{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:11:52Z","timestamp":1788412312633,"version":"build-2803163510"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,13]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Substandard and falsified medicines are harmful to patients, causing prolonged illness, side effects, and preventable deaths. Moreover, they have an impact on the health system and society more broadly by leading to additional care, higher disease burden, productivity losses and loss of trust in health care. Models that estimate the health and economic impacts of substandard and falsified medicines can be useful for regulators to contextualize the problem and to make an economic case for solutions. Yet these models have not been systematically catalogued to date. We reviewed existing models that estimate the health and economic impact of substandard and falsified medicines to describe the varying modeling approaches and gaps in knowledge. We compared model characteristics, data sources, assumptions, and limitations. Seven models were identified. The models assessed the impact of antimalarial (<jats:italic>n<\/jats:italic> = 5) or antibiotic (<jats:italic>n<\/jats:italic> = 2) quality at a national (<jats:italic>n<\/jats:italic> = 4), regional (<jats:italic>n<\/jats:italic> = 2), or global (<jats:italic>n<\/jats:italic> = 1) level. Most models conducted uncertainty analysis and provided ranges around potential outcomes. We found that models are lacking for other medicines, few countries\u2019 data have been analyzed, and capturing population heterogeneity remains a challenge. Providing the best estimates of the impact of substandard and falsified medicines on a level that is actionable for decision-makers is important. To enable this, research on the impact of substandard and falsified medicines should be expanded to more medicine types and classes and tailored to more countries that are affected, with greater specificity.<\/jats:p>","DOI":"10.4269\/ajtmh.21-1133","type":"journal-article","created":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T09:12:06Z","timestamp":1657789926000},"page":"14-20","source":"Crossref","is-referenced-by-count":12,"title":["Modeling the Health and Economic Impact of Substandard and Falsified Medicines: A Review of Existing Models and Approaches"],"prefix":"10.4269","volume":"107","author":[{"given":"Sachiko","family":"Ozawa","sequence":"first","affiliation":[{"name":"Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen R.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jude I.","family":"Nwokike","sequence":"additional","affiliation":[{"name":"Promoting the Quality of Medicines Plus (PQM+) Program, U.S. Pharmacopeial Convention, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souly","family":"Phanouvong","sequence":"additional","affiliation":[{"name":"Promoting the Quality of Medicines Plus (PQM+) Program, U.S. Pharmacopeial Convention, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"A Study on the Public Health and Socioeconomic Impact of Substandard and Falsified 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