Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors
Objectives To assess the quality of amoxicillin products in Indonesia’s private market by surveying the range of products available across different areas, followed by product sampling and laboratory testing.Design A cross-sectional survey employing mystery shoppers to purposively sample the widest...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/7/e093785.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849303614251597824 |
|---|---|
| author | Amalia Hasnida Maarten Olivier Kok Ayu Rahmawati Yusi Anggriani Mawadatti Rahmi Frank C M van Leth |
| author_facet | Amalia Hasnida Maarten Olivier Kok Ayu Rahmawati Yusi Anggriani Mawadatti Rahmi Frank C M van Leth |
| author_sort | Amalia Hasnida |
| collection | DOAJ |
| description | Objectives To assess the quality of amoxicillin products in Indonesia’s private market by surveying the range of products available across different areas, followed by product sampling and laboratory testing.Design A cross-sectional survey employing mystery shoppers to purposively sample the widest possible range of amoxicillin products available to patients across different areas in Indonesia.Setting Licensed and unlicensed medicine outlets in remote, rural and urban areas and online.Participants Amoxicillin products that are sold to patients as oral solid and dry liquid formulations.Main outcome measures Quality of amoxicillin products, assessed using compendial testing of active pharmaceutical ingredient content and dissolution. Samples that failed any quality test were classified as substandard or out-of-specification (OOS). The raw prevalence of substandard amoxicillin was adjusted based on the national market volume of each product variant.Results We surveyed 476 outlets, mostly pharmacies (68.5%), websites (19.7%) and drug stores (10.9%). Among the 120 collected samples, there were 59 distinct products, collectively representing 95% of the estimated market volume for oral solid products and 65% for dry syrups. 12 out of 110 oral solid samples tested OOS (10.9%), as did 3 out of 10 dry syrups (30%). The samples that failed originated from various areas and types of outlets. We found no relation between the price and quality of amoxicillin.Conclusions The oral solid amoxicillin products that tested OOS represent an estimated 12.7% of the national market volume. We found no relation between the price and quality of amoxicillin. Combining product-variety sampling with data on market volume presents a promising approach to gain insight into the prevalence of poor-quality medical products using a relatively small sample size. |
| format | Article |
| id | doaj-art-c19beffba538449eb94c4002c866f495 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c19beffba538449eb94c4002c866f4952025-08-20T03:56:00ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-093785Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factorsAmalia Hasnida0Maarten Olivier Kok1Ayu Rahmawati2Yusi Anggriani3Mawadatti Rahmi4Frank C M van Leth5Health Care Governance, Erasmus University Rotterdam, Rotterdam, The NetherlandsHealth Care Governance, Erasmus University Rotterdam, Rotterdam, The NetherlandsCenter for Pharmaceutical Policy, Management, and Services Studies, Faculty of Pharmacy, Universitas Pancasila, Jakarta, IndonesiaCenter for Pharmaceutical Policy, Management, and Services Studies, Faculty of Pharmacy, Universitas Pancasila, Jakarta, IndonesiaCenter for Pharmaceutical Policy, Management, and Services Studies, Faculty of Pharmacy, Universitas Pancasila, Jakarta, IndonesiaHealth Sciences, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsObjectives To assess the quality of amoxicillin products in Indonesia’s private market by surveying the range of products available across different areas, followed by product sampling and laboratory testing.Design A cross-sectional survey employing mystery shoppers to purposively sample the widest possible range of amoxicillin products available to patients across different areas in Indonesia.Setting Licensed and unlicensed medicine outlets in remote, rural and urban areas and online.Participants Amoxicillin products that are sold to patients as oral solid and dry liquid formulations.Main outcome measures Quality of amoxicillin products, assessed using compendial testing of active pharmaceutical ingredient content and dissolution. Samples that failed any quality test were classified as substandard or out-of-specification (OOS). The raw prevalence of substandard amoxicillin was adjusted based on the national market volume of each product variant.Results We surveyed 476 outlets, mostly pharmacies (68.5%), websites (19.7%) and drug stores (10.9%). Among the 120 collected samples, there were 59 distinct products, collectively representing 95% of the estimated market volume for oral solid products and 65% for dry syrups. 12 out of 110 oral solid samples tested OOS (10.9%), as did 3 out of 10 dry syrups (30%). The samples that failed originated from various areas and types of outlets. We found no relation between the price and quality of amoxicillin.Conclusions The oral solid amoxicillin products that tested OOS represent an estimated 12.7% of the national market volume. We found no relation between the price and quality of amoxicillin. Combining product-variety sampling with data on market volume presents a promising approach to gain insight into the prevalence of poor-quality medical products using a relatively small sample size.https://bmjopen.bmj.com/content/15/7/e093785.full |
| spellingShingle | Amalia Hasnida Maarten Olivier Kok Ayu Rahmawati Yusi Anggriani Mawadatti Rahmi Frank C M van Leth Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors BMJ Open |
| title | Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors |
| title_full | Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors |
| title_fullStr | Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors |
| title_full_unstemmed | Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors |
| title_short | Assessing the quality of amoxicillin in the private market in Indonesia: a cross-sectional survey exploring product variety, market volume and price factors |
| title_sort | assessing the quality of amoxicillin in the private market in indonesia a cross sectional survey exploring product variety market volume and price factors |
| url | https://bmjopen.bmj.com/content/15/7/e093785.full |
| work_keys_str_mv | AT amaliahasnida assessingthequalityofamoxicillinintheprivatemarketinindonesiaacrosssectionalsurveyexploringproductvarietymarketvolumeandpricefactors AT maartenolivierkok assessingthequalityofamoxicillinintheprivatemarketinindonesiaacrosssectionalsurveyexploringproductvarietymarketvolumeandpricefactors AT ayurahmawati assessingthequalityofamoxicillinintheprivatemarketinindonesiaacrosssectionalsurveyexploringproductvarietymarketvolumeandpricefactors AT yusianggriani assessingthequalityofamoxicillinintheprivatemarketinindonesiaacrosssectionalsurveyexploringproductvarietymarketvolumeandpricefactors AT mawadattirahmi assessingthequalityofamoxicillinintheprivatemarketinindonesiaacrosssectionalsurveyexploringproductvarietymarketvolumeandpricefactors AT frankcmvanleth assessingthequalityofamoxicillinintheprivatemarketinindonesiaacrosssectionalsurveyexploringproductvarietymarketvolumeandpricefactors |