines with the potential to be misused or that required a higher level of medical oversight (eg, antibiotics and controlled medicines). Participants demonstrated awareness of the presence and the risks of fake medicines available on the internet. The factors that influence participants' decision to buy medicines on the web were grouped into themes, including the advantages (avoiding long waiting times, bypassing gatekeepers, availability of medicines, lower costs, convenient process, and privacy), disadvantages (medicine safety concerns, medicine quality concerns, higher costs, web-based payment risks, lack of accountability, and engaging in an illegal behavior) of purchasing medicines on the web, social influencing factors (interactions with health care providers, other consumers' reviews and experiences, word of mouth by friends, and influencers' endorsement), barriers (general barriers and website-specific barriers) and facilitators (facilitators offered by the illegal sellers of medicines, facilitators offered by internet platforms, COVID-19 outbreak as a facilitating condition, and participants' personality) of the purchase, and factors that lead people to trust the web-based sellers of medicines (website features, product appearance, and past experience). CONCLUSIONS In-depth insights into what drives people in the United Kingdom to buy medicines on the web could enable the development of effective and evidence-based public awareness campaigns that warn consumers about the risks of buying fake medicines from the internet. The findings enable researchers to design interventions to minimize the purchasing of POMs on the web. A limitation of this study is that although the interviews were in-depth and data saturation was reached, the findings may not be generalizable, as this was a qualitative study. However, the theory of planned behavior, which informed the analysis, has well-established guidelines for developing a questionnaire for a future quantitative study.
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Affiliation(s)
| | - Nilesh Patel
- Department of Pharmacy Practice, Reading School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Parastou Donyai
- Department of Pharmacy and Forensic Science, School of Cancer & Pharmaceutical Sciences, King's College London, London, United Kingdom
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Jillani Z, Reinhard L, Hertig J. A narrative review of illegal online pharmacies and contemporary issues with restricting FDA-approved medication access. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231220512. [PMID: 38149839 PMCID: PMC10750516 DOI: 10.1177/27550834231220512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023]
Abstract
The rapid growth of technology has transformed the way the public purchases many products, including medications. Online medication purchasing has become a convenient and confidential route for patients to access healthcare without leaving their homes. Online pharmacies have many benefits but also present an increased risk for patient harm caused by unintentionally purchasing from illegal online pharmacies. Illegal online pharmacies are those that operate online without the requisite valid licenses or supply drugs not approved by the Food and Drug Administration (FDA). As obtaining certain medications has become restricted, either due to policy or drug shortages, more patients are relying on services provided by Internet pharmacies. The overturning of Roe versus Wade has caused an emerging drug restriction that may coerce the public to turn to Internet pharmacies for purchasing medications. A narrative review was conducted to analyze both the past and present effects of medications sold by illegal online pharmacies to help recognize the implications of restricting access to FDA-approved medications. Several large science and health literature databases were searched to find relevant references. Resulting resources, which referenced the connection between restricting access to FDA-approved medications and the increase in illegal online sales, were included in this review. The information evaluated in this article will help inform healthcare providers and policymakers of the inadvertent effects of restricting access to FDA-approved medications.
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Van Scoy LJ, Duda SH, Scott AM, Baker A, Costigan H, Loeffler M, Sherman MS, Brown MD. A mixed methods study exploring requests for unproven COVID therapies such as ivermectin and healthcare distrust in the rural South. Prev Med Rep 2022; 31:102104. [PMID: 36619802 PMCID: PMC9804965 DOI: 10.1016/j.pmedr.2022.102104] [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: 09/18/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 pandemic has led to contentious discourse regarding unproven COVID-19 therapies (UCTs),(e.g. ivermectin). Despite recommendations against it, ivermectin remains, in some areas, highly demanded. The goal of this study is to understand patient and provider perspectives about UCTs (e.g., ivermectin) and how responses to requests for UCTs impact healthcare distrust. This mixed methods observational study was conducted in a rural healthcare system in the Southern United States. Adults (n = 26) with a history of COVID-19 or clinicians (n = 8) from the same system were interviewed using questionnaires assessing healthcare distrust and qualitatively interviewed exploring perceptions about UCTs. Patient themes were: 1) Importance of anecdotal stories for decision-making; 2) Use of haphazard approaches to 'research'; 3) Strong distrust of government and healthcare organizations; 4) Inherent trust in local healthcare; 5) Decision-making as weighing pros/cons; and 6) Feeling a right to try medications. High survey medians indicated high distrust with differences of 8.5 points for those who requested/used ivermectin versus those who did not (p = 0.027). Clinician themes were: 1) Frustration when patients trust social media over clinicians; 2) Acceptance of community beliefs about UCTs; 3) Distrust originating outside of the healthcare system; 4) Feeling torn about prescribing UCTs to build trust; and 5) Variable educational strategies. When clinicians are perceived as aligned with government, this may void patients' trust of clinicians. Clinicians should leverage trust in local healthcare and distance themselves from distrusted information sources. Ethical questions arise regarding appropriateness of acquiescing to patient requests for ivermectin for building trust.
