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Abstract

Background: Simulated patient method has been frequently utilised to explore the healthcare provider’s behaviour, services information, and its quality of services. This study was aimed to systematically identify and review studies conducted using simulated client/patients that examine medicine selling prices in various healthcare settings.

Method: We searched Pubmed, OVID, Scopus, Ebsco (Medline) and ProQuest for papers reporting on simulated patient studies, specifying drug or pharmaceutical pricings. Randomized controlled trials, non-randomized controlled trials, longitudinal studies, cohort or case–control studies, and descriptive studies were included.

Results: A total of 19 papers from 13 countries from all regions of the world were included in this systematic review. Information on certain prescription and non-prescription drugs such as buprenorphine, methadone and antibiotics were reported in four studies. Most healthcare facilities adhere to prescribed selling prices, according to the medicine selling price trend examined in this study. Only around half of the research found that medicine prices were higher than the typical selling price. Some countries that practise price control policies were found to have higher drug selling prices than those that do not.

Conclusion: Most healthcare facilities adhered to the recommended selling price. Less than half of the studies have shown that the prices of drugs sold were higher than the standard selling price. Some countries that practise price control policies were found to have higher drug selling price than those that do not practise them.

Keywords: Simulated patient, mysterious buyer, undercover actor, drug cost, affordability, price control

References

[1 ] Amaratunge S, Harrison M, Perry D, Bond C, Ceulemans M, Foulon V, et al. Assessing the reporting quality of simulated patient studies in pharmacy research using a novel checklist (CRiSP).Res Soc Adm Pharm 2021.https://doi.org/10.1016/ j.sapharm.2021.04.007.

[2] Barrows HS, Abrahamson S. The programmed patient: a technique for appraising student performance in clinical neurology. J Med Educ 1964;39:802-5.

[3] Palaian S, Buabeid M, Ashames A. Patient safety culture in handling prescriptions and inter professional collaboration practices amongst community pharmacists: an investigative simulated patient study from the United Arab Emirates. Risk Manag Health Pol 2020;13:3201-9. https://doi.org/10.2147/RMHP.S282571.

[4] Collins JC, Chan MY, Schneider CR, Yan LR, Moles RJ. Measurement of there liability of pharmacy staff and simulated patient reports of non-prescription medicine requests in community pharmacies. Res Soc Adm Pharm 2020. https://doi.org/10.1016/j.sapharm.2020.09.006.

[5] Langer B, Grimm S, Lungfiel G, Mandlmeier F, Wenig V. The quality of counselling for oral emergency contraceptive pills-A simulated patient study in German community pharmacies. Int J Environ Res Publ Health 2020;17. https://doi.org/10.3390/ijerph17186720.

[6] Langer B, Kunow C. Donorth-eastern German pharmacies recommend a necessary medical consultation for acute diarrhoea? Magnitude and determinants using a simulated patient approach. F1000Res 2019;8:1841. https://doi.org/10.12688/f1000research.21045.2.

[7] Aziz MM, Yang S, Masood I, Zhu S, Raza MA, Ji W, et al. An assessment of counseling quality provided by community pharmacies to type 2 diabetic adult patients for oral therapy: a simulated patient study from Pakistan. Endocr J 2019;66: 233-9. https://doi.org/10.1507/endocrj.EJ18-0429.

[8] Bjornsdottir I, Granas AG, Bradley A, Norris P. A systematic review of the use of simulated patient methodology in pharmacy practice research from 2006 to 2016. Int J Pharm Pract 2020;28:13-25. https://doi.org/10.1111/ijpp.12570.

[9] DeCastro F, Place JM, Allen-Leigh B, Barrientos-Gutierrez T, Dues K, Eternod Aramburu M, et al. Perceptions of adolescent ‘simulated clients' on barriers to seeking contraceptive services in health centers and pharmacies in Mexico. Sex Reprod Health 2018;16:118-23. https://doi.org/10.1016/j.srhc.2018.03.003.

[10] Abdelaziz AI, Tawfik AG, Rabie KA, Omran M, Hussein M, Abou-Ali A, et al. Quality of community pharmacy practice in antibiotic self-medication encounters: a simulated patient study in upper Egypt. Antibiotics (Berlin) 2019;8. https:// doi.org/10.3390/antibiotics8020035.

