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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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Published: 22 April 2022

An Evaluation of the Reflective Constructs Influencing Community Pharmacists’ Decision-to-Procure from Pharmaceutical Suppliers: A Structural Equation Modeling Study

Theophilus Ehidiamen Oamen, Oamen Sophia Omorenuwa, Joshua Idiake, Emmanuel Olalekan Oladoja

Obafemi Awolowo University (Nigeria), University of Ibadan (Nigeria), University of Benin (Nigeria), Federal University of Technology (Nigeria)

journal of social and political sciences
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doi

10.31014/aior.1994.05.02.211

Pages: 49-61

Keywords: Community Pharmacy, Cost Management, Low and Middle-Income Countries, Medicines, Pharmacoeconomics, Pharmaceutical Marketing, Procurement, Structural Equation Modelling

Abstract

In low-and middle-income countries, patients’ access to affordable medicines is a perennial challenge at all levels of healthcare delivery. Community pharmacists are expected to bridge the supply and demand gap. Unlike the plethora of studies done at the hospital and government institutions level, there is a paucity of empirical evidence on the factors influencing medicine procurement decisions from supply channels at the community pharmacy level. The study aimed to investigate the influence of community pharmacists’ professional and entrepreneurial considerations on their decision-to-procure from medicine suppliers. A cross-sectional survey which adopted a self-administered questionnaire approach to obtain primary data from randomly sampled respondents (N=398) from three purposively selected states in southwestern, Nigeria. Structural equation modeling (SEM) methodology was used to test the hypothesized model at p<0.05. The study revealed acceptable model fit and validity measures for measurement and structural models. Cost and profitability factors were significant predictors of decision-to-procure compared to service and product quality factors among respondents [β=0.343, p=0.001 vs. β=0.044, p=0.606]. Product selection had a positive moderating effect on cost and profitability factors [t=1.980, p=0.048] and a negative directional effect on service and product quality factors in the hypothesized model [t=-2.960, p=0.003]. Community pharmacists should balance financial considerations with a professional focus to ensure patients’ access to quality and affordable medicines. Study outcomes suggest the development and implementation of universally acceptable guidelines on medicine procurement in community pharmacy settings in low-and middle-income countries. The study validated the SEM model for evaluating priorities influencing community pharmacists’ buying decisions. To the best of the authors’ knowledge, this is the first study to use the SEM framework to explore factors informing drug procurement decisions from the community pharmacists’ perspective in low-and middle-income countries.

References

  1. Adebiyi, O. Adeniji, F. O. (2021). Factors affecting utilization of the national health insurance scheme by federal civil servants in rivers state, Nigeria. The Journal of Health Care Organization, Provision, and Financing. Vol. 58, pp. 1-8

  2. Adesokun, O. O. Osemene, K. P. Ilori, M. O. Ihekoronye, R. M. (2020). Evaluation of Enrollees’ Perspectives on the Operations of the National Health Insurance Scheme in Nigeria. Journal of Health and Medical Sciences. Vol. 3, No. 4, pp. 411-422. https://doi.org/10.31014/aior.1994.03.04.135

  3. Adeniji, F. (2017). National Health Insurance scheme in Nigeria: progress towards universal coverage. Asian Journal of Medical Health. Vol. 2, No 4, pp. 1-2

  4. Bader, L. R. McGrath, S. Rouse, M. J, and Anderson, C. (2017). A conceptual framework towards identifying and analyzing challenges to the advancement of pharmacy. Research in Social and Administrative Pharmacy. Vol. 13, No. 2, pp. 321-331. https://doi.org/10.1016/j.sapharm.2016.03.01

  5. Brett, A. S. Burr, W. and Moloo, J. (2003). Are gifts from pharmaceutical companies ethically problematic? A survey of physicians. Archives of Internal Medicine. Vol.163, pp. 2213-2218.