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Affiliation(s)
- Lauren J. Van Scoy
- Penn State University College of Medicine, Hershey, PA, United States,Corresponding author at: Humanities and Public Health Sciences, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Penn State College of Medicine, 500 University Dr., H-041, Hershey, PA 17033-0850, United States.
| | - Sarah H. Duda
- Penn State University College of Medicine, Hershey, PA, United States
| | | | - Arian Baker
- Colquitt Regional Medical Center, Moultrie, GA, United States
| | - Heather Costigan
- Penn State University College of Medicine, Hershey, PA, United States
| | - Morgan Loeffler
- Penn State University College of Medicine, Hershey, PA, United States
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Fittler A, Paczolai P, Ashraf AR, Pourhashemi A, Iványi P. Prevalence of Poisoned Google Search Results of Erectile Dysfunction Medications Redirecting to Illegal Internet Pharmacies: Data Analysis Study. J Med Internet Res 2022; 24:e38957. [PMID: 36346655 PMCID: PMC9682446 DOI: 10.2196/38957] [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: 04/23/2022] [Revised: 07/31/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background
Illegal online pharmacies function as affiliate networks, in which search engine results pages (SERPs) are poisoned by several links redirecting site visitors to unlicensed drug distribution pages upon clicking on the link of a legitimate, yet irrelevant domain. This unfair online marketing practice is commonly referred to as search redirection attack, a most frequently used technique in the online illegal pharmaceutical marketplace.
Objective
This study is meant to describe the mechanism of search redirection attacks in Google search results in relation to erectile dysfunction medications in European countries and also to determine the local and global scales of this problem.
Methods
The search engine query results regarding 4 erectile dysfunction medications were documented using Google. The search expressions were “active ingredient” and “buy” in the language of 12 European countries, including Hungary. The final destination website legitimacy was checked at LegitScript, and the estimated number of monthly unique visitors was obtained from SEMrush traffic analytics. Compromised links leading to international illegal medicinal product vendors via redirection were analyzed using Gephi graph visualization software.
Results
Compromised links redirecting to active online pharmacies were present in search query results of all evaluated countries. The prevalence was highest in Spain (62/160, 38.8%), Hungary (52/160, 32.5%), Italy (46/160, 28.8%), and France (37/160, 23.1%), whereas the lowest was in Finland (12/160, 7.5%), Croatia (10/160, 6.3%), and Bulgaria (2/160, 1.3%), as per data recorded in November 2020. A decrease in the number of compromised sites linking visitors to illegitimate medicine sellers was observed in the Hungarian data set between 2019 and 2021, from 41% (33/80) to 5% (4/80), respectively. Out of 1920 search results in the international sample, 380 (19.79%) search query results were compromised, with the majority (n=342, 90%) of links redirecting individuals to 73 international illegal medicinal product vendors. Most of these illegal online pharmacies (41/73, 56%) received only 1 or 2 compromised links, whereas the top 3 domains with the highest in-degree link value received more than one-third of all incoming links. Traffic analysis of 35 pharmacy specific domains, accessible via compromised links in search engine queries, showed a total of 473,118 unique visitors in November 2020.
Conclusions
Although the number of compromised links in SERPs has shown a decreasing tendency in Hungary, an analysis of the European search query data set points to the global significance of search engine poisoning. Our research illustrates that search engine poisoning is a constant threat, as illegitimate affiliate networks continue to flourish while uncoordinated interventions by authorities and individual stakeholders remain insufficient. Ultimately, without a dedicated and comprehensive effort on the part of search engine providers for effectively monitoring and moderating SERPs, they may never be entirely free of compromised links leading to illegal online pharmacy networks.
