Original Research

Medicines used in mental, neurological and substance use disorders in Gauteng, South Africa: A secondary analysis of the 2017–2018 provincial pharmaceutical database, Part 1

Jade C. Bouwer, Shereen Govender, Lesley J. Robertson
South African Journal of Psychiatry | Vol 27 | a1552 | DOI: https://doi.org/10.4102/sajpsychiatry.v27i0.1552 | © 2021 Jade C. Bouwer, Shereen Govender, Lesley J. Robertson | This work is licensed under CC Attribution 4.0
Submitted: 28 April 2020 | Published: 28 January 2021

About the author(s)

Jade C. Bouwer, Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
Shereen Govender, National Department of Health, Pretoria, South Africa
Lesley J. Robertson, Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Access to essential medicines is an integral part of effective health systems. Analysis of medicine procurement may assist with ensuring sustainable access.

Aim: To describe the profile and cost of medicines procured for managing mental, neurological and substance use (MNS) disorders during the 2017–2018 financial year.

Setting: The study was conducted in the public health sector in the Gauteng province, South Africa.

Method: A secondary analysis of the Gauteng Medical Stores Administration System database was performed. Medicine procurement for managing MNS disorders was analysed descriptively by using the World Health Organization’s Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Procurement of each medicine was evaluated in local currency (Rands) and in DDD/1000 population served. The District Health Information System was used to estimate population served.

Results: Of the total provincial medicines expenditure in 2017–2018, 3.73% was for MNS disorders, which is similar to the spending on cardiovascular (4%) and respiratory (3%) disorders. Antivirals for systemic use comprised 44% of the total expenditure, followed by vaccines at 13%. Of the medicines for MNS disorders, 32.5% of DDDs procured were for anti-epileptics (ATC N03A) at 47.5% of expenditure; 26.2% of DDDs were for antipsychotics (ATC N05A) at 30.9% of expenditure; and antidepressants accounted for 30.8% of DDDs at 6% of expenditure.

Conclusion: Less than 4% of provincial medicines expenditure was on medicines for MNS disorders, of which almost 78.4% of expenditure was on anti-epileptics and antipsychotics. With limited financial resources, evaluation of procurement patterns raises awareness of relative costs.


Keywords

essential medicines; prescribing patterns; rational use; psychopharmacology; Anatomical Therapeutic and Chemical classification/Defined Daily Doses

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