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Sharma AK, Rastogi S, Ali F, Yadav AP, Goyal RK. A comprehensive quality control and cost comparison study of branded and generic angiotensin receptor blockers. Saudi Pharm J 2024; 32:101985. [PMID: 38380162 PMCID: PMC10877430 DOI: 10.1016/j.jsps.2024.101985] [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: 10/10/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024] Open
Abstract
This study was designed to assess both the quality and cost aspects of various branded and generic formulations of angiotensin receptor blockers, specifically Irbesartan, Losartan Potassium, Olmesartan Medoxomil, Telmisartan, and Valsartan. The collected samples underwent distinct quality evaluations using the methods outlined in different global Pharmacopoeias (British Pharmacopoeia/European Pharmacopoeia, Indian Pharmacopoeia and United States Pharmacopoeia). These drugs were characterized using Fourier-Transform Infrared Spectroscopy and Nuclear Magnetic Resonance techniques, while their quality and concentration were analysed using High Performance Liquid Chromatography. The release profile of the drugs was examined through dissolution testing. Additionally, a cost comparison analysis was carried out by determining the prevailing market prices of the drugs. The evaluated branded and generic angiotensin receptor blockers were found to meet the established standards for impurities, active drug content, and dissolution as set by these Pharmacopoeias, indicating their optimal quality. Notably, the generic drugs exhibited significantly lower costs compared to their branded counterparts. This study confirms that the quality of generic angiotensin receptor blockers is equivalent to that of their branded counterparts. Consequently, these findings support the practicality of utilizing generic drugs as a more economically sustainable and cost-effective approach to managing diseases, especially those of chronic nature.
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Affiliation(s)
- Arvind Kumar Sharma
- Delhi Pharmaceutical Science and Research University (DPSRU), Mehrauli-Badarpur Road, Sector-3, Pushp Vihar, New Delhi, 110017, India
- Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India, Sector-23 Raj Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Shruti Rastogi
- Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India, Sector-23 Raj Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Faraat Ali
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, Hradec Králové, 500 05, Czech Republic
| | - Anuj Prakash Yadav
- Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India, Sector-23 Raj Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Ramesh K. Goyal
- Delhi Pharmaceutical Science and Research University (DPSRU), Mehrauli-Badarpur Road, Sector-3, Pushp Vihar, New Delhi, 110017, India
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Yoshida N. Research on the Development of Methods for Detection of Substandard and Falsified Medicines by Clarifying Their Pharmaceutical Characteristics Using Modern Technology. Biol Pharm Bull 2024; 47:878-885. [PMID: 38692863 DOI: 10.1248/bpb.b23-00749] [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] [Indexed: 05/03/2024]
Abstract
The existence of substandard and falsified medicines threatens people's health and causes economic losses as well as a loss of trust in medicines. As the distribution of pharmaceuticals becomes more globalized and the spread of substandard and falsified medicines continues worldwide, pharmaceutical security measures must be strengthened. To eradicate substandard and falsified medicines, our group is conducting fact-finding investigations of medicines distributed in lower middle-income countries (LMICs) and on the Internet. From the perspective of pharmaceutics, such as physical assessment of medicines, we are working to clarify the actual situation and develop methods to detect substandard and falsified medicines. We have collected substandard and falsified medicines distributed in LMICs and on the Internet and performed pharmacopoeial tests, mainly using HPLC, which is a basic analytic method. In addition to quality evaluation, we have evaluated the applicability of various analytic methods, including observation of pharmaceuticals using an electron microscope, Raman scattering analysis, near-IR spectroscopic analysis, chemical imaging, and X-ray computed tomography (CT) to detect substandard and falsified medicines, and we have clarified their limitations. We also developed a small-scale quality screening method using statistical techniques. We are engaged in the development of methods to monitor the distribution of illegal medicines and evolve research in forensic and policy science. These efforts will contribute to the eradication of substandard and falsified medicines. Herein, I describe our experience in the development of detection methods and elucidation of the pharmaceutical status of substandard and falsified medicines using novel technologies.