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Affiliation(s)
- András Fittler
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Péter Paczolai
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Amir Reza Ashraf
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Amir Pourhashemi
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Péter Iványi
- Department of Systems and Software Technologies, Faculty of Engineering and Information Technology, University of Pécs, Pécs, Hungary
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15
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Sarker A, Lakamana S, Liao R, Abbas A, Yang YC, Al-Garadi M. Early detection of fraudulent COVID-19 products from Twitter chatter: a dataset and a baseline approach using anomaly detection (Preprint). JMIR INFODEMIOLOGY 2022; 3:e43694. [PMID: 37113382 PMCID: PMC10131818 DOI: 10.2196/43694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/31/2023] [Accepted: 02/25/2023] [Indexed: 02/27/2023]
Abstract
Background Social media has served as a lucrative platform for spreading misinformation and for promoting fraudulent products for the treatment, testing, and prevention of COVID-19. This has resulted in the issuance of many warning letters by the US Food and Drug Administration (FDA). While social media continues to serve as the primary platform for the promotion of such fraudulent products, it also presents the opportunity to identify these products early by using effective social media mining methods. Objective Our objectives were to (1) create a data set of fraudulent COVID-19 products that can be used for future research and (2) propose a method using data from Twitter for automatically detecting heavily promoted COVID-19 products early. Methods We created a data set from FDA-issued warnings during the early months of the COVID-19 pandemic. We used natural language processing and time-series anomaly detection methods for automatically detecting fraudulent COVID-19 products early from Twitter. Our approach is based on the intuition that increases in the popularity of fraudulent products lead to corresponding anomalous increases in the volume of chatter regarding them. We compared the anomaly signal generation date for each product with the corresponding FDA letter issuance date. We also performed a brief manual analysis of chatter associated with 2 products to characterize their contents. Results FDA warning issue dates ranged from March 6, 2020, to June 22, 2021, and 44 key phrases representing fraudulent products were included. From 577,872,350 posts made between February 19 and December 31, 2020, which are all publicly available, our unsupervised approach detected 34 out of 44 (77.3%) signals about fraudulent products earlier than the FDA letter issuance dates, and an additional 6 (13.6%) within a week following the corresponding FDA letters. Content analysis revealed misinformation, information, political, and conspiracy theories to be prominent topics. Conclusions Our proposed method is simple, effective, easy to deploy, and does not require high-performance computing machinery unlike deep neural network-based methods. The method can be easily extended to other types of signal detection from social media data. The data set may be used for future research and the development of more advanced methods.
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Affiliation(s)
- Abeed Sarker
- Department of Biomedical Informatics School of Medicine Emory University Atlanta, GA United States
| | - Sahithi Lakamana
- Department of Biomedical Informatics School of Medicine Emory University Atlanta, GA United States
| | - Ruqi Liao
- H Milton Stewart School of Industrial and Systems Engineering Georgia Institute of Technology Atlanta, GA United States
| | - Aamir Abbas
- Heinz College of Information Systems and Public Policy Carnegie Mellon University Pittsburgh, PA United States
| | - Yuan-Chi Yang
- Department of Biomedical Informatics School of Medicine Emory University Atlanta, GA United States
| | - Mohammed Al-Garadi
- Department of Biomedical Informatics School of Medicine Emory University Atlanta, GA United States
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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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An Analysis of the Deleterious Impact of the Infodemic during the COVID-19 Pandemic in Brazil: A Case Study Considering Possible Correlations with Socioeconomic Aspects of Brazilian Demography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063208. [PMID: 35328896 PMCID: PMC8953409 DOI: 10.3390/ijerph19063208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/03/2022] [Accepted: 03/03/2022] [Indexed: 12/16/2022]
Abstract
Due to COVID-19, a huge amount of incorrect information has been disseminated on the internet, which may interfere with the disease’s advance. This study analyzes the behavior of the Brazilian population during the pandemic, employing queries of infodemic data searched on Google Trends and relating them to socioeconomic and political indicators in the country. The z-score technique was used to standardize the data; and for multivalued analysis, dendrograms and the Elbow method detected similar patterns among Brazilian states. The result was divided into three analyses. In the analysis of the research trend of infodemic terms, the themes “Prevention and Beliefs” and “Treatment” prevailed. In the exploratory analysis, socioeconomic indicators related to income and education, as well as government programs, showed no impact on infodemic searches; but the results suggest that the states that supported the Brazilian president in the 2018 election, where he obtained more than 50% of the votes, were the states that most searched for infodemic terms: a total of 46.58% more infodemic searches than in the other states. In the multivalued analysis, the socioeconomic indicators used showed similarities in the patterns, highlighting a cluster containing 77% of all Brazilian states. The study concludes that denial about the pandemic and the influence of political leadership can influence infodemic information searches, contributing to a disorganization in the control of disease control and prevention measures.
