Abstract

BOUWER, Jade C.; GOVENDER, Shereen  and  ROBERTSON, Lesley J.. 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. S. Afr. j. psyc. [online]. 2021, vol.27, n.1, pp.1-10. ISSN 2078-6786.  http://dx.doi.org/10.4102/sajpsychiatry.v27i0.1552.

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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