This study has been carried out to assess pharmacists’ awareness and practices regarding counterfeit medicines in Aksum. In this study the most important finding was high experiences of drug counterfeiting. Most pharmacists thought medicine counterfeiting was widespread in Aksum and a similar practice was reported by study conducted in Alexandria, Egypt; as a result, developing countries should pay close attention to the issue of counterfeit medicines (11).
In this study 51.2% of the respondents didn’t know a way of counterfeit medication reporting system. About 58.5% didn’t pass any special training course about identifying counterfeit drugs and dealing with this problem. A study showed that pharmacists who attended a training course on counterfeit medicines and reporting system have a slightly greater ability to differentiate between authentic and CFM; and to report suspicious offers to the Egyptian Drug Authority (11). Therefore, aware and informed pharmacists can play a major role in supporting authorities incorporate appropriate measures to safeguard patients and minimize the risk of using CFM. Pharmacists should be involved in the supply chain management, by being selective of their sources and using only authorized distributors (12).
Most of the pharmacists considered that the current law and regulations of drug counterfeiting are not enough. This is consistent with a study conducted in South Africa which indicates that, there is no specific pharmaceutical legislation addressing the counterfeiting of medicines. Law enforcement has also been complicated by poor stakeholder engagement and information sharing (13). About 44% of the respondents in this study also believe that poor legislative and regulatory framework for monitoring drug quality encourages drug counterfeiting.
There is a variation on the definition of counterfeit medicines. Respondents of this study defined that counterfeit drug as a toxic material and/or high levels of impurities and contaminants. Therefore, there is a need for an official CFM definition that distinguishes between the different types of counterfeiting (14). A study in California support that academic institutions could play a key role in educating healthcare professionals about CFM. Input from academia would allow future pharmacists to better understand the risks and consequences regarding CFM (15).
About 42% of the respondents believed that analgesics are more susceptible to counterfeiting; a similar study showed that anti-infectives, anti-malarials, and analgesics were reported to be the most implicated drugs (16). Additionally, 9.8% responded that they did not know what counterfeit medicines were and this is consistent with a study conducted by (17). In these situations, there is a strong need to orient and inform respondents to issues of counterfeit medicine. Anti-counterfeit measures need to be incorporated into a set of guidelines to be developed for Pharmacists (18).
Findings from this study confirmed that majority of pharmacists’ distinguishing features of CFM were limited to common packaging and expire dates which implies they lack sufficient skills and funds to improve their capability to detect CFM. Similar responses have been reported by pharmacists in both developing and developed countries (19).
There are few aspects that have affected the generalizability of the study findings: study duration, sample size, subject selection and survey responses. The subjects were also selected using a non-random method which could cause a bias sample. Furthermore, due to the nature of a survey method, the responses were based on the subjects’ self-perception and they may not feel encouraged to provide accurate and honest answers.