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Gwenzi W, Selvasembian R, Offiong NAO, Mahmoud AED, Sanganyado E, Mal J. COVID-19 drugs in aquatic systems: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2022; 20:1275-1294. [PMID: 35069060 PMCID: PMC8760103 DOI: 10.1007/s10311-021-01356-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/02/2021] [Indexed: 05/14/2023]
Abstract
The outbreak of the human coronavirus disease 2019 (COVID-19) has induced an unprecedented increase in the use of several old and repurposed therapeutic drugs such as veterinary medicines, e.g. ivermectin, nonsteroidal anti-inflammatory drugs, protein and peptide therapeutics, disease-modifying anti-rheumatic drugs and antimalarial drugs, antiretrovirals, analgesics, and supporting agents, e.g. azithromycin and corticosteroids. Excretion of drugs and their metabolites in stools and urine release these drugs into wastewater, and ultimately into surface waters and groundwater systems. Here, we review the sources, behaviour, environmental fate, risks, and remediation of those drugs. We discuss drug transformation in aquatic environments and in wastewater treatment systems. Degradation mechanisms and metabolite toxicity are poorly known. Potential risks include endocrine disruption, acute and chronic toxicity, disruption of ecosystem functions and trophic interactions in aquatic organisms, and the emergence of antimicrobial resistance.
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Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Agricultural and Biosystems Engineering, Faculty of Agriculture, Environment and Food Systems, University of Zimbabwe, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Rangabhashiyam Selvasembian
- Department of Biotechnology, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamilnadu 613401 India
| | - Nnanake-Abasi O. Offiong
- International Centre for Energy and Environmental Sustainability Research (ICEESR), University of Uyo, Uyo, Nigeria
- Department of Chemical Sciences, Faculty of Computing and Applied Sciences, Topfaith University, Mkpatak, Nigeria
| | - Alaa El Din Mahmoud
- Environmental Sciences Department, Faculty of Science, Alexandria University, Alexandria, 21511 Egypt
- Green Technology Group, Faculty of Science, Alexandria University, Alexandria, 21511 Egypt
| | - Edmond Sanganyado
- Guangdong Provincial Key Laboratory of Marine Biotechnology, Institute of Marine Science, Shantou University, Shantou, 515063 China
| | - Joyabrata Mal
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, Uttar Pradesh India
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Pashkov V, Soloviov O, Harkusha A. LEGAL CHARACTERISTICS OF PHARMACEUTICAL ACTIVITY UNDER THE EMERGENCY CONDITIONS: PANDEMIC AND WAR. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2286-2292. [PMID: 36378710 DOI: 10.36740/wlek202209219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim: Study of the system of pharmaceutical activity legal support in emergency conditions, namely, the period of epidemics outbreak and during the war. PATIENTS AND METHODS Materials and methods: In the mentioned study, we analyze the state of the governmental pharmaceutical policy during the pandemic and the war in Ukraine. Legal norms and doctrinal positions of scientists regarding the above-mentioned issue are studied. The work analyzes the information presented by specialists in various scientific publications, and also uses scientific methods from a medical and legal point of view. This material is based on dialectical, comparative, analytical, synthetic, and complex research methods. This study analyzes the activities of pharmaceutical enterprises in the emergency state and the problem of ensuring patients' rights to medical care and epidemic safety. As part of the above-mentioned methods, we investigated the problems of pharmacies utilizing questionnaires. A survey of representatives of pharmacy chains, managers of purchasing pharmaceutical products and their pricing, in the cities of Kharkiv, Poltava, Kyiv, Mykolaiv and Lviv in the number of 460 specialists, shows negative trends in price gouging. This is a violation of patients' rights to affordable pharmaceutical products. CONCLUSION Conclusions: The pharmaceutical industry of Ukraine was not prepared in advance for extraordinary events, such as a pandemic and martial law, as well as for other natural disasters and foreseeable emergencies. This negatively affected and continues to affect the health of patients.
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Affiliation(s)
- Vitalii Pashkov
- POLTAVA LAW INSTITUTE OF YAROSLAV MUDRYI NATIONAL LAW UNIVERSITY, POLTAVA, UKRAINE
| | | | - Andrii Harkusha
- POLTAVA LAW INSTITUTE OF YAROSLAV MUDRYI NATIONAL LAW UNIVERSITY, POLTAVA, UKRAINE
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