Keywords
Stockpiling on Medications
Off-Labelled Medications
Community Pharmacists
Belize
Categories
How to Cite
Abstract
Introduction: Needless stockpiling of approved medications for the treatment of other diseases cause undue shortages of approved drugs. This study was conducted to assess stockpiling on off-label pharmaceutical products in anticipation of COVID-19 in the country of Belize. The results of the study provide evidence on needless and wasteful stockpiling of medications, with the aim to discourage artificial shortages while reducing the risks of inappropriate medication use.
Methods: The study utilized a qualitative phenomenological approach. Interviews using semi-structured questions were conducted with 15 community pharmacists in the country of Belize. The emerged themes and sub-themes were extracted and exported to Excel 2010® for integration, narration, and presented as summary findings.
Results: Data analysis yielded three salient and inter-related themes: stockpiled products, motives for stockpiling, and pharmacist response.
Conclusion: Panic stockpiling on pharmaceutical products in anticipation of COVID-19 was reported in this study. The World Health Organization advised against the needless stockpiling of approved medications for the treatment of other diseases, thereby causing undue shortages of approved drugs. Observing personal hygiene and social distancing is encouraged as a measure to curb the spread of COVID-19.
References
World Health Organization. Rolling updates on coronavirus disease (Covid-19). 2019. [Accessed 2021 Oct 04]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
WHO. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. [Accessed 2021 Oct 04]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151. https://doi.org/10.3760/cma.j.issn.0254-6450.2020.02.003
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-cantered, retrospective, observational study. Lancet Respir Med. 2020 May; 8(5):475-481. https://doi.org/10.1016/s2213-2600(20)30079-5
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15; 395(10223):497-506. https://doi.org/10.1016/s0140-6736(20)30183-5
Lamontagne F, Angus DC. Toward Universal Deployable Guidelines for the Care of Patients with COVID-19. JAMA. 2020 May 12; 323(18):1786-1787. https://doi.org/10.1001/jama.2020.5110
Belize Ministry of Health. [Accessed 2021 Oct 04]. Available from: http://health.gov.bz/www/component/content/article/177-general-health/1026-american-national-tests-positive-for-covid-19-after-departing-belize
Belize Ministry of Health. [Accessed 2021 Oct 04]. Available from: https://www.health.gov.bz/
Husaini DC, Abubakar YI. COVID-19-: Belize’s Success Story in Containing Community Spread Has Suffered a Setback! Asia Pac J Public Health. 2020 Nov; 32(8):536-538. https://doi.org/10.1177/1010539520962604
Busari S, Adebayo B. Nigeria records chloroquine poisoning after Trump endorses it for coronavirus treatment. CNN. 2020. [Accessed 2021 Oct 05]. Available from: https://edition.cnn.com/2020/03/23/africa/chloroquine-trump-nigeria-intl/index.html
CEBM. Chloroquine and hydroxychloroquine: Current evidence for their effectiveness in treating COVID-19. 2020. [Accessed 2021 Oct 04]. Available from: https://www.cebm.net/covid-19/chloroquine-and-hydroxychloroquine-current-evidence-for-their-effectiveness-in-treating-covid-19/
Lindo B. Belize and the COVID-19 in March 2020. Amandala. [Accessed 2021 Oct 04]. Available from: https://amandala.com.bz/news/belize-and-the-covid-19-in-march-2020/
Wittich CM, Burkle CM, Lanier WL. Ten common questions (and their answers) about off-label drug use. Mayo Clin Proc. 2012 Oct; 87(10):982-90. https://doi.org/10.1016/j.mayocp.2012.04.017
Roehr B. Abbott pays $1.6bn for promoting off label use of valproic acid. BMJ. 2012 May 11; 344:e3343. https://doi.org/10.1136/bmj.e3343
Thomas K, Schmidt MS. Glaxo agrees to pay $3 billion in fraud settlement. New York Times. 2012. [Accessed 2021 Oct 04]. Available from: https://www.nytimes.com/2012/07/03/business/glaxosmithkline-agrees-to-pay-3-billion-in-fraud-settlement.html
Ratner M. Pfizer settles largest ever fraud suit for off-label promotion. Nat Biotechnol. 2009 Nov; 27(11):961-2. https://doi.org/10.1038/nbt1109-961
Creswell, J. W. (2014). Research Design: Qualitative, Quantitative and Mixed Methods Approaches (4th ed). Thousand Oaks, CA: Sage. [Accessed 2021 Oct 04]. Available from: http://www.drbrambedkarcollege.ac.in/sites/default/files/Research-Design_Qualitative-Quantitative-and-Mixed-Methods-Approaches.pdf
Mail Online. Pharmacists plead with the public to STOP stockpiling medication after seeing a four-fold spike in prescription orders amid coronavirus panic. [Accessed 2021 Oct 04]. Available from: https://www.dailymail.co.uk/news/article-8142979/Pharmacists-plead-public-STOP-stockpiling-medication-amid-coronavirus-panic.html
Irish Health Pro. Available from: http://www.irishhealth.com/article.html?id=27048.
