Pharmacists Perceptions of the Development of Herbal Medicines in Iran Asghari G. Faculty of Pharmacy and Pharmaceutical Sciences Isfahan University of Medical Sciences, Isfahan, I.R.Iran

Objectives Identify pharmacists overall assessments of the WHO-TRM Strategy components influencing the development of herbal medicine market in Iran. In Iran, although the sale of herbal medicine is growing, at present its share in the drug market is <5%.

Methods:elements assessed Access: affordibility, supply, distrubution, market expansion, health insurance coverage, price Rational use: provider training, consumer information, public information, commercial advertizing, student education Safety, efficacy, quailty: pharmacovigilance, packeging and lebelling, quality assurance, clinical trial, new dosage form Regulation: registration , integration to NHS, legal consideration, licensing, auditing

Questionnaire used The 20 questions consisted of 5 items addressing safety, efficacy, and quality of herbal medicines, 5 items about the rational use, 5 items about the access to herbal medicines, and 5 items about regulation. A five – point Likert rating scale was used for the final 20-item with choices strongly agree, agree, somewhat agree, disagree, and strongly disagree.

Subjects 72 community retail pharmacists practicing in Isfahan city in private pharmacy were participate to complete the survey. Data were collected by self-administered questionnaire. After their continuing education course, pharmacists were asked to complete a written survey evaluating elements that can influence the development of herbal medicine in Iran .

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Results: In the safety, efficacy and quality section, there were significant differences between efficacy and others. The results showed that pharmacists believe poor efficacy in herbal product negatively influence their market. There was a significant difference in access section between cost and availability. The results demonstrated that the pharmacist perceptions of development of herbal medicines vary from access and regulation items to safety, efficacy, quality and rational use items.

Conclusion : Since this data were collected to assess the perception of specific city pharmacist, they may not necessarily show the reality and may not nationally applicable or acceptable. Iran health system needs to evaluate their herbal medicine market by various methods in order to promote their herbal medicine market to meet health care demands.

Challenging methodological issues: Reliability and validity in the collection of data: pretest group, clarity, wording, representative use of questionnaires in multi cultural society, (questions of quality, rational use, safety are strongly determined by the cultural context.)

Complexity of the herbal medicines use: Influence of social factors, cultural factors, definition of health ( herbal medicine is the best solution) Limitation: what people think or what they are willing to report is not necessarily the same as what actually happens.

Question should be included in future research: Public Demand Marketing mechanisms Level and distribution of wealth in the country Affordability of professional care Affordability of traditional herbal materials Free access to formal medical care

Number of pharmacies number of traditional healer availability of professional care Availability of drug Availability of traditional market

Behavioral factors: pharmacist dispensing behavior patient compliance illness behavior attitude of health professionals attitude to health Cultural values: