Survey On Drug Shops

STUDY OF DRUG LICENSING AND FINANCIAL STATUS OF THE DRUG SHOPS IN RURAL AND URBAN AREAS

A DISSERTATION SUBMITTED TO THE DEPARTMENT OF PHARMACY, STAMFORD UNIVERSITY BANGLADESH IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE DEGREE OF BACHELOR OF PHARMACY (HONS.)

SUBMITTED BY MD. XXXX ID NO: BPH -XXXXXXXX BATCH NO: xx

th

MARCH 200X

THE DEPARTMENT OF PHARMACY STAMFORD UNIVERSITY BANGLADESH

DECLARATION

I do hereby declare that the project report, entitled ―Study of drug licensing and financial status of the drug shops in rural and urban areas‖ presented to the Department of Pharmacy, Stamford University Bangladesh, is the outcome of the investigation performed by me under the supervision of Md. Xxxx, Associate Professor, the Department of Pharmacy, Stamford University Bangladesh. I also declare that no part of this Project Report has been or is being submitted elsewhere for the award of any Degree or Diploma.

Md. Xxxx ID NO: BPH -xxxxxxxxxx (Examinee)

Md. Xxxxxxxxxx Associate professor, Department of Pharmacy Stamford University Bangladesh (Supervisor)

APPROVAL This is to certify that project report on Drug shop titled “Study of drug licensing and financial status of the drug shops in rural and urban areas.” submitted by Md. Xxxx, Enrollment no: BPH: xxxxxxx during the last semester of the B Pharm. program embodies original work done by him and this report submission is a partial fulfillment of the requirements of the Bachelor of Pharmacy in Stamford University Bangladesh.

Signature of the supervisor Name

: Md. Xxxxxxxx

Designation : Associate Professor, Department of Pharmacy University

: STAMFORD UNIVERSITY BANGLADESH

ACKNOWLEDGEMENT

We cannot achieve anything worthwhile in the field of technical education unless or until the theoretical education acquired in the classroom is effectively wedded to its practical approach that is taking place in the modern industries and research institutes or in the area of product selling of those industries. It gives me a great pleasure to have an opportunity to acknowledge and to express gratitude to those who were associated with my Project. Constraints are the best source of inspiration and opportunity to explore us. Communication is the key towards all the responsibilities and demands of time, travel, work in competitive work. It is plus to have effective, secures communication. I am grateful to all personalities for stimulating and thought provoking during the entire project. For the successful completion of this project, I feel deep senses of gratitude to Md. Xxxxxxxxx, Associate Professor, my project supervisor, for motivating and inspiring to achieve the best and providing opportunity to explore for gathering knowledge and information. At last I would again like to express my sincere thanks to those proprietors of those drug shops, drug sellers and other medical representative for their friendly guidance during the entire stretch of this report. Every new step I took was due to their persistent enthusiastic backing and I acknowledge that with a deep sense of gratitude.

TABLE OF CONTENTS MAIN HEADINGS

PAGENO.

Chapter 1 1.1) Introduction and Background…………………………………………………... 1.2) Purpose and importance of this survey…………………………………………. 1.3) Drugs act, Criteria and importance of having Drug Selling License…………... 1.4) Importance and Role of registered Pharmacist in community pharmacy……….

1 2 2 5

1.5) Bad effect of unavailability of having Drug Selling License and Role of registered Pharmacist in drug shops……………………………………………..

6

2.1) Questionnaire and Limitations………………………………………………….

7

Chapter 2 2.2) Picture of surveyed rural area………………………………………………….. 2.3) Data of rural areas………………………………………………………………

8 11

2.4) List of the name of the companies according to their selling products in those surveyed rural area….........…………………………………………………….. 2.5) Picture of surveyed urban area………………………………………………….

21

2.6) Data of Urban areas…………………………………………………………….

22 24

3.1) Table, graph and findings on the Drug selling license in drug shops ………….

34

Chapter 3 3.2) Table, graph and findings on available registered Pharmacist in drug shops….. 3.3) Table, graph and findings on the selling per month in drug shops………..…... 3.4) Table, graph and findings on the present investment in drug shops………..…. 3.5) Table, graph and findings on MPO visits the drug shops……………………… 3.6) Table, graph and findings on most dispensed drug for Gastric Ulcer……….....

36 41 43 45

3.7) Table, graph and findings on most dispensed drug as Pain Killer……...………

47 48

4.1) Results..................................................................................................................

49

Chapter 4 4.2) Conclusion…………………………………………………............................... 4.3) Reference.............................................................................................................

50 50

ABSTRACT

The purpose of this survey was to provide information about the status of the drug shops according to their having the drug selling license, financial status, most dispensed drugs and the number of MPOs that visits to the drug shops in rural and urban area. Here I tried to fetch out the data and information about the availability of Pharmacist, having drug selling license, the present investment, sales per month, most dispensed drug for Gastric Ulcer and as Pain Killer and the number of MPOs that come to visit from various drug company in to the drug shops in the both rural and urban areas. In Bangladesh, the government healthcare system remains a very minor source of health care for rural households. The availability of registered physicians and pharmacists is scarce in our country, and the people, the majority of whom are underweight as indicated by body mass index measurement; have to depend on pharmacy salespersons, quacks and herbal or spiritual healers. Unlike most develop countries, almost every pharmacy salesperson illegally recommends and sells prescription medicines. In addition, there are also unqualified village 'doctors' who do not own a pharmacy shop but provide written prescriptions. However, the treatments provided by these village 'doctors' remain open to question, with instances of maltreatment or inadequate treatment. The treatments are mostly symptomatic and polypharmacy is common, with antibiotics and vitamins prescribed widely. In this project I, especially, tried to highlight that there are very insufficient pharmacist are involved in our community pharmacy and due to that reason of maltreatment or irrational drug use is going on and there is a great prospect for the pharmacist in community pharmacy to serve the people and for their job.

Chapter 1

1.1) Introduction and Background: Doing research is an opportunity to the students to express their ideas, concepts and opinions after research. In a developing country like Bangladesh with 120 million people and limited financial resources in the health sector, the rational treatment of most common diseases is essential. 85% of the population lives in rural communities; poor social economic conditions, demographic structure, system of sanitation, water supply and food are the reasons for the common prevailing diseases. The concept of essential drugs in Bangladesh was introduced in 1982 after the implementation of the national drug policy and drug ordinance (Drug Control Ordinance, 1982). The impact of the national drug policy on actual drug use with regard to disease patterns and drug utilization patterns, compounding, dispensing and consumption, etc. have not been properly assessed either at macro or micro levels. Similarly, no comprehensive study has been conducted to assess the extent of rational prescribing and dispensing, except a few works which were carried out on these aspects at micro level. Inappropriate drug use has been identified as an important health and economic problems in primary health care and such prescribers should explore practical ways to promote rational drug use. According to the Drugs (Control) Ordinance 1982 which controls the manufacture, import, distribution, and sale of drugs in Bangladesh it is said in section (viii) that no person, being a retailer, is allowed to sell any drug without the personal supervision of a pharmacist registered in any Register of the Pharmacy Council of Bangladesh. But irrational and inappropriate prescribing is observed in both graduate and non-graduate medical prescribers in both rural and urban areas in Bangladesh and most of the time the drugs are dispensing to the patients without the direct supervision of any registered pharmacist. On the other hand the many people have their own drug shops which are not licensed for selling drugs and from those drug shops the less quality and irrational drug dispensing is going on everyday in absence of a proper guidance of a qualified registered pharmacist. So it is required to have a registered pharmacist in every licensed drug shop but unfortunately the ratio of qualified registered pharmacist in even licensed shop is very poor. It is happening all most every day in many drug shops that wrong and irrational drug dispensing in going on, especially, in rural areas where a lot of MPOs visit to the licensed and non licensed drug shops and try to promote their low quality of drug products and increasing the selling of those low quality products of different little companies around the whole country. Considering those common problem I have done a survey and project report on drug shops in both rural and urban areas under a constant supervision of my honorable project supervisor to fetch out the actual data and picture of those drug shops. I had to explore in the fields and drug shops and I had to collect the data on some specific questions. Those questions was asked by myself to the drug sellers or to the proprietor of the drug shops in both rural and urban area to get the actual picture of the percent of licensed drug shops, community pharmacist, approximate sales per month and present investment in their drug shops, number of MPOs visits to their drug

