Community pharmacies are valued for their potential role in the management of common ailments. This cross-sectional study aimed to document the management of diarrhoea by community pharmacies in 3 cities in Pakistan. Visits were performed to 371 randomly selected pharmacies to request advice for a simulated paediatric case of diarrhoea. The pharmacy's management was scored on a checklist including history taking and provision of advice and information. Customers were served by a salesperson in 97.3% of visits and by a pharmacist in only 2.2%. Medication was dispensed in 77.1% of visits. Of the medications dispensed, 58.7% were antiamoebics, 14.0% antibiotics and 18.9% antidiarrhoeals; only 8.4% were oral rehydration salts. None of the regimens matched with a standard prescription. The dosage regimen was explained to the customer in only 52.6% of cases. Drug safety, unqualified personnel, lack of history taking, inappropriate treatment and lack of counselling are concerns to be addressed. Sciences, University Sains Malaysia, Penang, Malaysia and Hamdard Institute of Pharmaceutical Sciences, Hamdard University, Islamabad, Pakistan (Correspondence to A. Hussain: azharhussain10971@gmail.com 1 School of Pharmaceutical Prise en charge des cas de diarrhée en pharmacies communautaires dans trois villes du PakistanRÉSUMÉ Les pharmacies communautaires sont précieuses pour leur rôle potentiel dans la prise en charge des affections courantes. La présente étude transversale visait à documenter la prise en charge des cas de diarrhée en pharmacies communautaires dans trois villes du Pakistan. Des visites ont été faites dans 371 pharmacies sélectionnées aléatoirement afin de solliciter des conseils sur un cas simulé de diarrhée chez un enfant. Une liste de vérification incluant l'interrogation sur les antécédents, et les conseils et les informations donnés a été utilisée pour évaluer la prise en charge au sein de l'officine. Les clients ont été servis par un vendeur dans 97,3 % des cas et par un pharmacien dans 2,2 % des cas. Par ailleurs, 77,1 % des visites se sont conclues par la délivrance de médicaments. Parmi ceux-ci, 58,7 % étaient des antiamibiens, 14,0 % des antibiotiques et 18,9 % des antidiarrhéiques ; seuls 8,4 % étaient des sels de réhydratation par voie orale. Aucun des schémas thérapeutiques proposés ne correspondait à une prescription normalisée. La posologie a été expliquée au client dans 52,6 % des cas uniquement. La non-garantie de l'innocuité des médicaments, le personnel non qualifié, l'absence d'interrogation sur les antécédents, un traitement inapproprié et l'absence de conseils sont des lacunes auxquelles il faut s'attaquer.

Malaysia is reliant on the availability of generic medicines to contain the rising national pharmaceutical expenditure. This paper assesses the factors determining the market entry of a new generic medicine following patent expiration on the innovator product in Malaysia. Data were gathered by using mail survey approach. The prevalidated Likert-scale questionnaire was mailed to all licensed members of the Malaysian Organization of Pharmaceutical Industries. A usable response rate of 53.8% (14/26) was achieved following four successive mailings. The overall internal reliability coefficients for the 5-item entry decision variables scale and 11-item entry barrier variables scale were 0.62 and 0.82 respectively. The results revealed that the major factors driving decisions to develop and introduce a new generic medicine into the Malaysian pharmaceutical market are consistent with the business model of the generic pharmaceutical industry. The pre-patent expiration market value of the innovator product was found to be a significant factor influencing entry decisions for domestic market-oriented generic firms as compared with export-oriented firms (Z ¼ À2.36, p ¼ 0.01). Foremost among the barriers to new generic medicines development and market introduction in Malaysia were patent clustering by innovator firms and the earlier market entry of imported generic medicines. There is a need for strict adherence to the patentability criteria in the examination and grant of pharmaceutical patents in Malaysia, and coherence in policies related to local generic drug development and production is recommended in order to meet the policy objectives of drug affordability and containment of pharmaceutical cost.

Purpose: To explore the perceptions' of dispensers regarding dispensing practices and the salient factors affecting dispensing practices in three major cities of Pakistan -Islamabad, Peshawar and Lahore. Methods: A qualitative study with snowball sampling technique was used to identify fifteen dispensers working in community pharmacies in Islamabad, Peshawar and Lahore. Semi-structured interviews were conducted with the dispensers until the point of saturation was obtained. The interviews which focused on three major components, namely dispensing practices, regulation and influencing factors, and suggestions for improvements were audio-taped, transcribed verbatim and analyzed. Results: Thematic content analysis of the interview components yielded further seven major themes which were services provided at community pharmacies, quality of service provided by community pharmacies, expectation from community pharmacies, who was responsible for dispensing, obstacles to appropriate dispensing practices, laws and factors governing pharmacy practice in Pakistan, and strategies to improve current dispensing practices. Conclusion: All respondents in the different cities agreed that there was a shortage of pharmacists leading to their roles being taken over by the non-professionally qualified personnel working in community pharmacies. They also agreed that implementation of laws governing pharmacy practice in Pakistan is weak. These two main factors were considered to be responsible for the low quality services provided at community pharmacies.