[11] Pokrajac N, Schertzer K, Poffenberger CM, Alvarez A, Marin-Nevarez P, Winstead-Derlega C, et al. Mastery learning ensures correct personal protective equipment use in simulated clinical encounters of COVID-19. West J Emerg Med 2020;21:1089-94. https://doi.org/10.5811/westjem.2020.6.48132.

[12] Hrisos S,Thomson R. Seeing it from both sides: do approaches to involving patients in improving their safety risk damaging the trust between patients and health care professionals? An interview study. PLoSOne 2013;8:e80759. https://doi.org/10.1371/journal.pone.0080759.

[13] Leiva A, Shaw M, Paine K, Manneh K, McAdam K, Mayaud P. Management of sexually transmitted diseases in urban pharmacies in the Gambia. Int JSTDAIDS 2001;12: 444-52.

[14] Patrick SW, Richards MR, Dupont WD, McNeer E, Buntin MB, Martin PR, et al. Association of pregnancy and insurance status with treatment access for opioid use disorder. JAMA Netw Open 2020;3:e2013456. https://doi.org/10.1001/jamanetworkopen.2020.13456.

[15] Piuzzi NS, Ng M, Kantor A, Ng K, Kha S, Mont MA, et al. What is the price and claimed efficacy of platelet-rich plasma injections for the treatment of knee osteoarthritis in the United States? J Knee Surg2019;32:879-85. https://doi.org/10.1055/s-0038-1669953.

[16] Alabid AHMA, Ibrahim MIM, Hassali MAA. Dispensing practices of general practitioners and community pharmacists in Malaysia-A pilot study. J Pharm Pract Res2013;43:187-9. https://doi.org/10.1002/j.2055-2335.2013.tb00251.x.

[17] Carney PA, Dietrich AJ, Freeman Jr DH, Mott LA. The periodic health examination provided to

asymptomatic older women: an assessment using standardized patients. Ann Intern Med 1993;119:129-35. https://doi.org/10.7326/00034819-119-2-199307150-00007.

[18] Chua SS, Ramachandran CD, Paraidathathu TT. Response of community pharmacists to the presentation of back pain: a simulated patient study. Int J Pharm Pract 2006;14:171-8. https://doi.org/10.1211/ijpp.14.3.0003.

[19] Hadi U, vanden Broek P, Kolopaking EP, Zairina N, Gardjito W, Gyssens IC. Cross-sectional study of availability and pharmaceutical quality of antibiotics requested with or without prescription (Over the Counter) in Surabaya, Indonesia. BMC Infect Dis 2010;10:203. https://doi.org/10.1186/1471-2334-10-203.

[20] Hussain A, Ibrahim MI, Malik M. Assessment of disease management of insomnia at community pharmacies through simulated visits in Pakistan. Pharm Pract 2013;11:179-84.

[21] Langer B, Kunow C. Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhea by community pharmacies in Germany: a simulated patient study. Pharm Pract 2019;17:1579. https:// doi.org/10.18549/PharmPract.2019.3.1579.

[22] Medford-Davis LN, Lin F, Greenstein A, Rhodes KV. I broke my ankle: access to orthopedic follow-up care by insurance status. Acad Emerg Med: Off J Soc Acad Emerg Med 2017;24: 98-105. https://doi.org/10.1111/acem.13058.

[23] MohamedIbrahim MI, Awaisu A, Palaian S, Radoui A, Atwa H. Do community pharmacists in Qatar manage a cute respiratory conditions rationally? A simulated client study. J Pharmaceut Health Serv Res 2018;9:33-9. https://doi.org/10.1111/jphs.12204.

[24] Morten Baltzer H, Helle BachØlgaard M, Trelda lC, Andersen SL, Haupt TH, Petersen J, et al. One-stop dispensing: hospital costs and patient perspectives on self-management of medication. Pharmacy 2018;6. https:// doi.org/10.3390/pharmacy6020046.

[25] Mugo PM, Duncan S, Mwaniki SW, Thiong'o AN, Gichuru E, Okuku HS, et al. Cross-sectional survey of treatment practices for urethritis at pharmacies, private clinics and government health facilities in coastal Kenya: many missed opportunities for HIV prevention. Sex Transm Infect 2013;89: 583-9. https://doi.org/10.1136/sextrans-2012-050979.