shops and the most dispensed drug for Gastric Ulcer and as Pain Killer and the age of their drug shops. 1.2) Purpose and importance of this survey: This Survey has been done to get know the actual current conditions of the drug shops in both rural and urban areas where irrational drug dispensing is going on every day in absence of qualified registered pharmacist which causing many bad and sometimes adverse effect to the patient by the community pharmacy. 1.3) Drugs act, Criteria and Importance of having Drug Selling License: Grant of drugs selling licenses: Food and Drug Administration, Grants Selling Licenses for Drugs according to the provisions of Drugs and Cosmetics Act-1940. For the sale of Allopathic, Homeopathic drugs in form 20, 21, 20B, 21B, 20A, 21A, 20C, 20D, 20F, 20G, 20BB, 21BB. For the sale of Ayurvedic Drugs and Cosmetics no sale license is required.

The Requirements of Sales premises are as follows: Minimum carpet area:• For Retail sale - 10 square meter • For Wholesale - 10 square meter • For Retail - Wholesale - 15 square meter

Storage facilities: Adequate storage facilities including cupboards with glass doors, racks refrigerator and UPS are required. Procedure to obtain Drug Selling license (Fresh): Stage 1: Application for grant of Selling License The applicant has to make application in the requisite form viz 19, 19A, 19B, 19AA details of.

Forms and pay: Necessary fees as given in fee chart

Documents to be attached along with the application form: • Requisite Application Form. • Receipt for the fees paid or challan, as the case may be or their attested copies. • Layout plan of selling premises in 3 copies. • Documents viz. rent receipt, purchase documents or its attested copies showing lawful possession of the premises. • Documents relating to the constitution of the firm viz. Partnership-deed, memorandum and article of association etc. • Full particulars of the competent technical staff /registered persons along with copies of their educational qualification, experience and registration certificates. • Full name of the proprietor or the partners, as the case may be shall be provided in the application. In Case of private or public limited concerns, full name of the Directors who sign the application and the authorized signatory, if any, shall be provided in the application. • Documents for the purchase of Refrigerator/Deep freezer (For Vaccines / Sera).

Stage 2: Inspection The application is scrutinized and premises inspected.

Stage 3: Grant of License If all conditions as prescribed by the act are complied license is granted.

Procedure to Renew Drug selling license Licenses in Forms 20, 21, 20B, 21B, 20A, 21A, 20C, 20D, 20F, 20G, 20BB, 21BB be renewed.

Stage 1: Application for renewal of Drug Selling License The applicant has to make application in the requisite form19, 19A, 19B, 19AA and pay necessary fees as given in fee chart The mode of payment of fees is same as fresh license.

Documents to be enclosed along with application of renewal of license:• Copy of cash receipt or challan for payment of fees. • Xerox copy of License /Previous renewal certificate. • Documents viz. rent receipt, purchase documents or its attested copies showing lawful possession of the premises. • Full particulars of the competent technical staff /registered persons along with copies of their educational qualification, experience and registration certificates. Stage 2: Inspection The application is scrutinized and premises inspected . Stage 3: Grant of License If all conditions as prescribed by the act are complied license is granted. So drug shops have to be licensed according to the drugs act to maintain rational use of drugs.

1.4) Importance and Role of registered Pharmacist in community pharmacy: Pharmacist: Pharmacists are health professionals who practice the art and science of pharmacy. Qualifications and registration for the Pharmacists: The requirements of pharmacy education, pharmacist licenser and post-graduate continuing education vary from country to country and between regions/localities within countries. In most countries, prospective pharmacists study pharmacy at a pharmacy school or related institution. Upon graduation, they are licensed either nationally or by region to dispense medication of various types in the settings for which they have been trained. Role of the Pharmacists in Community pharmacy: A pharmacy is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers.

Picture 1: The pharmacist’s role is to dispense drug according to the Doctor’s prescription. Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications; there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients. All pharmacies are required to have a pharmacist on-duty at all times when open. They also play roles as a community pharmacist are those: 

Nutrition Counseling



Decreased medication errors



Women Welfare-Pregnancy and Infant Care



Rational Use of Drugs



Increased patient compliance in medication regime



Better chronic disease state management



Lessening the cost of prescription drug insurance



Sexually Transmitted Diseases-AIDS



Alcohols, Drug Abuse and Smoking Cessation



Family Planning



Individualization of Drug Therapy



Fostering strong pharmacist-patient relationships

1.5) Bad effect of unavailability of having Drug Selling License and Role of registered Pharmacist in drug shops: Poor and irrational prescribing are frequently done and wrong treatment happen mostly in absence of a qualified registered pharmacist from the both licensed and non licensed drug shops. The non graduate drug seller can prescribe wrong drug, which is illegal, from the non licensed drug shops and can be responsible for the bad or adverse happen frequently to the patient. Those are like:     

Over use of antibiotics, metronidazoles and anti diarrhoeals; Indiscriminate use of injections; Prescribing of tab iron and vitamin B complexes randomly; and Inappropriate dosages and duration of antibiotics. Inappropriate dispensing of drug

Key reasons for this include:       

Inadequate education and training of prescribers; Misleading promotional activities by pharmaceutical companies; Uncertain diagnosis; Patients desire; Prescribers relying on their clinical experiences; Irrational prescribing by peers; Lack of monitoring system.

Chapter 2 2.1) Questionnaire: Several questions had been asked to them and those are: Q1. What are the most dispensed drugs as general Pain Killer in your shop? Say two or three brand or group name. Q2. What are the most dispensed drugs for Gastric Ulcer in your shop? Say two or three brand or group name. Q3. How many MPO or Medical Representative visit to your shop? From how many companies? Q4. What is the age of your drug shop? Q5. What is the present or current investment in your shop? Q6. What is the amount of average sale per month in your shop? Q7. Do you have Drug selling License for this drug shop? Q8. Is there any registered pharmacist in your drug shop? Q9. What is the educational qualification of the drug dispenser or seller in your drug shop? Object of those above question:    

To find out the most dispensed drug as pain killer and for Gastric ulcer. To find out the number of MPOs come from different companies. To find out the financial status of the drug shop i.e. the investment and sales. And the most important things are to find out the percent of licensed and non licensed drug shop and also the percent of registered pharmacist in drug shops in both rural and urban surveyed areas.

