Challenges Associated with Addressing Counterfeit Medicines in Nigeria: An Exploration of Pharmacists’ Knowledge, Practices, and Perceptions

Figures & data

Table 1 Socio-Demographic Characteristics

Variable	Frequency (%)
Gender
Male	185 (47.4)
Female	205 (52.6)
Age
<30	166 (42.6)
31–40	125 (32.1)
41–50	37 (9.5)
Above 50 years	44 (11.3)
Missing data	18 (4.5)
Years of practice
≤5	146 (37.4)
5–10	73 (18.7)
11–15	78 (20.0)
Above 15	65 (16.7)
Missing data	28 (7.2)
Highest level of education
First degree	278 (71.3)
Master’s	95 (24.4)
Ph.D.	4 (1.0)
Missing data	13 (3.3)
Area of practice
Hospital	175 (44.9)
Community	144 (36.9)
Research/academia	13 (3.3)
Industry	2 (0.5)
NGO	14 (3.6)
Administration	17 (4.4)
Regulation	13 (3.3)
Missing data	12 (3.1)

Abbreviations: Ph.D., Doctor of Philosophy, NGO, Non-Governmental Organization.

Table 2 Knowledge of Drug Counterfeiting

Statement	Correct Response (%)
Counterfeit medicines are drugs that do not contain active pharmaceutical ingredients.	285 (74.6)
Fake medicines are drugs with illegally modified label information.	335 (88.6)
Counterfeit medicines have altered expiry dates.	312 (82.3)
Counterfeit drugs have been a serious threat to healthcare in the country.	375 (97.2)
The circulation of fake/counterfeit medicines has increased in the last couple of years.	325 (84.2)
Fake drugs can lead to anti-microbial resistance.	352 (91.2)
Counterfeit medicines have detrimental effects on a patient’s chance of recovery.	380 (98.7)
Fake medications contribute to the incidences of mortality in Nigeria.	379 (97.2)
Counterfeit pharmaceutical products can result to treatment failure.	384 (99.5)

Table 3 Practice Towards Addressing Counterfeiting

Statement	Yes (%)	No (%)
You regularly check the batch number and expiry dates of purchased drugs.	355 (92.4)	29 (7.6)
Your current knowledge and skills are adequate to detect counterfeit/fake medicines.	262 (69.3)	116 (30.7)
You have detected counterfeit medicines in the course of your practice.	284 (74.2)	99(25.8)
You sometimes purchase pharmaceutical products from unreliable sources.	57 (14.8)	327 (85.2)
You have unintentionally purchased counterfeit medicines in the course of your practice.	149 (39.6)	227 (60.4)
You have unintentionally dispensed counterfeit medicines in the course of your practice.	123 (33.0)	250 (67.0)

Figure 1 Legislation and inspection.

Figure 2 Collaboration and cross-border law enforcement.

Figure 3 Online sales of medicines.

Table 4 Cross-Tabulation of Demography with Detection of Counterfeit Medicines in the Course of Practice

Demography	Yes (%)	No (%)	X^2	p-value
Gender
Female	135 (67.8)	64 (32.2)	9.117	0.010
Male	149 (81.0)	35 (19.0)
Age
≤30 years	102(62.6)	61(37.4)	28.988	<0.001
5–10 years	97(79.5)	25(20.5)
10–15 years	35(94.6)	2(5.4)
Above 15 years	39(88.6)	5(11.4)
Years of practice
≤5 years	88(61.1)	56(38.9)	33.830	<0.001
5–10 years	61(84.7)	11(14.3)
10–15 years	59(77.6)	17(22.4)
Above 15 years	59(92.2)	5(7.8)
Area of practice
Hospital	109(63.7)	62(36.3)	23.560	0.023
Community	116(82.3)	25(17.7)
Research/academia	10(76.9)	3(23.1)
Industry	2(100.0)	0(0.0)
NGO	14(100)	0(0.0)
Administration	11(64.7)	6(35.3)
Regulation	12(92.3)	1(7.7)
Highest level of education
First degree	181(67.0)	89(33.0)	3.161	0.531
Masters	67(72.8)	25(27.2)
Ph.D.	4(100.0)	0(0.0)

Table 5 Cross-Tabulation of Demography with Inadequacy of Inspection by Regulatory Agencies as a Challenge to the Mitigation of Counterfeit Medicines

Demography	Strongly Disagree (%)	Disagree (%)	Neutral (%)	Agree (%)	Strongly Agree (%)	X^2	p-value
Age
≤30 years	0(0.0)	3(1.9)	11(7.1)	63(40.4)	79(50.6)	24.052	0.020
31–40 years	1(0.8)	6(4.9)	3(2.4)	47(38.2)	66(53.7)
41–50 years	2(5.7)	0(0.0)	1(2.9)	19(54.3)	13(37.1)
Above 50 years	0(0.0)	3(6.8)	4(9.1)	17(38.6)	20(45.5)
Area of practice
Hospital	1(0.6)	5(3.0)	11(6.6)	61(36.5)	89(53.3)	80.88	<0.001
Community	1(0.7)	0(0.0)	4(2.9)	60(43.8)	72(52.6)
Research/academia	0(0)	0(0)	0(0.0)	8(61.5)	5(38.5)
Industry	0(0)	0(0)	0(0.0)	0(0.0)	2(100.0)
NGO	0(0)	0(0)	0(0.0)	4(28.6)	10(71.4)
Administration	1(5.9)	2(11.8)	2(11.8)	2(11.8)	10(8.9)
Regulation	0(0)	5(38.5)	1(7.7)	4(30.8)	3(23.1)