Kalil AC. Treating COVID-19—Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics. JAMA. 2020 May 19; 323(19):1897-1898. https://doi.org/10.1001/jama.2020.4742
Mahase E. Covid-19: what treatments are being investigated? BMJ. 2020 Mar 26;368:m1252. https://doi.org/10.1136/bmj.m1252
Pauling LC. Vitamin C and the Common Cold. San Francisco: W.H. Freeman; 1970.
Jariwalla RJ, Harakeh S. Antiviral and immunomodulatory activities of ascorbic acid. Subcell Biochem.1996; 25:213-31.
Kennes B, Dumont I, Brohee D, Hubert C, Neve P. Effect of vitamin C supplements on cell-mediated immunity in old people. Gerontology. 1983; 29(5):305-10. https://doi.org/10.1159/000213131
Frei B, Birlouez-Aragon I, Lykkesfeldt J. Authors' perspective: What is the optimum intake of vitamin C in humans? Crit Rev Food Sci Nutr. 2012; 52(9):815-829. https://doi.org/10.1080/10408398.2011.649149
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999 Jun; 69(6):1086 1107. https://doi.org/10.1093/ajcn/69.6.1086
Milan SJ, Hart A, Wilkinson M. Vitamin C for asthma and exercise-induced bronchoconstriction. Cochrane Database Syst Rev. 2013 Oct 23; 2013(10):CD010391. https://doi.org/10.1002/14651858.cd010391.pub2
Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31; 2013(1):CD000980. https://doi.org/10.1002/14651858.cd000980.pub4
Offit P. The Vitamin Myth: Why We Think We Need Supplements. The Atlantic. [Accessed 2021 Oct 04]. Available from: https://www.theatlantic.com/health/archive/2013/07/the-vitamin-myth-why-we-think-we-need-supplements/277947/
Lichtenstein K. Can Vitamin C Prevent and Treat Coronavirus? Medicine net. 2020. [Accessed 2021 Oct 05]. Available from: https://www.medicinenet.com/script/main/art.asp?articlekey=228745
Salzberg S. No, Megadoses Of Vitamin C Will Not Cure Coronavirus. Forbes. 2020. [Accessed 2020 Oct 04]. Available from: https://www.forbes.com/sites/stevensalzberg/2020/03/29/no-megadoses-of-vitamin-c-will-not-cure-coronavirus/?sh=16c7ea01a4ab#5e85e9ae1a4a.
Erdman JWJ, Macdonald IA, Zeisel SH. Present Knowledge in Nutrition. 10th ed. Wiley-Blackwell; 2012:248-260.
LPI. Vitamin C. [Accessed 2020 Oct 04]. Available from: https://lpi.oregonstate.edu/mic/vitamins/vitamin-C#reference21.
González Plaza JJ, Hulak N, Zhumadilov Z, Akilzhanova A. Fever as an important resource for infectious diseases research. Intractable Rare Dis Res. 2016 May; 5(2), 97–102. https://doi.org/10.5582/irdr.2016.01009
Michael D. Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists. BMJ. 2020 Mar 17; 368:m1086. https://doi.org/10.1136/bmj.m1086
Matthys H, Bleicher B, Bleicher U. Dextromethorphan and codeine: objective assessment of antitussive activity in patients with chronic cough. J Int Med Res. 1983; 11(2):92–100. https://doi.org/10.1177/030006058301100206
Heigener DF, Rabe KF. Palliative Care Concepts in Respiratory Disease. Respiration. 2011; 82(6):483-491. https://doi.org/10.1159/000334189
Lewis SR, Pritchard MW, Thomas CM, Smith AF. Pharmacological agents for adults with acute respiratory distress syndrome. Cochrane Database Syst Rev. 2019 Jul 23;7(7):CD004477. https://doi.org/10.1002/14651858.cd004477.pub3
Poston JT, Patel BK, Davis AM. Management of Critically Ill Adults With COVID-19. JAMA. 2020 May 12; 323(18):1839-1841. https://doi.org/10.1001/jama.2020.4914
WHO. Clinical management of severe acute respiratory infection when Novel coronavirus (2019-nCoV) infection is suspected: Interim Guidance. 2020. [Accessed 2021 Oct 04]. Available from: https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
AMCP. Medication Stockpiling. 2019. [Accessed 2021 Oct 04]. Available from: https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-stockpiling
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Danladi Chiroma Husaini, Yusuf Abubakar, David D. Mphuthi