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Affiliation(s)
- Naoko Yoshida
- AI Hospital/Macro Signal Dynamics Research and Development Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
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Tshilumba PM, Ilangala AB, Mbinze Kindenge J, Kasongo IM, Kikunda G, Rongorongo E, Impele AB, Marini Djang’eing’a R, Ndoumba JBK. Detection of Substandard and Falsified Antibiotics Sold in the Democratic Republic of the Congo Using Validated HPLC and UV-Visible Spectrophotometric Methods. Am J Trop Med Hyg 2023; 109:480-488. [PMID: 37339757 PMCID: PMC10397439 DOI: 10.4269/ajtmh.23-0045] [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: 01/20/2023] [Accepted: 05/11/2023] [Indexed: 06/22/2023] Open
Abstract
The access to afford safe, effective, and genuine medications is a major challenge for people in low- to middle-income countries. This study aimed at developing and validating simple, accurate, and inexpensive analytical liquid chromatography and ultraviolet-visible spectrophotometric methods to ensure quality control of antibiotics sold in formal and informal pharmaceutical markets. It focused on four antibiotics (azithromycin [AZT], cefadroxil [CFD], cefixime [CFX], and erythromycin [ERH]) used to treat infectious diseases in the region of Haut-Katanga in the Democratic Republic of the Congo (DRC). The total error strategy (accuracy profile) matching with the validation requirements of International Council on Harmonization was used for the validation. The validation results showed that three analytical methods of AZT, CFD, and ERH were validated according to the accuracy profile obtained, whereas the proposed method of CFX was not validated. Therefore, the United State Pharmacopoeia method permitted to quantify CFX samples. The dosage intervals ranged from 25 to 75 µg/mL for CFD, from 750 to 1,500 µg/mL for AZT, and from 500 to 750 µg/mL for ERH. The application of the validated method to samples collected (N = 95) allowed the detection of 25% substandard antibiotics with a rate of poor quality much higher in the informal circuit compared with the formal one (54% versus 11%; P < 0.05). The routine application of these methods will strengthen the quality control of drugs marketed in DRC. This study gives evidence for the availability of poor-quality antibiotics in the country, requiring the immediate attention of the national medicine regulatory authority.
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Affiliation(s)
- Pierrot Mwamba Tshilumba
- Department of Drug Analysis and Galenic, LAMEDA, University of Lubumbashi (UNILU), Lubumbashi, Democratic Republic of the Congo
| | - Ange B. Ilangala
- Laboratory of Pharmaceutics and Phytopharmaceutical Drug Development, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jeremie Mbinze Kindenge
- Laboratory of Pharmaceutics and Phytopharmaceutical Drug Development, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Isaac Mutshitshi Kasongo
- Department of Drug Analysis and Galenic, LAMEDA, University of Lubumbashi (UNILU), Lubumbashi, Democratic Republic of the Congo
| | - Guelord Kikunda
- Department of Drug Analysis and Galenic, LAMEDA, University of Lubumbashi (UNILU), Lubumbashi, Democratic Republic of the Congo
| | - Elie Rongorongo
- Department of Drug Analysis and Galenic, LAMEDA, University of Lubumbashi (UNILU), Lubumbashi, Democratic Republic of the Congo
| | - Alex Bokanya Impele
- Department of Drug Analysis and Galenic, LAMEDA, University of Lubumbashi (UNILU), Lubumbashi, Democratic Republic of the Congo
| | - Roland Marini Djang’eing’a
- Department of Pharmacy, Laboratory of Pharmaceutical Analytical Chemistry, University of Liege (ULiège), CIRM, VibraSante Hub, Liege, Belgium
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Jean-Baptiste Kalonji Ndoumba
- Department of Drug Analysis and Galenic, LAMEDA, University of Lubumbashi (UNILU), Lubumbashi, Democratic Republic of the Congo
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Rousham EK, Nahar P, Uddin MR, Islam MA, Nizame FA, Khisa N, Akter SMS, Munim MS, Rahman M, Unicomb L. Gender and urban-rural influences on antibiotic purchasing and prescription use in retail drug shops: a one health study. BMC Public Health 2023; 23:229. [PMID: 36732727 PMCID: PMC9896778 DOI: 10.1186/s12889-023-15155-3] [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: 10/20/2022] [Revised: 01/11/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Few studies have reported antibiotic purchases from retail drug shops in relation to gender in low and middle-income countries (LMICs). Using a One Health approach, we aimed to examine gender dimensions of antibiotic purchases for humans and animals and use of prescriptions in retail drug shops in Bangladesh. METHODS We conducted customer observations in 20 drug shops in one rural and one urban area. Customer gender, antibiotic purchases, and prescription use were recorded during a four-hour observation (2 sessions of 2 hours) in each shop. We included drug shops selling human medicine (n = 15); animal medicine (n = 3), and shops selling both human and animal medicine (n = 2). RESULTS Of 582 observations, 31.6% of drug shop customers were women. Women comprised almost half of customers (47.1%) in urban drug shops but only 17.2% of customers in rural drug shops (p < 0.001). Antibiotic purchases were more common in urban than rural shops (21.6% versus 12.2% of all transactions, p = 0.003). Only a quarter (26.0%) of customers who purchased antibiotics used a prescription. Prescription use for antibiotics was more likely among women than men (odds ratio (OR) = 4.04, 95% CI 1.55, 10.55) and more likely among urban compared to rural customers (OR = 4.31 95% CI 1.34, 13.84). After adjusting for urban-rural locality, women remained more likely to use a prescription than men (adjusted OR = 3.38, 95% CI 1.26, 9.09) but this was in part due to antibiotics bought by men for animals without prescription. Customers in drug shops selling animal medicine had the lowest use of prescriptions for antibiotics (4.8% of antibiotic purchases). CONCLUSION This study found that nearly three-quarters of all antibiotics sold were without prescription, including antibiotics on the list of critically important antimicrobials for human medicine. Men attending drug shops were more likely to purchase antibiotics without a prescription compared to women, while women customers were underrepresented in rural drug shops. Antibiotic stewardship initiatives in the community need to consider gender and urban-rural dimensions of drug shop uptake and prescription use for antibiotics in both human and animal medicine. Such initiatives could strengthen National Action Plans.
