Friday November 16, 2018

Low Quality Drugs, Medicine Costs More Than Just Money

Even in high-income countries, purchasing cheaper medicines from illegitimate sources online could result in obtaining substandard or falsified medicines.

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Medicines
A seized counterfeit hydrocodone tablets in the investigation of a rash of fentanyl overdoses in northern California is shown in this Drug Enforcement Administration (DEA). VOA
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About one in eight essential medicines in low- and middle-income countries may be fake or contain dangerous mixes of ingredients that put patients’ lives at risk, a research review suggests.

Researchers examined data from more 350 previous studies that tested more 400,000 drug samples in low- and middle-income countries. Overall, roughly 14 percent of medicines were counterfeit, expired or otherwise low quality and unlikely to be as safe or effective as patients might expect.

“Low-quality medicines can have no or little active pharmaceutical ingredient [and] can prolong illness, lead to treatment failure and contribute to drug resistance,” said lead study author Sachiko Ozawa of the University of North Carolina at Chapel Hill.

“Or it may have a too much active ingredient and cause a drug overdose,” Ozawa said by email. “If it is contaminated or has other active ingredients, then the medication could cause poisoning, adverse drug interactions or avertable deaths.”

Much of the research to date on counterfeit or otherwise unsafe medicines has focused on Africa, and about half of the studies in the current analysis were done there.

 

medicines
One in five medications tested in Africa were fake. Pixabay

 

Almost one in five medications tested in Africa were fake or otherwise potentially unsafe, researchers report in JAMA Network Open.

 

Another third of the studies were done in Asia, where about 14 percent of medicines tested were found to be counterfeit or otherwise unsafe.

Antibiotics and antimalarials were the most tested drugs in the analysis. Overall, about 19 percent of antimalarials and 12 percent of antibiotics were falsified or otherwise unsafe.

While fake or improperly made medicines undoubtedly harm patients, the current analysis couldn’t tell how many people suffered serious side effects or died as a result of falsified drugs.

Researchers did try to assess the economic impact of counterfeit or improperly made medicines and found the annual cost might run anywhere from $10 billion to $200 billion.

While the study didn’t examine high-income countries, drug quality concerns are by no means limited to less affluent nations, Ozawa said.

Medicines
Different vaccines. Pixabay

“Even in high-income countries, purchasing cheaper medicines from illegitimate sources online could result in obtaining substandard or falsified medicines,” Ozawa said. “Verify the source before you buy medications, and make policymakers aware of the problem so they can work to improve the global supply chain of medicines.”

The study wasn’t a controlled experiment designed to prove whether or how counterfeit or poorly made medicines directly harm patients, however. And the economic impact was difficult to assess from smaller studies that often didn’t include a detailed methodology for calculating the financial toll.

Also Read: Eating in 10-hour Window May Boost Health

The report “provides important validation of what is largely already known,” Tim Mackey of the Global Health Policy Institute in La Jolla, California, writes in an accompanying editorial.

“It is important to note that although the study is comprehensive, its narrow scope means it only provides a snapshot of the entire problem, as it is limited to studies conducted in low- and middle-income countries and to those
medicines classified as essential by the World Health Organization.” (VOA)

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NASA to Send Organ-on-Chips To Test Human Tissue Health in Space

Called a micro-physiological system, a tissue chip needs three main properties

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NASA, tissue
NASA to send tissue chips to space to test human health, genetic changes. Flcikr

NASA is planning to send small devices containing human cells in a 3D matrix — known as tissue chips or organs-on-chips — to the International Space Station (ISS) to test how they respond to stress, drugs and genetic changes.

Made of flexible plastic, tissue chips have ports and channels to provide nutrients and oxygen to the cells inside them.

The “Tissue Chips in Space” initiative seeks to better understand the role of microgravity on human health and disease and to translate that understanding to improved human health on Earth, NASA said.

“Spaceflight causes many significant changes in the human body,” said Liz Warren, Associate Program Scientist at the Center for the Advancement of Science in Space (CASIS) in the US.

Kepler, NASA, tissue
This illustration made available by NASA shows the Kepler Space Telescope. As of October 2018, the planet-hunting spacecraft has been in space for nearly a decade. VOA

“We expect tissue chips in space to behave much like an astronaut’s body, experiencing the same kind of rapid change,” Warren said.

The US space agency is planning the investigations in collaboration with CASIS and the National Center for Advancing Translational Sciences (NCATS) at the National Institutes for Health (NIH).

Many of the changes in the human body caused by microgravity resemble the onset and progression of diseases associated with ageing on Earth, such as bone and muscle loss. But the space-related changes occur much faster.

That means scientists may be able to use tissue chips in space to model changes that might take months or years to happen on Earth.

Parkinson's Disease, Kepler, NASA, tissue
A researcher takes a tissue sample from a human brain at the Multiple Sclerosis and Parkinson’s UK Tissue Bank, VOA

This first phase of Tissue Chips in Space includes five investigations. An investigation of immune system ageing is planned for launch on the SpaceX CRS-16 flight, scheduled for this year.

The other four, scheduled to launch on SpaceX CRS-17 or subsequent flights, include lung host defense, the blood-brain barrier, musculoskeletal disease and kidney function.

In addition, four more projects are scheduled for launch in summer 2020, including two on engineered heart tissue to understand cardiovascular health, one on muscle wasting and another on gut inflammation.

Kepler, NASA, tissue
“Detecting life in an agnostic fashion means not using characteristics particular to Earth life,” said Heather Graham at NASA’s Goddard Space Flight Center in Greenbelt, Maryland. Pixabay

Also called a micro-physiological system, a tissue chip needs three main properties, according to Lucie Low, scientific programme manager at National Center for Advancing Translational Sciences in the US.

Also Read: NASA’s Ralph Will Explore Jupiter’s Trojan Asteroids in 2021

“It has to be 3D, because humans are 3D,” she explained.

“It must have multiple, different types of cells, because an organ is made up of all kinds of tissue types. And it must have microfluidic channels, because every single tissue in your body has vasculature to bring in blood and nutrients and to take away detritus,” she added. (IANS)