Why do people end up buying fake medicines online? A thematic analysis of newspaper articles
Authors: Donyai P , Patel N , Almomani H 
Published: March 2021

Abstract

Introduction
The internet provides a platform for both legal and illegal online suppliers of medicines, which are sometimes difficult to distinguish between. Therefore, consumers accessing the internet are at risk of purchasing fake medicines from illegal suppliers. This is particularly problematic when people buy Prescription-Only Medicines (POMs) from the internet, despite an abundance of governmental campaigns 1. This under-researched issue has nonetheless been highlighted in news articles in the past few years which are a potential source of information, albeit informally, about how and why people end up buying fake medicines via the internet. This study is phase-1 of a larger study that aims to develop a questionnaire using the Theory of Planned Behaviour (TPB)2 to examine risky online purchasing of medicines to help focus future campaigns.

Aim
The aim is to identify the factors that lead people to inadvertently buy fake POMs online by examining newspaper articles covering this topic and categorising the findings according to the TPB’s indirect measures; namely, behavioural beliefs, normative beliefs, and control beliefs.

Methods
Newspaper articles were collected from the electronic database “ProQuest” using a series of search words for retrieving newspaper articles covering the purchasing of fake medicines online throughout the world. The search was limited to articles published from April-2019 to March-2020 to retrieve relevant articles in this fast-developing field. Articles that did not focus on POMs or only covered the supply side (e.g. efforts to combat illegal suppliers) were excluded. After evaluating each article using the inclusion/exclusion criteria, 52 articles remained. Thematic analysis was employed to analyse the newspaper articles against the TPB. The NVivo software program (version 12) was used to aid the generation of the themes.

Results
Using thematic analysis, 12 themes were generated and categorised according to the TPB’s indirect measures as follows. The behavioural beliefs (i.e. advantages and disadvantages of buying medicines online) included a perception of convenience, low price, privacy of the purchase, potential harmful effect, low quality, and lack of medical oversight. The normative beliefs (i.e. social factors influencing decisions to buy medicines online) included endorsement by influencers, deceptive marketing by suppliers, as well as organizations fighting the fake supply chain. The control beliefs (i.e. what encourages or stops purchasing medicines online) included encountering medicines shortages, outbreak of pandemic diseases, and accessibility issues.

Conclusion
This newspaper-analysis study created an initial map of ideas for why consumers might inadvertently buy fake POMs online highlighting the complexity of personal beliefs as well as a range of external circumstances. Further exploring these factors provides the basis for future campaigns for changing/controlling the purchasing of fake medicines online. Although the newspaper articles offer a wide range of data and provide different points of view, the validity of their content cannot be proven and are taken at face value. Therefore, the next step for this study is to complete semi-structured interviews with consumers purchasing medicines online (Phase-2) to verify the themes generated in Phase-1 before developing a larger questionnaire study (Phase-3).

References
1. HM Government. Protect your health when buying medicines online. Accessed 08 October 2020 from: https://fakemeds.campaign.gov.uk/
2. Ajzen, I. The theory of planned behaviour. Organizational behaviour and human decision processes. 1991; 50 (2),179–211.