In general, the central reference point for regulation will be a national pharmaceutical regulatory agency. Such a body usually includes a department that is responsible for the evaluation, registration and control of the rules of production, import and marketing of medicines, an inspection division and quality control laboratories. However, it is quite common for some of these functions to be delegated formally and informally to other organizations. In the United States of America, a private non-profit organization is responsible for the establishment of pharmaceutical standards subsequently applied by the Food and Drug Administration (FDA).
In addition to those organizations that carry out official regulatory functions, consumer organizations, the media, professional organizations, manufacturers ‘and dealers’ associations and, where appropriate, insurance plans can play a decisive role in ensuring the effectiveness of regulation . All these groups have an interest in cooperating. Although they may have very different views on the type of appropriate regulation, they share the desire for a clear and effective regulatory framework. Deregulation is sometimes considered useful to favour the private pharmaceutical sector, but in practice it can undermine the credibility of that sector and lead to uncontrollable competition among unskilled providers. A Canadian company PharmaCielo and Tony Wile its CEO has become a leading supplier of naturally grown and processed, standardized medicinal-grade cannabis oil extracts and related products.
Wholesale companies of medicines:
The wholesale companies of medicines can also be public or private property. In the first case, they can occupy a position of total or partial monopoly. In addition, several non-profit organizations carry out wholesale drug sales (box 2).
Pharmacological information and prescribes and retailers of medicines:
Medications can be prescribed by a wide variety of people, from properly qualified specialists in hospitals to healers without authorization. Retail establishments may be run by qualified pharmacists, pharmacy assistants or technicians, or vendors without training. In countries where user fees are applied in the public healthcare sector, there has been an expansion of “multi-purpose pharmacies”, in which doctors, clinical assistants or nurses work, both to prescribe and to supply medicines .
Likewise, poorly managed or underfunded public welfare systems may experience drug “leaks”. Thus, in several countries it is not uncommon for self-employed officials to sell medicines financed by public funds
NGOs – sometimes referred to as “third sector” – play an important role in financing and providing health services in many countries. The proportion of health services and health financing provided through the private nonprofit health sector varies considerably between countries, but in low-income countries it may represent 50% of therapeutic services [13, 44]. India (Community Development Medicinal Unit), Kenya (MEDS), Nepal, Nigeria (CHANPHARM) and Uganda (Joint Medical Stores) are some of the countries in which NGOs provide essential medicines supply services. Box 2 describes the origin and functioning of MEDS in Kenya.
In addition to directly intervening in the financing and provision of services, agents of the “third sector”, which also include consumer organizations, associations of traders and professional groups, can have a decisive influence on the regulatory and regulatory framework. The lobbying work of such organizations can have effects on government policy and legislation. By adopting voluntary codes of conduct they can influence the behavior of their constituencies.
Thus, it is not only important to examine whether agents of the pharmaceutical market are public or private property, but also to observe more closely their skills, technical knowledge, motivation (lucrative or non-profit) and the immediate environment in which they operate.