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Value for money of medicine sampling and quality testing

Evidence from Indonesia

Bibliographic Data

ID21879595
AuthorsSara Valente de Almeida (0000-0001-9178-2105, Public Health England), Katharina Hauck (0000-0003-3138-4169, Imperial College London), Sarah Njenga (University of Oxford), Yunita Nugrahani (Pancasila University), Ayu Rahmawati (0009-0001-2757-6670, Pancasila University), Rahmi Mawaddati (Pancasila University), Stanley Saputra (0009-0006-5969-0183, Pancasila University), Amalia Hasnida (0000-0002-9264-334X, Erasmus University Rotterdam), Elizabeth Pisani (0000-0002-3674-631X, King's College London), Yusi Anggriani (0000-0001-7787-0539, Pancasila University), Adrian Gheorghe (0000-0002-0517-8807, Imperial College London)
Year2024
Volume9
Issue9
Pagese015402
Publication date2024-09-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-015402
PMID39313254
OpenAlexW4402750071
LanguageEN
Citations received1
References cited14

BACKGROUND: Substandard and falsified medicines (SFMs) are a public health concern of global importance. Postmarket surveillance in the form of medicine sampling and quality testing can prevent and detect SFM, however, there is remarkably scarce evidence about the cost and value for money of these activities: how much do they cost and how effective are they in detecting SFM? METHODS: Between February and October 2022, Systematic Tracking of At Risk Medicines (STARmeds) collected and analysed for quality 1274 samples of 5 medicines from physical and online retail outlets in 7 Indonesian districts. We collated data on the resources consumed by STARmeds, related to all stages of medicines sampling and quality testing including design, fieldwork and laboratory analysis. We used activity-based costing principles to calculate the financial and economic cost of medicine quality surveillance from the perspective of a hypothetical medicines' regulator. We calculated the cost per day and per week of fieldwork, per sample collected and per substandard sample. We used bootstrapping to capture uncertainty in the number of samples collected, by seller location type (urban, rural and online). RESULTS: The total cost of sampling and testing medicines from the market was US$712 964 (current 2022 values). Laboratory costs represented the largest share (70%), followed by other direct costs (12%) and indirect costs (7%). On average, it costs STARmeds US$479 (95% CI US$462 to US$516) to collect one medicine sample and US$5990 (95% CI US$5601 to US$6258) to identify one substandard sample. CONCLUSION: Our findings bring urgently needed and novel information on the cost and value for money of medicine quality surveillance. These may support planning and budgeting of the Indonesian pharmaceutical regulator, but also of regulators and researchers elsewhere, particularly in low-income and middle-income settings, as well as international organisations with health regulation and quality of care remits

Economics · Public economics · Statistics · Value for money · Biosimilars and Bioanalytical Methods · Computer Science · Mathematics · Medicine · Pharmaceutical Economics and Policy · Pharmaceutical Quality and Counterfeiting · Philosophy

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Citations per year0.5
Citation span2024 - 2024 (1)
Highly citedNo

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