Limitation:   

Few persons did not answer of some questions. Few persons did not give accurate answer or information. The data obtained from some specific areas does not represent the exact or the total accurate picture of the whole country.

2.2) Picture of surveyed rural area:

Picture 2: Map of Ghatail Upazila.

Picture 3: One of surveyed drug shop.

Picture of surveyed rural area:

Picture 4: Aerial View of the survey area – GHATAIL. Page | 9

Picture 5: Aerial View of the survey area – SONARGAON. Page | 10

2.3) Data of rural areas: Area Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

1. Ghatail

Morshed Drug House

Flexi (Acelofenac)

Seclo (Omeprazol)

25 MPO

24y

8 lakh.

3 lakh.

YES

LMAF

2. Ghatail

Arup Drug House

Acelofenac

Ranitidine

25 MPO

8y

10 lakh.

3 lakh.

YES

No

3. Ghatail

Reba Medical Hall

Clofenac

Cosec (Omeprazol)

25 MPO

10y

8 lakh.

3 lakh.

YES

LMAF

4. Ghatail

Maya Medical Hall

Mervan (Acelofenac)

Neotack (Ranitidine)

25 MPO

30y

12 lakh

6.6 lakh.

YES

Yes

5. Ghatail

Kazi Pharmacy

Indoxyl (Indomethacin)

Normacid (Ranitidine)

50 MPO

6m

2 lakh.

0.8 lakh.

YES

No

6. Ghatail

Shorna Medical

Isocloamax, Move.

Neotack (Ranitidine)

25 MPO

6y

Not known

2.1 lakh.

YES

No

Page | 11

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

7. Ghatail

Shefa Pharmacy

Clofenac

Losectil (Omeprazol)

10 MPO

7y

3 lakh.

0.6 lakh

YES

No

8. Ghatail

Takwa Medical Hall

Clofenac

Seclo (Omeprazol)

25 MPO

4y

2 lakh.

1.2 lakh.

YES

No

9. Ghatail

Selim Pharmacy

Clofenac, Ciprocin (Ciprofloxacin)

Losectil (Omeprazol)

20 MPO

37y

0.5 lakh.

0.45 lakh.

YES

Yes

10. Ghatail

Mattri Medical Hall

Acelofenac, Etorix (Etoricoxib).

Omeprazol

16 MPO

26y

2 lakh.

1 lakh.

YES

Yes

11. Ghatail

Rahaman A Pharmacy

DiclofenacSodium

Ranitidine

25 MPO

20y

3 lakh.

1.5 lakh.

YES

Yes

12. Ghatail

M/S Arif Medical Hall

DiclofenacSodium

Ranitidine, Omeprazol.

16 MPO

30y

0.5 lakh.

0.3 lakh.

YES

Yes

Page | 12

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

13. Ghatail

Siddiq Pharmacy

Paracetamol, Ace Plus.

Neotack (Ranitidine)

25 MPO

21y

Not known

0.36 lakh.

YES

Yes

14. Ghatail

Rahaman Pharmacy

Acelofenac

Ranitidine, Omeprazol.

10 MPO

22y

3 lakh.

0.6 lakh.

YES

Yes

15. Ghatail

Amena Pharmacy

Flexi (Acelofenac)

Neotack (Ranitidine)

25 MPO

7y

Not known

0.6 lakh.

YES

No

16. Ghatail

M/S Masud Medical Hall

Napa (Paracetamol).

Antacid, Ranitidine.

20 MPO

12y

0.5 lakh.

0.3 lakh.

YES

Yes

17. Ghatail

Sujit Medical Hall

DiclofenacSodium, Acelofenac.

Antacid Plus, Ranitidine.

25 MPO

8y

0.6 lakh.

0.3 lakh.

YES

No

18. Ghatail

Dipta Medical Hall

DiclofenacSodium, Acelofenac.

Ranitidine

20 MPO

11y

0.2 lakh.

0.18 lakh.

YES

Yes

Page | 13

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

19. Ghatail

Khandaker Medical Hall

DiclofenacSodium

Ranitidine

25 MPO

17y

0.5 lakh.

0.45 lakh.

YES

Yes

20. Ghatail

Shobuj Medical Hall

Clofenac

Ranitidine

25 MPO

4y

0.5 lakh.

0.15 lakh.

YES

No

21. Ghatail

Jewel Pharmacy

DiclofenacSodium

Neotack (Ranitidine), Neoceptin (Ranitidine).

20 MPO

12y

0.65 lakh.

0.6 lakh.

YES

No

22. Ghatail

Tanmoy Medical Hall

DiclofenacSodium

Ranitidine

80 MPO

3y

1 lakh.

0.75 lakh

YES

Yes

23. Ghatail

Panna Medical Hall

Corax

Seclo (Omeprazol), Neotack (Ranitidine).

25 MPO

2y

15 lakh.

2.4 lakh.

YES

Yes

24. Ghatail

Faisal Medical Hall

Etorix (Etoricoxib)

Losectil (Omeprazol)

50 MPO

10y

1 lakh.

0.6 lakh.

YES

No

Page | 14

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

25. Ghatail

Kausiq Pharmacy

Clofenac

Antacid Plus, Seclo (Omeprazol).

25 MPO

2y

1.5 lakh.

0.6 lakh.

YES

Yes

26. Ghatail

Maa Medical Hall

Acelofenac. Paracetamol, Ace Plus.

Antacid, Ranitidine.

25 MPO

4y

1 lakh,

0.45 lakh.

YES

Yes

27. Ghatail

Hamdard Labratories.*

__

__

No Other MPOs

11m

15 lakh.

6 lakh.

YES

Yes

28. Ghatail

Payel Medical Hall

Flexi (Acelofenac)

Neotack (Ranitidine)

30 MPO

__

4 lakh.

2.4 lakh.

YES

Yes

29. Ghatail

Khan Popular Pharmacy

Acelofenac, DiclofenacSodium.

Ranitidine

20 MPO

3 lakh.

0.36 lakh.

YES

Yes

30. Ghatail

Unique Pharmacy

Acelofenac

Ranitidine

2 lakh.

0.45 lakh.

YES

No

__

20 MPO

__

Page | 15

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Sales per month

License

Degree of the seller

31. Porabari

Doctor’s Medical Hall

Flexi (Acelofenac)

Apex (Ranitidine)

12 MPO

__

1 lakh.

0.25 lakh.

YES

Yes

32. Porabari

G K Pharmacy

Acelofenac

Ranitidine

12 MPO

__

2 lakh.

0.6 lakh.

YES

No

33. Chandpur Sadar.

Milon Pharmacy

Paracetamol

Antacid Plus

20 MPO

8y

7lakh

3 lakh

Yes

No

34. Chandpur Sadar

Gazi Pharmacy

DiclofenacSodium

Ranitidine

40 MPO

30y

16 lakh.

6 lakh.