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Affiliation(s)
- Emily K. Rousham
- grid.6571.50000 0004 1936 8542School of Sport, Exercise and Health Sciences, Loughborough University, LE11 3TU Loughborough, Leicestershire, UK
| | - Papreen Nahar
- grid.12082.390000 0004 1936 7590Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton and Hove, UK
| | - Mohammad Rofi Uddin
- grid.414142.60000 0004 0600 7174Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Aminul Islam
- grid.30064.310000 0001 2157 6568Paul G. Allen School for Global Health, Washington State University, Pullman, WA USA
| | - Fosiul Alam Nizame
- grid.414142.60000 0004 0600 7174Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nirnita Khisa
- Tarum Development Organization, Rangamati, Bangladesh
| | - S. M. Salim Akter
- grid.414142.60000 0004 0600 7174Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Saeed Munim
- grid.414142.60000 0004 0600 7174Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahbubur Rahman
- grid.414142.60000 0004 0600 7174Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Leanne Unicomb
- grid.414142.60000 0004 0600 7174Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Waffo Tchounga CA, Sacré PY, Ciza Hamuli P, Ngono Mballa R, De Bleye C, Ziemons E, Hubert P, Marini Djang’eing’a R. Prevalence of Poor Quality Ciprofloxacin and Metronidazole Tablets in Three Cities in Cameroon. Am J Trop Med Hyg 2023; 108:403-411. [PMID: 36535257 PMCID: PMC9896317 DOI: 10.4269/ajtmh.22-0221] [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: 03/23/2022] [Accepted: 10/05/2022] [Indexed: 12/23/2022] Open
Abstract
Quality is one of the essential components of medicines and needs to be ensured to preserve the population's health. This can be achieved through post-marketing quality control of medicines and is one of the most important duties of national regulatory authorities. In collaboration with the Cameroonian National Drug Quality Control and Valuation Laboratory, the decision was made to initiate a prevalence study to assess the quality of antiinfective medicines in Cameroon. A total of 150 samples of ciprofloxacin tablets and 142 samples of metronidazole tablets were collected from 76 licensed pharmacies and 75 informal vendors in three cities in Cameroon using a random strategy wherever possible and a mystery shopper approach. Three tests were carried out on each of the samples. Visual inspection allowed to find two falsified samples (0.7%) due to lack of information about the manufacturing company, and five more samples (1.7%) were deemed to be substandard due to flaws in the product. An additional 13 samples (4.5%) failed disintegration testing, and six (2.1%) others failed high-performance liquid chromatography assay testing due to insufficient active pharmaceutical ingredient (API) content. All samples were found to contain some API. A prevalence of 7.9% substandard or falsified (SF) medicines was found. Moreover, the prevalence of outlets selling SF medicines was greater in the informal sector (26.7%) than in the formal sector (2.6%). Although the prevalence of SF medicines found was low, efforts need to be made by national regulatory authorities to monitor the pharmaceutical market more closely.
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Affiliation(s)
- Christelle Ange Waffo Tchounga
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Pierre-Yves Sacré
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
| | - Patient Ciza Hamuli
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
- Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Rose Ngono Mballa
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Laboratoire National de Contrôle des Médicaments et Expertise, Yaoundé, Cameroon
| | - Charlotte De Bleye
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
| | - Eric Ziemons
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
| | - Philippe Hubert
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
| | - Roland Marini Djang’eing’a
- Laboratory of Pharmaceutical Analytical Chemistry, Department of Pharmacy, University of Liege, CIRM, Vibra-Santé Hub, Liège, Belgium
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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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