  6. Cavicchi, C. and Vagnoni, E. (2020). Sustainable Business Models in Hybrids: A conceptual Framework for Community Pharmacies’ Business Owners. Sustainability. Vol. 12, No. 19, pp. 8125. https://doi.org/10.3390/su12198125

  7. Chappell, N. L. and Barnes, G. E. (1984). Professional and business role orientations among practicing pharmacists. Social Science Medicine. Vol.18, No 2, pp.103-110. https://doi.org/10.1016/0277-9536 (84)90030-3.

  8. Chin, W. W. Thatcher, J. B. and Wright, R. T. (2012) Assessing common method bias: Problems with the ULMC technique. MIS Quarterly. Vol. 36, pp.1003–1019.

  9. Dedrick, S. C. Eckel, F. M. (1984). Assessment of vendors and drug-product selection. American Journal of Hospital Pharmacists.Vol. 41, No. 4, pp.703-708

  10. Desai, R. J. Sarpatwari, A. Dejene, S. Khan, N. F. Rogers, J. R. et al (2019). Comparative effectiveness of generic and brand-name medication use: A database study of US health insurance claims. PLoS Med. Vol. 16, No. 3:e1002763. https://doi.org/10.1371/journal.pmed.1002763

  11. Dubois, P. Lefouili, Y. and Straub, S. (2019). ''Pooled procurement of drugs in low and middle-income countries’’ CGD Working Paper508. Washington, DC: Center for Global Development. https://www.cgdev.org/publication/pooled-procurement-drugs-low-and-middle-income-countries

  12. Edmunds, J. Calnan M. W. (2001). The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practitioners in the United Kingdom. Social Science & Medicine. Vol. 53, No. 7, pp. 943-955.

  13. Ekmann, B. (2007). Catastrophic health payments and health insurance: some counterintuitive evidence from one low-income country. Health Policy. Vol. 83, pp. 304-313

  14. Elizabeth Seeley and Surya Singh. The role of Pharmacies in making drug purchasing more efficient and in promoting access to preventive care (Commonwealth Fund, August 2021). https://doi.org/10.26099/g749-h298

  15. Giralt, N. A. Bourasseau, A. White, G. Pouget, C. et al (2020). Quality assurance systems of pharmaceutical distributors in low-income and middle-income countries: weaknesses and ways forward. BMJ Global Health. Vol. 5, pp. 1-9. https://doi.org/10.1136/bmjgh-2020-003147

  16. Hair, J. F. Hult, G. T. Ringle, C. M. and Sarstedt, M. (2014). A Primer in Partial Least Squares Structural Equation Modeling (PLS-SEM). Thousand Oaks; SAGE.

  17. Hall, K. B. Tett, S. E. and Nissen, L. M. (2008). Perceptions of the influence of prescription medicine samples on prescribing by family physicians. Medical Care, Vol. 44, pp. 383-387.

  18. Hassali, M. A. Shafie, A. A. Haddad, M. et al (2010). A qualitative study exploring the impact of the pharmaceutical price war among community pharmacists in the state of Penang, Malaysia. Journal of Clinical and Diagnostic Research. Vol. 4, No. 5, pp. 3161-3169.

  19. Henseler, J. Ringle, C. M. and Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing. Vol. 43, No. pp.115-135.

  20. Hepler, C. D. and Strand. L. M. (1990). Opportunities and responsibilities in pharmaceutical care. American Journal of Hospital Pharmacy. Vol. 47, No. 3, pp.:533-543. https://doi.org/10.1093/ajhp/47.3.533

  21. Hu, L. and Bentler, P. M. (1998). Fit Indices in Covariance structure modeling: Sensitivity to under parameterized model misspecification. Psychological Methods. Vol. 3. No. 4, pp.424-453

  22. Hu, L. and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal. Vol. 6, pp.1-55

  23. Iffat, W. Shakeel, S. Imam, S. Quda, T. (2015). Perceived barriers and expectations of the general public for establishing community pharmacy in Pakistan. World Journal of Pharmacy and Pharmaceutical sciences. Vol. 4. No. 10, pp. 2258-2265