Yes

C grade Registered Pharmacist

35. Chandpur Sadar

Metro Pharmacy

Paracetamol

Antacid Plus

25 MPO

3y

Yes ___

___

C grade Registered Pharmacist

36. Panam City, Sonargoan

Addarsha Pharmacy

DiclofenacSodium

1.2 lakh

0.9 lakh

Yes

No

Ranitidine

15 MPO

Age of the Present Dispensary Investment

20y

Page | 16

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

37. Mogra Para, Sonargoan

Seba Medical Hall

Paracetamol Acelofenac

Antacid Plus Ranitidine

20 MPO

11y

0.5 lakh

1.2 lakh

Yes

C grade Pharmacist

38. Mogra Para, Sonargoan

Mousumi Drug House

Paracetamol + Neotack Wrong!

Omeprazol

30 MPO

1y6m

2.5 lakh

0.75 lakh

No

No

39. Mogra Para, Sonargoan

Khandoker Medical centre

Acelofenac

Ranitidine

20 MPO

3y

2.5 lakh

0.9 lakh

Yes

C grade Pharmacist

40. Mogra Para, Sonargoan

Islamia Pharmacy

Etoricoxib DiclofenacSodium

Ranitidine Omeprazol

25 MPO

20y

0.5 lakh

0.45 lakh

Yes

C grade Pharmacist

41. Mogra Para, Sonargoan

Janata Pharmacy

DiclofenacSodium

Omeprazol Antacid plus (Pantoprazol –for female)

25 MPO

3y6m

1 lakh

0.45 lakh

Yes

No

42. Mogra Para, Sonargoan

Sirin Pharmacy

Paracetamol

Ranitidine Omeprazol Pantoprazol

30 MPO

12y

4 lakh.

3.6 lakh

Yes

LMAF

Page | 17

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

43. Progoti Medical Mogra Hall Para, Sonargoan

No drug without prescription

Ranitidine

15 MPO

20y

44. Mogra Para, Sonargoan

Ma Pharmacy

Paracetamol Acelofenac

Antacid Plus Omeprazol

45 MPO

45. Mogra Para, Sonargoan

Bhuyan Pharmacy

DiclofenacSodium

Ranitidine

46. Mogra Para, Sonargoan

Mamun Pharmacy

No drug without prescription

47. Sawkat Medical Mogra Centre Para, Sonargoan 48. Mogra Para, Sonargoan

Nupur Drug House

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

8 lakh

9 lakh

Yes

DMF

16y

6 lakh

4.5 lakh

Yes

C grade Pharmacist

30 MPO

5y

6 lakh

3 lakh

Yes

C grade Pharmacist

Ranitidine

25 MPO

3y

4 lakh

3 lakh

Yes

No

Paracetamol + Caffeine

Pantoprazol

14 MPO

2y6m

3 lakh

No

No

No drug without prescription

No drug without prescription

Yes

LMAF

-----

35 MPO

2y6m -------

Page | 18

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

49. Mogra Para, Sonargoan

Sonargoan Pharmacy

Bad Practice

Ranitidine

60 MPO

50y

18 lakh

7.5 lakh

Yes

DMF

50. Mogra Para, Sonargoan

Habib Medical Hall

DiclofenacSodium Acelofenac

Ranitidine Omeprazol

70 MPO

10y

1.5 lakh

1.2 lakh

Yes

LMAF

51. Mogra Para, Sonargoan

Modern Medicine Hall

Paracetamol

Antacid Plus

50 MPO

3y6m

1.5 lakh

1.5 lakh

Yes

LMAF

52. Sufia Pharmacy Mogra Para, Sonargoan

Paracetamol

Antacid Plus

20 MPO

4y

Yes

No

-----

------

53. Mogra Para, Sonargoan

Japani Pharmacy

DiclofenacSodium

Antacid Plus Ranitidine

30 MPO

8m

6 lakh

1.2 lakh

Yes

LMAF

54. Mogra Para, Sonargoan

Eva Drug House

Paracetamol

Ranitidine

20 MPO

18y

3 lakh

0.9 lakh

Yes

B grade Pharmacist

Page | 19

Area

Name of the Most Drug Dispensary dispensed drug as Pain Killer

55. Mogra Para, Sonargoan

Ali Drug House

56. Mogra Para, Sonargoan

Limon Pharmacy

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Paracetamol DiclofenacSodium

Ranitidine

25 MPO

Paracetamol

Ranitidine

Age of the Present Dispensary Investment

10y

Sales per month

License

Degree of the seller

0.9 lakh

Yes

Yes

0.75 lakh

Yes

Yes

-----

25 MPO

8y ----

Page | 20

2.4) List of the name of the companies according to their products in those surveyed rural area: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

Square Pharmaceuticals Ltd. ACI Limited Beximco Pharmaceuticals Ltd. The Ibn Sina Pharmaceutical Industry Lt Novartis (Bangladesh) Ltd. Novo Healthcare and Pharma Ltd. Nuvista Pharma Ltd. Opsonin Pharma Ltd. Orion Infusion Ltd. Pacific Pharmaceuticals Peoples Pharma Ltd. Incepta Pharmaceuticals Ltd. Jayson Pharmaceuticals Ltd. Navana Pharmaceuticals Ltd. Glaxosmithkline Bangladesh Ltd. The Acme Laboratories Ltd. Globe Pharmaceuticals Ltd. Somatec Pharmaceuticals Ltd. Desh Pharmaceuticals Ltd. Apollo Pharmaceuticals Drug International Ltd. Eskayef Bangladesh Ltd. Gaco Pharmaceuticals Apex Pharma Ltd. Aristopharma Ltd. Asiatic Laboratories Ltd. Beacon Pharmaceuticals Ltd. Nipa Pharmaceuticals Ltd. Hudson Pharmaceuticals Ltd.

31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60.

Jalalabad Pharmaceuticals Ltd. Janata Health care Kapricorn Enterprise Ltd. Kumudini Pharma Ltd. Libra Infusions Ltd. Popular Pharmaceuticals Ltd. Proteety Pharmaceuticals Ltd. Rangs Pharmaceuticals Ltd. Rasa Pharmaceuticals Ltd. Chemist Laboratories Ltd. City Overseas Ltd. Doctor’s Chemical Works Ltd. General Pharmaceuticals Ltd. Gonoshasthaya Pharmaceuticals Ltd. Hamdard Laboratories Bangladesh Ultra Pharma Ltd. Unimed & Unihealth Manufacturers Ltd. Zenith Pharmaceuticals Ltd. Ziska Pharmaceuticals Ltd. Biopharma Laboratories Ltd. Medicon Laboratories Ltd. Medimet Pharmaceuticals Ltd. Ambee Pharmaceuticals Ltd. Amico Laboratories Ltd. A.H Janakalyan Pharmaceuticals Alco Pharma Ltd. Belsen Pharmaceuticals Ltd. Skylab Pharmaceuticals Ltd. Pharmaco International Ltd.

61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74.

