在私营部门的制药商店中采购抗疟疾药物:决策复杂性和对坦桑尼亚药品质量的影响
Gerry Mshana1, Tubeti Mayebe1, Rebecca Balira1
1National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
BMJ global health
|September 11, 2023
概括
质量差的药物危及低收入国家的弱势群体. 零售商的决定优先考虑价格和个人联系,而不是质量风险,将不合格的抗疟疾药物引入供应链.
科学领域:
- 制药科学 制药科学
- 卫生经济学 卫生经济学
- 全球健康 全球健康
背景情况:
- 质量差的药物对低收入国家的医疗保健构成重大威胁,不成比例地影响儿童和妇女等弱势群体.
- 虽然已知宏观层面的原因,但制药供应链中的决策过程,特别是零售层面的决策过程,仍未得到充分研究.
- 了解这些微观层面的动态对于识别药品质量的漏洞至关重要.
研究的目的:
- 调查坦桑尼亚的零售商-供应商互动和抗疟疾药物的决策.
- 探索经济因素和个人关系如何影响药品零售商对供应商的选择.
- 识别这些低级供应链动态产生的对药品质量的潜在风险.
主要方法:
- 采用混合方法方法,将118家零售商的调查与12次深入采访相结合.
- 该研究集中在坦桑尼亚的塔博拉,多多马和 Mbeya 地区的城市和农村地区.
- 采访特别探讨了Tabora的药店员工和业主之间的决策动态.
主要成果:
- 零售商优先考虑商业和经济因素:低购买价格,免费送货和信用可用性是关键.
- 与供应商的个人联系,无论是业务还是非业务相关,都会显著影响零售商的选择.
- 药品质量是零售商在选择供应商时的低优先级,通常被经济和关系考虑所掩盖.
结论:
- 经济压力和个人关系主导着零售商的供应商选择,可能会损害药品质量.
- 这种动态造成了低质量的抗疟疾药物透的风险,特别是在监管监督较弱的环境中.
- 解决漏洞需要了解并可能干预复杂的制药供应链中的零售商决策过程.
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