  24. Ihekoronye, M. R. Osemene, K. P. Erhun, W. O. Afolabi, M. O. (2021). Customers' Perspectives of Service quality in community pharmacies in Nigeria: a cross-sectional survey. Journal of Health and Medical Sciences. Vol. 4, No. 1, pp. 8-17. https://doi.org/10.31014/aior.1994.04.01.150

  25. Khan, N. Naqvi, A. A. Ahmad, R. Ahmed, F. R. McGarry, K. Fazlani, R. Y. and Ahsan, M. (2016). Perceptions and Attitudes of Medical Sales Representatives (MSRs) and Prescribers regarding pharmaceutical sales promotion and prescribing practices in Pakistan. Journal of Young Pharmacists. Vol. 8 No 3, pp.244-250. https://doi.org/10.5530/jyp.2016.3.13

  26. Kho, B. P. Hassali, M. A. Lim, C. J. and Saleem, F. (2017). Challenges in the management of community pharmacies in Malaysia. Pharmacy Practice. Vol, 15, No 2, pp.933. https://doi.org/10.18549/PharmPract.2017.02.933

  27. Lee, K. S. Kassab, Y. W. Taha, N. S. and Zainal, Z. A. (2021). Factors impacting Pharmaceutical Prices and Affordability: Narrative Review. Pharmacy, Vol. 9, No. 1. https://doi.org/10.3390/pharmacy9010001

  28. Lexchin, J. (1993). Interactions between physicians and the pharmaceutical industry: what does the literature say? Canadian Medical Association Journal, Vol.149, pp.1401-1407

  29. Lima-Dellamora, E. C. Caetano, R. Gustafsson, L. L. Godman, B. B. et al (2014). An analytical framework for assessing drug and therapeutics committee structure and work processes in tertiary Brazilian Hospitals. Basic & Clinical Pharmacology and Toxicology. Vol. 115, No.3, pp. 268-276

  30. Mathews, A. Ming, L. C. Che, Rose, F. Z. and Abbas, S. A. (2020) Cross-sectional study on the impact of Discount Pricing and Price Competition on Community Pharmacy Practice. Cureus. Vol. 12, No 8, e9903. https://doi.org/10.7759/cureus.9903

  31. Muhia, J. Waithera, L., and Songole, R. (2017). Factors affecting the procurement of pharmaceutical drugs: a case study of Narok county referral hospital, Kenya. Medical & Clinical Reviews. Vol. 3, No. 4, pp. 20.

  32. Mukherjee, A. (2012). ‘’Advances in pharmaceutical marketing: theoretical and empirical foundations’’. International Journal of Pharmaceutical and Healthcare Marketing. Vol. 6, No. 4. https://doi.org/10.1108/ijphm.2012.32406daa.001

  33. Mukherjee, A. (2015). ‘’Role of communications in healthcare marketing’’. International Journal of Pharmaceutical and Healthcare Marketing. Vol. 9, No. 4. https://doi.org/10.1108/IJPHM-09-2015-0046

  34. Nguyen, T. A. Knight, R. Roughead, E. E. Brooks, G. and Mant, A. (2015). Policy options for pharmaceutical pricing and purchasing: issues for low- and middle-income countries. Health Policy and Planning. Vol. 30, pp. 267-280

  35. NHIS (2012). National Health Insurance Scheme. Operational Guidelines. Available at http;//www.nhis.gov.ng/home/ (Accessed 2021)

  36. Njoki, G. N. and Kimiti, G. (2018). Influence of competitive procurement practices on service delivery in public hospitals in Nakuru Kenya. International Journal of Economics, Commerce, and Management. Vol.6. No. 4, pp. 73-89

  37. Oamen, T. E. (2021). Analysis of factors influencing pharmaceutical sales workforce engagement in pharmaceutical marketing in Nigeria: a structural equation modeling approach. Global Journal of pure and applied sciences. Vol. 27, pp. 405-410. https://dx.doi.org/10.4314/gjpas.v27i4.7

