Patent Medicine Dealers and Irrational Use of Medicines in Children: The Economic Cost and Implications for Reducing Childhood Mortality in Southeast Nigeria

Benjamin S C Uzochukwu,Chinenye Okwuosa,Obinna E Onwujekwe,Ogochukwu P Ibe,Maarten Postma

doi:10.1371/journal.pone.0091667

Benjamin S C Uzochukwu, Chinenye Okwuosa + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0091667

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Journal: PLoS ONE	Publication Date: Mar 12, 2014
Citations: 31	License type: CC BY 4.0

Affiliation: University of Nigeria

Abstract

This study assessed the economic costs of irrational medicine use by Patent Medicine Dealers (PMDs) for malaria, acute respiratory infection (ARI) and diarrhea diseases (DD) in Nigeria. Exit interviews were conducted with 395 respondents who sought care for their children from 15 PMDs in Abakpa district of Enugu state Nigeria. Of the total respondents, 80.0% received treatment for malaria while 12.0% and 8.0% received treatment for DD and ARI respectively. The average number of drugs dispensed per patient was 6.8, average percentage of patients given injections was 72.5%, average percentage of patients given one or more antibiotics was 59.7%, while the percentage of patients given non essential drugs was 45.9%. The additional costs to the standard treatment in Naira was 255, 350 and 175 for malaria, ARI and DD respectively. The losses attributable to irrational dispensing was 4,500 Naira. However, more than half of the drugs were on essential drug list, implying some cost savings for the consumers, but the high number of drugs (6.8) on average/patient is likely to increase the total cost of drugs cancelling out the cost savings to consumers arising from dispensing essential drugs.

Highlights

Diarrhea diseases (DD), acute respiratory infection (ARI) and malaria cause more than half of childhood mortality in some developing countries and irrational prescribing of drugs has been noted as a major health concern in these countries. [1,2]
In Nigeria, many children under the age of five die from these diseases that are preventable or treatable with low cost drugs and these drugs are usually bought from patent medicine dealers (PMD) that have constituted the primary source of drugs in rural and urban Nigeria especially for the poor [3,4,5]
Patients incurred additional costs as a result of irrational dispensing of medicines and this is more with patients presenting with ARI who incurred the highest additional costs

Summary

Introduction

Diarrhea diseases (DD), acute respiratory infection (ARI) and malaria cause more than half of childhood mortality in some developing countries and irrational prescribing of drugs has been noted as a major health concern in these countries. [1,2]. Diarrhea diseases (DD), acute respiratory infection (ARI) and malaria cause more than half of childhood mortality in some developing countries and irrational prescribing of drugs has been noted as a major health concern in these countries. The patent medicine dealer has been defined as ‘‘a person without formal training in pharmacy and sells orthodox pharmaceutical products on a retail basis for profit’’ [6]. They dispense drugs most of the time but do not prescribe. It has been noted that these PMDs have poor knowledge of childhood illnesses and dispensing behaviour especially with malaria episodes [8]

Methods

Results

Conclusion