An Evaluation of the Reflective Constructs Influencing Community Pharmacists’ Decision-to-Procure from Pharmaceutical Suppliers: A Structural Equation Modeling Study

Abstract

In low-and middle-income countries, patients’ access to affordable medicines is a perennial challenge at all levels of healthcare delivery. Community pharmacists are expected to bridge the supply and demand gap. Unlike the plethora of studies done at the hospital and government institutions level, there is a paucity of empirical evidence on the factors influencing medicine procurement decisions from supply channels at the community pharmacy level. The study aimed to investigate the influence of community pharmacists’ professional and entrepreneurial considerations on their decision-to-procure from medicine suppliers. A cross-sectional survey which adopted a self-administered questionnaire approach to obtain primary data from randomly sampled respondents (N=398) from three purposively selected states in southwestern, Nigeria. Structural equation modeling (SEM) methodology was used to test the hypothesized model at p<0.05. The study revealed acceptable model fit and validity measures for measurement and structural models. Cost and profitability factors were significant predictors of decision-to-procure compared to service and product quality factors among respondents [β=0.343, p=0.001 vs. β=0.044, p=0.606]. Product selection had a positive moderating effect on cost and profitability factors [t=1.980, p=0.048] and a negative directional effect on service and product quality factors in the hypothesized model [t=-2.960, p=0.003]. Community pharmacists should balance financial considerations with a professional focus to ensure patients’ access to quality and affordable medicines. Study outcomes suggest the development and implementation of universally acceptable guidelines on medicine procurement in community pharmacy settings in low-and middle-income countries. The study validated the SEM model for evaluating priorities influencing community pharmacists’ buying decisions. To the best of the authors’ knowledge, this is the first study to use the SEM framework to explore factors informing drug procurement decisions from the community pharmacists’ perspective in low-and middle-income countries.