Pharmadesh Laboratories Ltd. Chemico Laboratories Ltd. Reckitt Benckiser Ltd. Shamsulalamin Pharmaceuticals Ltd. Shuvro Ltd. Silva Pharmaceuticals Ltd. Healthcare Pharmaceuticals Ltd. Modern Pharmaceuticals Ltd. Supreme Pharmaceuticals Ltd. Bristol Pharma Ltd. Central Pharmaceuticals Ltd. Renata Ltd. Rephco Laboratories Ltd. Sanofi Aventis

Page | 21

2.5) Picture of surveyed urban area:

Picture 6: Aerial View of the survey area – Merul and South Badda. Page | 22

Picture 7: Aerial View of the survey area – East and Middle Badda. Page | 23

2.6) Data of urban areas: Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

1. South Badda

Talukder Medical Hall

----

Ranitidine

20 MPO

2. South Badda

Jibon Drug House

Ace Plus Etoricoxib

Neotack (Ranitidine) Seclo (Omeprazol)

5 MPO

3. South Badda

Ali Medical Hall

DiclofenacSodium

Neotack (Ranitidine)

4. South Badda

Badda Medical Hal

Napa Acelofenac

5. South Badda

Dwan Medical Hall

6. South Badda

Sima Medical Hall

Age of the Present Dispensary Investment

Sales per month

14y

License

Degree of the seller

Yes

No

----

----

29y

3 lakh

1.8 lakh

Yes

Yes

40 MPO

20y

1.5 lakh

1.5 lakh

Yes

Registered Pharmacist (C)

Ranitidine Seclo (Omeprazol)

3 MPO

20y

3 lakh

1.5 lakh

No

No

Napa Paracetamol DiclofenacSodium

Neotack (Ranitidine) Antacid Plus

8 MPO

1y

4 lakh

1.6 lakh

No

No

Napa Extra DiclofenacSodium

Ranitidine Antacid Plus

Yes

-----

0.75 lakh

Registered Pharmacist (C)

30y ___

Page | 24

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

7. South Badda

Islam Drug House

Depend Upon Condition

Depend Upon Condition

12 MPO

8. South Badda

Krisna Nursing Hall

No drug without prescription

3MPO

9. South Badda

Bismillah Medical Hall

DiclofenacSodium

Ranitidine

10. South Badda

Nir Dental and Medical Care

Acelofenac

Depend Upon Condition

11. South Badda

Lutfun Medical Hall

Paracetamol

Ranitidine

12. Middle Badda

Nahar Drug House

DiclofenacSodium

No drug without prescription

Age of the Present Dispensary Investment

10y

2 lakh

License

Degree of the seller

Yes

Registered Pharmacist (B)

Yes

Yes

___

____

____

___

2 MPO

4y

Secret

0.6 lakh

Yes

No

5 MPO

5y

3 lakh

1.8 lakh

Yes

LMAF

Yes

LMAF

Yes

LMAF

8y ___

Ranitidine

Sales per month

5 MPO

7y

___

___

7 lakh

2.1 lakh

Page | 25

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

13. Middle Badda

Cosmic Medical Hall

DiclofenacSodium

Ranitidine

10 MPO

15y

3 lakh

14. Middle Badda

Al-Amin Pharmacy

Paracetamol

Ranitidine

4 MPO

16y

1.5 lakh

15. Middle Badda

Monowara Drugs

DiclofenacSodium

Omeprazol

16. Middle Badda

Apan Medical Hall

Paracetamol + Antacid Wrong!

Antacid Plus Neotack (Ranitidine)

17. Middle Badda

Ma Pharmacy

DiclofenacSodium

Omeprazol

18. DIT, Middle Badda

Medicine Plus

DiclofenacSodium

Omeprazol

Sales per month

License

Degree of the seller

1.8 lakh

Yes

LMAF

Yes

Registered Pharmacist (B)

Yea

BRMA

-----

4 MPO

15 MPO

1y6m ___

___

12y

2 lakh

1.2 lakh

Yes

LMAF

6y

2 lakh

0.6 lakh

Yes

No

6m

3 lakh

1.5 lakh No

No

------

4 MPO

Page | 26

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

19. DIT, Middle Badda

Neha Pharmacy

DiclofenacSodium

Depend on condition

10 MPO

Paracetamol DiclofenacSodium

Ranitidine Omeprazol

Ranitidine

20. DIT, Middle Badda

Golden Pharmacy

21. DIT, Middle Badda

S.S Mediacal Hall

Paracetamol + caffeine

22. Middle Badda

Gourinodi Medical Hall

Paracetamol

23. Middle Badda

M.S Medical

DiclofenacSodium Acelofenac

24. Middle Badda

Asim Pharmacy

DiclofenacSodium Paracetamol

Age of the Present Dispensary Investment

4y

Sales per month

3 lakh

License

Degree of the seller

Yes

LMAF

Yes

LMAF

___

3y ___

___

____ 2 MPO

7y

3 lakh

1.8 lakh

Yes

Yes

No Answer

7y

3 lakh

0.9 lakh

Yes

LMAF

Ranitidine Antacid

10 MPO

5y

No

LMAF

___

0.12 lakh

Antacid Plus

10 MPO

2.5lakh

0.6 lakh

Yes

LMAF

No Answer

1y

Page | 27

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

25. East Badda

Tareq Medical Corner

DiclofenacSodium

Antacid Plus Ranitidine Omeprazol

7 MPO

5y

3 lakh

1.3 lakh

Yes

Yes

26. East Badda

Joy Dev Medical Hall

Acelofenac Paracetamol

Seclo (Omeprazol)

15 MPO

12y

1.5 lakh

Yes

Yes

27. East Badda

Mahabub Pharmacy

DiclofenacSodium

Ranitidine

6 MPO

8m

4 lakh

1.6 lakh

Yes

No

28. East Badda

Hamim Clinic

Acelofenac DiclofenacSodium

Ranitidine Omeprazol

8 MPO

8m

15 lakh

6 lakh

No

No

29. East Badda

Siam Pharmacy

Paracetamol

Ranitidine Antacid Plus

10 MPO

5y

2 lakh

0.6 lakh

Yes

Yes

30. East Badda

ICL Health Care

Paracetamol Aceclofenac Ibuprofen

Ranitidine

10 MPO

1y

3 lakh

1.8 lakh

Yes

No

----

Page | 28

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

31. East Badda

Amena Pharmacy

Acelofenac

Losectil (Omeprazol)

3 MPO

2y

4 lakh

1.5 lakh

Yes

No

32. East Badda

Jahanara Pharmacy

DiclofenacSodium

Ranitidine

8 MPO

7y

15 lakh

6 lakh

Yes

Yes

33. East Badda

Sonar Bangla Medical Corner

DiclofenacSodium

Ranitidine

4 MPO

3y

4 lakh

1.5 lakh

No

No

34. East Badda

Barisal Pharmacy

Paracetamol Cefenal DiclofenacSodium

Ranitidine Omeprazol

15 MPO

7y

10 lakh

Yes

Yes

35. East Badda

Annanda Mediacal Certre

DiclofenacSodium

Ranitidine

15 MPO

10y

15 lakh

7 lakh

Yes

36. East Badda

Ma Pharmacy

DiclofenacSodium Paracetamol + Caffeine

Ranitidine Omeprazol Esomeprazole

25 MPO

1y

4 lakh

1.6 lakh

Yes

____

LMAF

LMAF

Page | 29

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

37. East Badda

Rahaman Pharmacy

DiclofenacSodium Mephenamic Acid

Ranitidine Omeprazol

30 MPO

39y

1.5 lakh

0.75 lakh

Yes

C grade Registered Pharmacist

38. East Badda

Ashik Pharmacy

Clofenac DiclofenacSodium Ketefen

Neotack (Ranitidine)

6 MPO

3y

3 lakh

1.4 lakh

Yes

LMAF

39. East Badda

Doctor’s Pharmacy

Paracetamol DiclofenacSodium

Ranitidine Omeprazol

5 MPO

4y

6 lakh

3.5 lakh

No

No

40. East Badda

Mollah Pharmacy

No drug without prescription

No drug without prescription

2 MPO

1.5y

0.2 lakh

Yes

LMAF

41. East Badda

Kazi Pharmacy

DiclofenacSodium Paracetamol Acelofenac

Ranitidine Omeprazol

20 MPO

7y

4 lakh

1.2 lakh

Yes

LMAF

42. East Badda

Desh Medical Centre

Ibuprofen DiclofenacSodium

Neotack (Ranitidine)

10 MPO

5y

4 lakh

1.6 lakh

Yes

Yes

___

Page | 30

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer Neotack (Ranitidine)

Number of MPOs that came to the Dispensary

43. East Badda

Mukta Medicine Corner

DiclofenacSodium Paracetamol

44. East Badda

Vhuiyan Pharmacy

45. East Badda

Age of the Present Dispensary Investment

Paracetamol Acelofenac

Ranitidine Omeprazol

30 MPO

20y

Mokta Pharmacy

Clofenac DiclofenacSodium

Ranitidine

12 MPO

20y

46. East Badda

Tanvir Drug House

Paracetamol

Ranitidine

16 MPO

47. East Badda

Biplab Health Care

Acelofenac DiclofenacSodium

Ranitidine Omeprazol Esoprajol

48. East Badda

Taslima Medical Hall

DiclofenacSodium with Amoxicillin

Ranitidine

13m

Sales per month

1.5 lakh

___

License

Degree of the seller

Yes

LMAF

Yes

C grade Registered Pharmacist

___

4 lakh

1.5 lakh

Permission of Permission of Drug Drug Administration Administration

___

___

1y

1.5 lakh

0.6 lakh

No

LMAF

20 MPO

6y

2.5 lakh

1.2 lakh

No

LMAF

12 MPO

1y

4 lakh

1.6 lakh

No

LMAF

Page | 31

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

Sales per month

License

Degree of the seller

49. East Badda

Bismillah Medical Hall

DiclofenacSodium

Ranitidine

15 MPO

3y

3 lakh

0.45 lakh

Yes

LMAF

50. East Badda

Shakil Pharmacy

Napa Paracetamol DiclofenacSodium

Ranitidine Omeprazol Pantoprazol

14 MPO

10y

6 lakh

3 lakh

No

LMAF

51. Merul Badda

Matri Sheba Medical Hall

DiclofenacSodium

Antacid Plus Ranitidine

10 MPO

7

4 lakh

1.5 lakh

Yes

LMAF

52. Merul Badda

Manikgoan Medical Hall

Napa Extra

Ranitidine

7 MPO

6

4 lakh

1.8 lakh

Yes

No

53. Merul Badda

Vojon Mediacal Hall

Ace Napa Extra Ibuprofen Etoricoxib

Ranitidine

15 MPO

1y6m

3 lakh

1.8 lakh

Yes

LMAF

54. Merul Badda

Rajit Medical Hall

Ranitidine

12 MPO

2y6m

3 lakh

1.5 lakh

No

Yes

___

Page | 32

Area

Name of the Drug Dispensary

Most dispensed drug as Pain Killer

Most dispensed drug for Gastric Ulcer

Number of MPOs that came to the Dispensary

Age of the Present Dispensary Investment

55. Merul Badda

Sheba Pharmacy

Paracetamol Diclofenac

Antacid Plus Ranitidine

15 MPO

7y

56. Merul Badda

Noyon Pharmacy

Diclofenac

Ranitidine

8 MPO

5y

Sales per month

License

Degree of the seller

6 lakh

2 lakh

Yes

Yes

2.5 lakh

1.5 lakh

Yes

No

Page | 33

Chapter 3 3.1) Table, graph and findings on the Drug selling license in drug shops: Table 1: Rural Areas

Number of drug shops

Number of Licensed drug shops

Number of Non-Licensed drug shops

Ghatail, Tangail.

32

32

0

Sonargaon, Narayangang. Chandpur sadar

21

19

2

3

2

1

Total

56

53

3

Table 1: Those estimated data in this table has been derived after surveying 56 drug shops in the rural areas (Ghatail, Sonargaon and Chandpur sadar). Here the table is representing the comparative values of the number of licensed and non licensed drug shops. Here we got 53 drug shops have drug selling license and 3 are non-licensed among 56 the of surveyed drug shops.

5%

Licensed Non-Licensed

95%

Figure 1 Figure 1: This pie-chart is representing the ratio of licensed and non-Licensed drug shops in those rural areas (Ghatail, Sonargaon and Chandpur sadar). Here we found that 95% and 5% drug shops are licensed and non-licensed respectively. Findings 1: There are 5% drug-shops are non-licensed but there should not have any drug shop

without drug selling license according to the drugs acts. Page | 34

Table 2: Urban Areas

Badda, Dhaka.

Number of drug shops

Number of Licensed drug shops

Number of Non-Licensed drug shops

56

43

13

Table 2: Those estimated data in this table has been derived after surveying 56 drug shops in the urban areas (Badda). Here the table is representing the comparative values of the number of licensed and non licensed drug shops. Here we got 43 drug shops have drug selling license and13 are non-licensed among the 56 of surveyed drug shops.

23% Licensed Non-Licensed 77%

Figure 2 Figure 2: This pie-chart is representing the ratio of licensed and non-Licensed drug shops in the urban area (Badda). Here we found that 77% and 23% drug shops are licensed and non-licensed respectively. Findings 2: There are 23% drug-shops are non licensed but there should not have any drug shop without drug selling license according to the drugs acts and the percent of licensed drug shop is less in urban area than rural area.

Page | 35

Ratio of licensed drug shop in rural and urban area: Rural

53

Urban

43

Total

56

Figure 3

Figure 3: This Bar-Chart is representing the total comparative ratio of licensed drug shop in urban and rural areas. Total 120 shops were surveyed, 56 shops in rural and another 56 shops in urban areas. The above Bar-Chart is showing the ratio of Total shop : Shops in urban areas: Shops in rural area is equal to 56 : 43 : 53 i.e. 77% and 95% (see figure 2 and 1) shops are licensed in urban and rural area respectively in those surveyed areas.

3.2) Table, graph and findings on available registered Pharmacist in drug shops: Table 3: Rural Areas

Number of drug shops

Number of Pharmacist

Number of LMAF diploma holder

Do not have required Degree

Ghatail, Tangail.

32

5

5

11

Sonargaon, Narayangang. Chandpur sadar

21

0

5

1

3

2

0

27

Total

56

7

10

39

Table 3: Those estimated data in this table has been derived after surveying 56 drug shops in the

rural areas (Ghatail, Sonargaon and Chandpur sadar). Here the table is representing the comparative values of the number of pharmacist, the number of LMAF diploma holder and do not have required degree in those drug shops. Here we got only 7 pharmacists. Also 10 LMAF diploma holders and 39 persons have no required degree for drug selling. Page | 36

60

50

40

30

20

10

0

Series 1

Total Shop

Pharmacist

LMAF

Do not have required degree

56

7

10

39

Figure 4 Figure 4: This Bar-Chart is illustrating the data of registered pharmacist, LMAF diploma holder and do not have required degree in rural areas according to the table-3 explained in above.

