6ER-031 Relationship between price of purchase and quality of oral antidiabetic drugs in Sub-Saharan Africa: the diabdaf study
Rattachement africain : fr, Côte d’Ivoire, Sénégal, Tunisie, lu. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background and Importance Falsified and substandard medicines remain a major challenge in sub-Saharan Africa (SSA), affecting the quality of care for non-communicable diseases such as diabetes. While medicine pricing is often used as a proxy for quality, the actual relationship between the cost and quality of oral antidiabetic drugs (OAD) in SSA remains poorly explored. Aim and Objectives We conducted a post hoc analysis of the DIABDAF study to examine the relationship between OAD prices of purchase and their quality in Africa. Material and Methods OAD were chosen by investigators as those frequently prescribed in SSA: one biguanide (metformin) and three sulfonylureas (glyburide, gliclazide, glimepiride). Drugs were collected from licensed pharmacies and street markets in capital and border cities of seven countries. Prices of purchase were converted into international dollars (int$) using purchasing power parity to ensure comparability across countries. Quality of drugs was assessed based on active pharmaceutical ingredient content (APIC), impurity level, or both (composite quality criteria). A multivariate analysis using a mixed-effects linear model was fitted, with two random effects (pharmaceutical batch and country of purchase), using R (v4.4.3). Results Overall, 610 samples with a price of purchase were collected from seven countries. Prices ranged from 0.06 int$ to 1.92 int$. Mean prices were 0.43±0.26 int$ for metformin (n=220, 36%), 0.40±0.39 int$ for glyburide (n=80,13%), 0.91±0.33 int$ for glimepiride (n=180, 30%) and 1.25±0.54 int$ for gliclazide (n=130, 21%). Branded medicines had a mean price of 0.92±0.54 int$, and 0.57±0.40 for generics. In univariate analysis price was significantly associated with quality according to APIC (p=0.004) and composite quality criteria (p=0.003): poor-quality drugs were less expensive than good-quality drugs, but not quality according to impurity level (p=0.869). In multivariate analysis, drug status (generics being less expensive, p=0.001) and INN (p<0.001) remained significantly associated with price. There was a significant interaction between drug quality and place of manufacture (p=0.002). Specifically, poor-quality drugs produced in Asia were about 4.6% less expensive than good-quality ones (p=0.001), whereas no significant difference was observed for drugs produced in Europe or Africa. Conclusion and Relevance This large study of 610 samples supports a price–quality association of OADs in SSA, influenced by drug, status and manufacturing origin. References and/or Acknowledgements 1. https://pubmed.ncbi.nlm.nih.gov/40823495/ Conflict of Interest No conflict of interest
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- 6ER-031 Relationship between price of purchase and quality of oral antidiabetic drugs in Sub-Saharan Africa: the diabdaf study
- Date Crossref
- 01/03/2026
- Éditeur
- British Medical Journal Publishing Group
- Type
- proceedings-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Inserm pays non établi dans la noticeOrganisme public
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Sorbonne Université pays non établi dans la noticeUniversité ou école supérieure
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Pitié-Salpêtrière Hospital pays non établi dans la noticeÉtablissement de santé
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Hôpital Charles-Foix pays non établi dans la noticeÉtablissement de santé
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Institut Universitaire d'Abidjan Institut Universitaire d'Abidjan, Côte d’Ivoire (code pays fourni par la source)Université ou école supérieure
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Université Paris-Saclay pays non établi dans la noticeUniversité ou école supérieure
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Centre de Suivi Ecologique Sénégal (code pays fourni par la source)Institution
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Ministère de la Santé Nouakchott, Tunisie (code pays fourni par la source)Organisme public
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Ministère de la Santé pays non établi dans la noticeOrganisme public
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Université Paris Cité pays non établi dans la noticeUniversité ou école supérieure
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Sorbonne Paris Cité pays non établi dans la noticeInstitution
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Paris Cardiovascular Research Center pays non établi dans la noticeStructure de recherche
Inserm, Sorbonne Université et Pitié-Salpêtrière Hospital, avec 9 autres affiliations. Pays d’affiliation : Côte d’Ivoire, Sénégal, Tunisie.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.