Pharmacists seek Tinubu’s intervention over improper drug prescription, dispensing
The Association of Community Pharmacists of Nigeria has urged President Bola Tinubu to take urgent action to address the regulation of drug prescription and dispensing.
In a letter to the Presidency on Sunday, the ACPN warned that without government intervention, the safety of Nigerian health consumers is at risk due to poor prescription quality and dispensing rights, amid rising drug costs.
According to the letter titled “Current Situation of Prescription Practices In Nigeria,” ACPN identified lapses in dispensing and prescribing of drugs, noting that it is a major drawback in Nigeria’s version of social Health Insurance dubbed the National Health Insurance Scheme.
The letter was jointly signed by the ACPN National Chairman, Adewale Oladigbolu, and the National Secretary, Ashore Omokhafe.
Both ACPN officials regretted that the anomalies in payment mechanisms to providers and challenges in the separation of professional roles had not been addressed by the NHIS, which is now restructured as the National Health Insurance Authority.
The letter reads, “In Nigeria today, there are only about six thousand (6,000) registered pharmacy facilities in the various cadres of practice, including retailers, wholesale, importation and manufacturing. Of this number, less than four thousand (4,000) are retailers who provide services directly to the consuming public.
“While there are less than four thousand (4,000) registered retail pharmacies; there exist over a million different drug sellers who are unregistered. It is this plethora of illegal drug sellers who are largely unregulated who perpetrate most of the obnoxious and dirty practices in drug distribution in Nigeria,” it added.
The ACPN, in the letter, alleged that doctors in the country are illegally dispensing drugs in both the public and private sectors in the country. It argued that doctors are not trained to dispense drugs, and therefore, they are part of the problems of drug abuse and misuse as well as the inherent complications of this unwholesome development.
It further accused doctors of purchasing drugs they use in practice in open markets and the scores of unregistered wholesalers, presumably because the drugs are cheaper, through their hospital facilities. “In this way, they sustain some of the illegalities associated with drug distribution in Nigeria.”
It insisted that stocking and dispensing drugs in unlawful facilities is contrary to the provisions of Cap PCN 2022 and the Fake Drug Act, which prohibits the sales and dispensing of drugs in unregistered pharmacy facilities. However, it alleged that the usually widely publicised activities of State regulatory authorities for the private hospitals have never indicted any of these hospitals for violating relevant drug laws.
The statement further reads, “Every Health System hinges its drug flow patterns on the use of well-trained professionals who anchor prescribing and dispensing endeavours. In Nigeria, because drug matters are on the exclusive list, prescribing and dispensing of medicines can only be regulated by Federal authorities. The Poison and Pharmacy Act (PPA) and the National Drug Policy are regulatory tools of the National Assembly and the Federal Ministry of Health, respectively, to modulate prescribing and dispensing today in Nigeria.
“There were existing recommendations that all medicines in the Nigerian drug Market be classified before the year 2008 by NAFDAC (National Agency for Food and Drug Administration and Control).
“The classes that were recommended under the coordination of the National Agency for Food and Drug Administration and Control (NAFDAC) by representatives of the relevant care providers include Prescription Only Medicines (POM), Pharmacist Initiated Medicines (PIM), and Over-the-Counter Medicines (OTC ).”
ACPN condemned what it described as the phenomenon of dispensing Doctors and prescribing Pharmacists as perhaps a peculiar feature of the Health Sector in Nigeria.”
It noted that ACPN’s position aligns with that of the Pharmaceutical Society of Nigeria (PSN) stressing that poor drug regulation constitutes a hindrance towards responsible healthcare delivery.
ACPN’s letter identified specific local issues promoting hazardous prescribing practices in the country, which include Physician-Patient Ratio, Inadequate Healthcare Facilities, poverty, and illiteracy.
It noted that the pharmacy laws and regulations, the World Health Organisation (WHO), and the National Drug Policy are clear about dispensing and prescribing drugs.
Given the lamentable high cost of drugs, which is rapidly becoming a global phenomenon, ACPN said, “The Federal Government must compel legitimate prescribers, including Medical Doctors, Dentists, and Veterinary Surgeons, to embrace generic drug prescribing in alignment with existing norms and guidelines in all health systems.
“The Federal Government must resuscitate the National Prescription and Dispensing Committee, made up of eminent Pharmacists and Physicians under the Chairmanship of the Permanent Secretary of the FMOH as constituted in 2013 based on a clarion call of the PSN. That Committee assignment was abandoned due to the pecuniary interests of some professionals who were not ready to let go of their unlawful practices.
“Prescribers must be made to generate prescriptions with their stamps and seals, while dispensers of drugs will affix their stamps and seals on all prescriptions duly dispensed.
“The Federal Government must authorise a comprehensive survey of dispensing and prescription practices to identify gaps.
“The NAFDAC must clearly delineate OTCs, POMs, and Pharmacist Initiated Medicines (PIMs) in line with its statutory powers.
“The International Pharmaceutical Federation (IFP) guidelines on Good Pharmacy Practice (GPP) should become the minimum standard for dispensing medication to Nigerians.”
It insisted, “Our health system must place a premium on prescription quality and appropriate dispensing rights before we can vouch for the safety of consumers of health in Nigeria.”
The ACPN assures the Presidency of its competence to drive these principles in collaboration with the Federal Government and other relevant stakeholders.