11%

Pharmacist Total shop

89%

Figure 5 Figure 5: This pie chart is representing the ratio of the registered pharmacists and total shops in those rural areas. Here the ratio has found as the Total shop : Pharmacist is equal to 89 : 11. Findings 3: Very poor number of pharmacists is available in those rural areas which is a serious ignoring of the drug acts. Page | 37

Table 4: Urban Areas

Badda

Number of drug shops Number of Pharmacist

Number of LMAF diploma holder

Do not have required Degree

56

23

25

8

Table 4: Those estimated data in this table has been derived after surveying 56 drug shops in the urban area (Badda). Here the table is representing the comparative values of the number of pharmacist, the number of LMAF diploma holder and do not have required degree in those drug shops. Here we got only 8 pharmacists. Also 23 LMAF diploma holders and 25 persons have no required degree for drug selling.

60

50

40

30

20

10

0

Series 1

Total Shop

Pharmacist

LMAF

Do not have required degree

56

8

23

25

Figure 6 Figure 6: This Bar-Chart is illustrating the data of registered pharmacist, LMAF diploma holder and do not have required degree in urban areas according to the table-4 explained in above.

Page | 38

12%

Pharmacist Total shop

88%

Figure 7 Figure 7: This pie chart is representing the ratio of the registered pharmacists in those urban areas and total shops. Here the ratio has found as the Total shop : Pharmacist is equal to 88 : 12. Findings 4: Very poor number of pharmacists is also available in those urban areas which are a serious ignoring of the drug acts. Table 5: Area

Licensed shops

Pharmacist

LMAF

Rural

Number of shops 56

54

7

10

Urban

56

43

8

23

Total

112

97

15

33

Table 5: Those estimated data in this table has been derived after surveying 112 drug shops in the

both rural (56) areas and urban (56) areas. Here the table is representing the comparative values of the number of licensed drug shops, the number of pharmacists and the number of LMAF diploma holder in those drug shops. Here we got 97 licensed shops and total only 15 pharmacists in 112 drug shops. Also 33 LMAF diploma holders in out of 112 surveyed shops.

Page | 39

120 100 80 60 40 20 0

Rural

Urban

Total

Number of shops

56

56

112

Licensed shops

54

43

97

Pharmacist

7

8

15

LMAF

10

23

33

Figure 8 Figure 8: This Bar-Chart is illustrating the total data summary of licensed shops, registered pharmacist and LMAF diploma holder in both rural and urban areas according to the table-5 explained in above. Total Shops

Number of Pharmacist

12%

88%

Figure 9 Figure 9: This pie chart is representing the total ratio of the registered pharmacists in both rural and urban areas and total shops. Here the ratio has found as the Total shop : Pharmacist is equal to 88 : 12. Findings 5: Very poor number of pharmacist is available in both rural and urban areas which is a serious ignoring of the drug acts. Page | 40

3.3) Table, graph and findings on the selling per month in drug shops: Table 6: Amount of average Sales/Month

Rural

Urban

Less than 50 thou

14

3

50 thou

14

8

1 lakh

5

5

1.5 lakh

2

21

2 lakh

4

2

3 lakh

7

1

3.5 lakh

1

1

4.5 lakh

1

6 lakh

2

2

7 lakh

1

1

9 lakh

1

12 lakh

1

No Answer

3

12

Total

56

56

Table 6: The estimated data found in here after surveyed 112 little drug shops in both rural (56) and urban (56) areas. Here 3 and 12 person did not answer in rural and urban area about their sales per month respectively. There I have got 14 (rural) and 3 (urban) little shops where the average sale per month is less than 50 thousand. Here also 14 (rural) and 8 (urban) little shops where sale per month is 50 thousand to less than one lakh, and 2 (rural) and 21 (urban) little shops where a sale per month is around 1.5 lakh. Findings 6: We can see that in the little or medium drug shops in urban areas has more sales per month compare to the rural areas if we compare those 1, 2, 3 and 4 no rows in above table-6.

Page | 41

60

50

40

30

20

10

0

Less 1.5 3.5 than 50 1 lakh 2 lakh 3 lakh lakh lakh 50 thou thou

Rural

14

14

5

2

4

7

1

Urban

3

8

5

21

2

1

1

No 4.5 12 6 lakh 7 lakh 9 lakh Answe Total lakh lakh r 1

2

1

2

1

1

1

3

56

12

56

Figure 10

Figure 10: This Bar-Chart is illustrating the total data summary of sales per month, mostly, into the little drug shops in both rural and urban areas according to the table-6 explained in above.

Page | 42

3.4) Table, graph and findings on the present investment in drug shops: Table 7: Amount of Present Investment Less than 50 thou

Rural

Urban

1

0

50 thou

9

0

1 lakh

6

0

1.5 lakh

1

6

2 lakh

5

4

2.5 lakh

2

3

3 lakh

5

14

4 lakh

3

11

6 lakh

3

3

7 lakh

1

1

8 lakh

3

10 lakh

1

12 lakh

1

15 lakh

4

20 lakh

2

No Answer

9

10

Total

56

56

1

3

Table 7: The estimated data found in here after surveyed 112 little drug shops in both rural (56) and urban (56) areas. Here 9 and 10 person did not answer in rural and urban area about their present investment in their shops respectively. There I have got 1 (rural) and 0 (urban) little shops where the approximate present investments are less than 50 thousand. Here also 9 (rural) and 0 (urban) little shops where the approximate present investment is 50 thousand to less than one lakh, and 6 (rural) and 0 (urban) little drug shops where the approximate present investment is 1 lakh to less than 1.5 lakh. Findings 7: We can see that in the little or medium drug shops in urban areas have more investment compare to the rural areas if we compare those 1, 2, and 3 no rows in above table-7.

Page | 43

60

50

40

30

20

10

0

Less No 1 1.5 2 2.5 3 4 6 7 8 10 12 15 20 than 50 Answ Total 50 thou lakh lakh lakh lakh lakh lakh lakh lakh lakh lakh lakh lakh lakh er thou

Rural

1

9

6

1

5

2

5

3

3

1

Urban

0

0

0

6

4

3

14

11

3

1

3

1 1

1

4 3

2

9

56

10

56

Figure 11

Figure 11: This Bar-Chart is illustrating the total data summary on current or present investment into the little drug shops in both rural and urban areas according to the table-7 explained in above.

Page | 44

3.5) Table, graph and findings on MPO visits the drug shops: Table 8: Number of MPO goes to the drug shop

Rural Area

Urban Area

Less than 5 MPO 5 MPO 10 MPO

5

11 10 14

15 MPO 20 MPO

4 11

8 3

25 MPO

21

1

30 MPO 35 MPO

5 1

2 1

40 MPO

1

45 MPO 50 MPO

1 3

60 MPO

1

70 MPO

1

80 MPO

1

NO Answer

1

6

Total

56

56

Table 8: The estimated data found in here after surveyed 112 little drug shops in both rural (56) and urban (56) areas. Here I got 11 and 10 shops (row 1 and 2) in those surveyed urban area where less than 5 and more than 5 to 9 MPO visits respectively but there is no little or medium drug shop in rural area where less than 5 or 5 to 9 MPO visit from different companies. In the lower part table also showing that there are 3 drug shops in rural areas in where about 60, 70 and 80 MPO visit respectively from different companies but there is no drug shop in those surveyed urban areas where 60 or 70 or 80 MPO visit from different companies. Findings 8: More MPOs from more companies are more available in rural area compare to the urban area. May be due to this reason less quality or substandard product is more available in rural areas than urban area.

