Status of Ayurvedic Medicines Available in the Markets of Nepal

Abstract

Background: A large number of Ayurvedic medicines have been being used in Nepal since the time immemorial. The popularity as well as market of Ayurvedic medicines has been increasing day by day. Though the raw materials for most of the Ayurvedic medicines are available within Nepal, most of the medicines in Nepalese market are imported from outside the country. On the other hand, as there is no laboratory facility or well established mechanism for standardization and monitoring so far within the country to assure and control the quality of such medicines, many questions are raised regarding the quality, safety and efficacy of these medicines. Hence, substandard Ayurvedic medicines also might have been brought to the market which not only defames Ayurvedic physicians and decreases faith to the Ayurveda but also creates a risk of public health hazards. It requires very urgent and serious multi-dimensional attempts by concerned authorities and other stakeholders to manage and regulate this situation. In this context, present study was designed to identify and explore some of the issues and problems of Ayurvedic medicines available in the market of Nepal. Methods: Three cities of Kathmandu valley and six other densely populated cities to represent all development regions were selected on the basis of number of Ayu medicine stores and transaction of medicines in those cities. Lists of top selling 10 Ayu medicines were collected from 87 medicine stores and detail list of information was collected from 26 stores among those. Altogether one hundred and twenty seven samples of the top selling five classical Ayu medicines representing various packing sizes and manufacturers were collected from retailers in Kathmandu valley. Observation and study on packing, label and properties of the selected five classical medicines were conducted by direct observation and using some available tools and methods/measures like measuring tape, Vernier caliper, measuring cylinder, pan balance, electronic weighing machines, incubator, water bath, pH meter, refractometer and digital camera, as applicable. Comparative studies on various samples were noted on the spot immediately after observation/test using specific formats/sheets and code. All the data were put into computer, edited as required, processed and analyzed with MS-excel and SPSS 10.0. Results: The research found 1029 items of Ayu medicines among which 235 (22.84%) were only Nepali (manufactured within the country), 669 (65.01%) were only Indian and the remaining 125 (12.15%) were both Nepali and Indian manufacturers. Similarly, classical and patent medicines were found to be 458 (44.51%) and 571 (55.49%) respectively. The study also identified 201 Ayu medicines as top selling items among 870 names collected from 87 medicine shops. The study revealed that there is no basis or similar criteria followed for packing and labeling of Ayu medicines available in the market of Nepal, whether manufactured by domestic or foreign manufacturers. The research also found marked differences in colour, taste, smell, fineness, pH, unit dose, etc. within the five classical medicines. There were big variations in quality among the same medicines manufactured by different manufacturers and even in different batches of the same manufacturer in some cases. Conclusions: Although the study found so many variations regarding the production, prescription and marketing of Ayu medicines, they are still popular in the Nepalese as well as global markets. The efficacy and popularity of these medicines can be further increased if the quality and safety measures are assured through the development and adoption of standardization and quality control mechanisms.