Extracting low-cost signals of perceived quality control in community pharmacies: a simulated client study of contraceptive dispensing in Bogotá

We determine whether community pharmacies in Bogota produce differential quality signals, and if they are related to an objective quality measure: the compliance with prescription rules. In this quantitative descriptive study, we use the simulated client methodology (N=298) to assess whether Bogota’s community pharmacies comply with prescription rules related to contraceptive medications. Simulated clients requested a specific brand of contraceptive pills for their young sister. We find that one per cent of the staff at the pharmacy asked for a prescription when the pills were requested. Five per cent of the staff made additional questions that signal knowledge or interest in correct delivery of pills (e.g., the sister’s age or if the pills were prescribed for acne). We do not find differences by socio-economic level or type of ownership of the pharmacy (i.e., large firm versus independent) on the request of prescriptions or further questions about the pills. Concerning the aesthetic signals of quality, independent pharmacies were less likely to portray a diploma of their chemist, and the likelihood that their staff wore white coats was also lower; however, those signals are not associated with the actual quality measure. We conclude that Bogota’s community pharmacies differentiation is based on simple signals associated with a professional image, but not with actual procedures that guarantee the safety of consumers.