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60

50

40

30

20

10

0

Less NO 10 15 20 25 30 35 40 45 50 60 70 80 than 5 Answ Total 5 MPO MPO MPO MPO MPO MPO MPO MPO MPO MPO MPO MPO MPO er MPO

Rural Area Urban Area

11

10

5

4

11

21

5

1

14

8

3

1

2

1

1

1

3

1

1

1

1

56

6

56

Figure 12

Figure 12: This Bar-Chart is illustrating the total data summary of the number of MPO visits to the drug shops in both rural and urban areas from different companies according to the table-8 explained in above.

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3.6) Table, graph and findings on most dispensed drug for Gastric Ulcer: Table 9: Most dispensed drug for Gastric Ulcer Ranitidine Omeprazol Antacid Plus Pantoprazol Others Total

Rural

Urban

33 10 10 1 2 56

41 5 4 0 6 56

Table 9: This table representing the comparative sales amount of Antacid Plus, Ranitidine, omeprazol and other groups of drugs as the most dispensed drug for Gastric ulcer. Here Ranitidine is the most dispensed drug Gastric Ulcer. On the other hand the Omeprazol, Antacid plus and other drugs are in 2nd, 3rd and 4th position used for Gastric ulcer treatment. Findings 9: Ranitidine is the most dispensed drug for Gastric Ulcer treatment which is a H2 receptor antagonist. But omeprazol should be the most used drug for Gastric Ulcer treatment as it is a proton pump inhibitor which works at the last stage of acid secretion and more appropriate to use than Ranitidine. 60 50 40 30 20 10 0

Ranitidine

Omeprazol

Antacid Plus

Pantoprazol

Others

Total

Rural

33

10

10

1

2

56

Urban

41

5

4

0

6

56

Figure 13 Figure 13: This Bar-Chart is illustrating the total data for the most dispensed drugs for Gastric Ulcer treatment according to Table-9 explained in above. Page | 47

3.7) Table, graph and findings on most dispensed drug as Pain Killer: Table 10: Most dispensed drug as Pain Killer Diclofenac Sodium Paracetamol Acelofenac Others Total

Rural

Urban

18 6 13 19 56

21 22 5 8 56

Table 10: This table representing the comparative sales amount of Paracetamol, Diclofenac, Acelofenac and other groups of drugs as pain killer. Here Diclofenac Sodium is the most dispensed drug as general pain killer. The Paracetamol is in 2nd position, used as general pain killer in both rural and urban area. Findings 10: Diclofenac Sodium is the most dispensed drug as general pain killer in both rural and urban area. But other groups (19) are also use mostly in rural areas where sometimes antibiotics are used as wrong treatment as painkiller as I have observed twice during this survey. 60

50

40

30

20

10

0

Diclofenac

Paracetamol

Acelofenac

Others

Total

Rural

18

6

13

19

56

Urban

21

22

5

8

56

Figure 14 Figure 14: This Bar-Chart is illustrating the total data for the most dispensed drugs as pain killer according to Table-10 explained in above. Page | 48

Chapter 4 4.1) Results: 1. Among the 112 surveyed drug shops I have found about 5% and 23% (see figure-1 & 2) drug shops are non-licensed in rural and urban area respectively. So those non-licensed drug shops are ignoring the Drug acts and the percentage of licensed drug shops is more in rural areas than urban areas that I have found from this survey. 2. There are only 11% and 12% (see figure-5 & 7) qualified registered pharmacist in rural and urban areas respectively and I found only 15 pharmacists (see table-5) in 112 surveyed Drug shops. The total percent of community pharmacist is 12% (see figure-9) which is the main cause of mal-treatment or irrational drug use in our country. 3. Here (see table-6) I have got 14 (rural) and 3 (urban) little shops where the average sale per month is less than 50 thousand. Also 14 (rural) and 8 (urban) little shops where sale per month is 50 thousand to less than one lakh, and 2 (rural) and 21 (urban) little shops where a sale per month is around 1.5 lakh which indicates that the amount of drug selling is more in urban area in spite of less licensed drug shops than rural areas. 4. There I have got 1 (rural) and 0 (urban) little shops (see table-7) where the approximate present investments are less than 50 thousand. Also 9 (rural) and 0 (urban) little shops where the approximate present investments are 50 thousand to less than one lakh, and 6 (rural) and 0 (urban) little drug shops where the approximate present investments are 1 lakh to less than 1.5 lakh which also indicates that the investment is more in urban area in spite of less licensed drug shops than rural areas. 5. This project report has revealed that there are 11 and 10 shops (see table-8) in those surveyed urban area where less than 5 and more than 5 to 9 MPO visits respectively but there is no little or medium drug shop in rural area where less than 5 or 5 to 9 MPO visit from different companies. The lower part of the table-8 also showing that there are 3 drug shops in rural areas where about 60, 70 and 80 MPO visit respectively from different companies but there is no drug shop in those surveyed urban areas where 60 or 70 or 80 MPO visit from different companies. So the table-8 indicating that more MPOs from more companies are more available in rural areas compare to the urban areas. Due to this reason less quality or substandard products are more available in rural areas than urban areas. 6. This project report has revealed that Ranitidine is the most dispensed drug (see figure-13) for Gastric Ulcer treatment.

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7. This project report has also revealed that Diclofenac Sodium is the most dispensed drug (see figure-14) as general Pain Killer.

4.2) Conclusion: Considering the results and findings that I have already mentioned after every table or chart or graph I have found that the drug shops in both rural and urban areas are not running according to the Drug Acts. I have surveyed 112 drug shops where most drug shops are running on little or medium investment and where the non-licensed drug shop is more in urban area than rural areas but the present investment into the drug shops are more in urban areas than the rural areas. Also the drug selling is more in urban areas than rural areas as like the more present investment in urban areas. From the above results, it is clearly manifested that the number of qualified Pharmacists are very inadequate who have definite beneficial roles regarding health matters in community pharmacy. But a pharmacist is the legally qualified and professionally competent person to handle drugs and allied supplies required for the patients within and outside the hospital. Most of the maltreatment and irrational use of drugs is happening or responsible due to do not having adequate number of qualified registered pharmacist in drug shops. I have found only 15 pharmacists in 112 surveyed drug shops and it is a matter of regret that the government of our country is taking very little effort to employ highly skilled pharmacy personnel in community pharmacy. But in the developed countries, pharmacists are in unique position in this regard and there have a lot of job scopes for them, especially, in community pharmacy. So the governmental health policy should be modify by incorporating pharmacist and increase their job scopes in community pharmacy and there should not have any non-licensed drug shop to improve and ensure the better health service for the safety, rational use of drugs and wellbeing of the patients of our country. 4.3) Reference: 1) banglapedia.search.com.bd/ 2) pubmedcentral.nih.gov/ 3) pdfcoke.com/doc/4951691/Role-of-Pharmacists 4) The Drug Control Ordinance 1982

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