The Effect of Customer Knowledge on Antimalarial Drug Quality

Anne Fitzpatrick, University of Michigan

Recent empirical work finds that as many as one-third of anti-malarial drugs in sub-Saharan Africa are counterfeit. These substandard medicines contribute to increased mortality and drug resistance. I conduct a randomized audit study with mystery shoppers at 447 drug shops in Uganda to investigate whether low levels of customer knowledge contribute to counterfeit rates or affect the price. Two mystery shoppers purchase anti-malarial drugs from each shop according to randomly assigned scripts. The scripts vary according to whether the shopper knows the disease is malaria or asks for a diagnosis; then the shopper either knows for the first-line treatment or instead asks for a product recommendation. Purchased drugs are tested for quality and linked with shop surveys and customer exit interviews. Preliminary results indicate that shoppers reciting the script that signals the least amount of knowledge are asked to pay the least amount of money; quality results are forthcoming.