Background

The quality of medicines available in some less-developed countries is inadequate in terms of content of active ingredient. Reasons for the poor quality of drugs include widespread counterfeiting of medicines in less-developed countries, excessive decomposition of active ingredient as a result of high temperature and humidity, and poor quality assurance during the manufacture of medicinal products. Our aim was to investigate the quality of different drugs obtained from retail pharmacies in two urban areas of Nigeria, and, in instances of poor quality, to ascertain the reason why.

The NHIS in recent times has opted for a health insurance scheme in which capitation payments made to physicians will cover not only their direct services, but cost of drugs and other indirect services such as X-ray diagnosis (see annexure A). By this arrangement, the physician will be expected to stock most drugs and only send out prescriptions to approved pharmacies for the few drugs he does not carry. The physician will then be responsible for reimbursing the private pharmacy for such few prescriptions filled.