[26] Pongsupap Y, Van Lerberghe W. Is motivation enough? Responsiveness, patient-centredness, medicalization and cost in family practice and conventional care settings in Thailand. Hum Resour Health 2006;4:19.

[27] Pongsupap Y, Van Lerberghe W. Choosing between public and private or between hospital and primary care: responsiveness, patient-centredness and prescribing patterns in out patient consultations in Bangkok. Trop Med Int Health: TM&IH 2006;11:81-9.

[28] Sancar M, Tezcan E, Okuyan B, Izzettin FV. Assessment of the attitude of community pharmacists and pharmacy technicians towards diarrhea: a simulated patient study in Turkey. Trop J Pharmaceut Res 2015;14:1509-15. https:// doi.org/10.4314/tjpr.v14i8.26.

[29] Wang X, Xuan Z, Storella TH, Zhou X. Determinants of non prescription antibiotic dispensing in Chinese community pharmacies from socio-ecological and health system perspectives. Soc Sci Med 1982;2020(256):113035. https://doi.org/10.1016/j.socscimed.2020.113035.

[30] Netere AK, Erku DA, Sendekie AK, Gebreyohannes EA, Muluneh NY, Belachew SA. Assessment of community pharmacy professionals' knowledge and counseling skills achievement towards headache management: a cross sectional and simulated-client based mixed study. J Headache Pain 2018;19:96. https://doi.org/10.1186/s10194018-0930-7.

[31] Siang TC, Hassali MA, Saleem F, Alrasheedy AA, Aljadhey H. Assessment of medicines price variation among community pharmacies in the state of Penang, Malaysia by using simulated client method. J Med Market 2014;14: 115-24. https://doi.org/10.1177/1745790414564260.

[32] Madden JM, Quick JD, Ross-Degnan D, Kafle KK. Under cover care seekers: simulated clients in the study of health provider behavior in developing countries. Soc Sci Med 1997;45:1465-82. https://doi.org/10.1016/s0277-9536(97)00076-2.

[33] Aoki R, Shiragami M. Reasonable dispensing fee for patients. Yakugaku Zasshi 2009;129:247-52. https://doi.org/10.1248/ yakushi.129.247.

[34] Bjornsdottir I, Granas AG, Bradley A, Norris P. A systematic review of the use of simulated patient methodology in pharmacy practice research from 2006 to 2016. Int J Pharm Pract 2020;28:13-25. https://doi.org/10.1111/ijpp.12570.

[35] WHO. WHO guideline on country pharmaceutical pricing policies. Geneva: World Health Organization; 2015.

[36] Ball D. Working paper 3: the regulation of mark-ups in the pharmaceutical supply chain. In: Review series on pharmaceutical pricing policies and interventions; 2011.

[37] Tikkanen R, Osborn R, Mossialos E, Djordjevic A, Wharton G. International profiles of health care systems. 2020. p. 2020.

[38] Espin J, Rovira J, Labry AOd. WHO/HAI project on medicine prices and availability. In: Review series on pharmaceutical pricing policies and interventions. Andalusian School of Public Health; 2011.

[39] Medicaid. Medicaid covered out patient prescription drug reimbursement information by state. Available online: 2020. Accessed March 5 2021, https://www.medicaid.gov/ medicaid/prescription-drugs/state-prescription-drugresources/medicaid-covered-outpatient-prescription-drugreimbursement-information-state/index.html.

[40] Andi H, Luh W, Susi AK, Sherly M. Primary health care policy and vision for community pharmacy and pharmacists in Indonesia. Pharm Pract 2020;18. https://doi.org/10.18549/ PharmPract.2020.3.2085.

[41] Wind L, Dalen J, Muijtjens A, Rethans J-J. Assessing simulated patients in an educational setting: the MaSP (Maastricht assessment of simulated patients).Med Educ 2004;38: 39-44. https://doi.org/10.1111/j.1365-2923.2004.01686.x.

[42] Kloos H, Chama T, Abemo D, Tsadik KG, Belay S. Utilization of pharmacies and pharmaceutical drugs in Addis Ababa, Ethiopia. Soc Sci Med 1986;22:653-72. https://doi.org/10.1016/0277-9536(86)90038-9.

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