  38. Oamen, T. E. and Omorenuwa, S. O. (2021). Path analysis of determinant factors influencing purchasing decisions among community pharmacists in Nigeria using structural equation modeling. Advances in Medical, Dental, and Health Sciences. Vol. 4. No 2, pp.21-25. https://doi.org/10.5530/amhdhs.2021.2.5

  39. Oamen, T. E. and Osemene, K. P. (2021). Drug utilization evaluation of medications used by hypertensive patients in hospitals in Nigeria. Hospital Topics pp. 44-53. https://doi.org/10.1080/00185868.2021.1916416

  40. Oamen, T. E. Osemene, K. P. and Ihekoronye, R. M. (2021). Assessing the application of pharmacoeconomic evaluations in medicines management by hospital pharmacists in Nigeria: a cross-sectional survey. Hospital Topics. 1-10. https://doi.org/10.1080/00185868.2021.20014090

  41. Ozawa, S. Higgins, C. R. Yemeke, T. T. Nwokike J. I. Evans, L. Hajjou M., et al (2020). Importance of medicine quality in achieving universal health coverage. PLoS ONE. Vol 15, No. 7: e0232966. https://doi.org/10.1371/journal.pone.0232966.

  42. Pharmacists Council of Nigeria. (2020). List of registered community pharmacies in Nigeria. Available at http://www.pcn.gov.ng (Accessed January 2021)

  43. Perumal-Pillay, V. A. and Suleman, F. (2020). Understanding the decision-making process of selection of medicines in the private sector in South Africa- lessons for low-middle income countries. Journal of Pharmaceutical Policy and Practice. Vol. 13, No. 17. https://doi.org/10.1186/s40545-020-00223-5

  44. Suh, G-H. (2011). High medicine prices and poor affordability. Current Opinion in Psychiatry. Vol. 24, No. 4, pp. 341-345. https://doi.org/10.1097/YCO.0b013e3283477b68

  45. Taber, K. S. (2018). The use of Cronbach’s Alpha when developing and reporting research instruments in science education. Research in Science Education. Vol. 48, pp.1273-1296. https://doi.org/10.1007/s11165-016-9602-2

  46. The Jamovi Project (2021). Jamovi. (Version 2.2) [Computer software]. Retrieved from https://www.jamovi.org.

  47. Vogler, S. Zimmermann, N. Habl, C. and Mazag, J. (2013). The role of discounts and loss leaders in medicine procurement in Austrian hospitals- a primary survey of official and actual medicine prices. Cost-Effectiveness and Resource Allocation. Vol. 11, No. 15.

  48. World Health Organization (2002) Practical Guidelines on Procurement for Countries with Small Procurement Agencies. World Health Organization Regional Office for the Western Pacific Manila, Philippines. pp. 5-6. (Accessed May 2021)

  49. World Health Organization (2018) WHO Quality Assurance Policy for the Procurement of Essential Medicines and other Health Products. Corporate procurement policy and coordination programs. (Accessed May 2021)

  50. World Health Organization. (1999), Operational principles for good pharmaceutical procurement. Essential Drugs and Medicines Policy Interagency Pharmaceutical Coordination Group. Geneva. (Accessed May 2021)

  51. You, H. W. Tajuddin, N. S. A. and Anwar, Y. A. S. (2019). Measuring availability, prices, and affordability of Ischaemic Heart Disease Medicines in Bangi, Selangor, Malaysia. Malaysian Journal of Medical Science. Vol. 26, No.5, pp. 113-121. https://doi.org/10.21315/mjms2019.26.5.10

  52. Zaki, N. M. (2014). Pharmacists’ and physicians’ perception and exposure to drug promotion: a Saudi study. Saudi Pharmaceutical Journal. Vol. 22, pp. 528-536. https://doi.org/10.1016/j.jsps.2014.02.008

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