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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

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.


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eISSN: 2078-6786
print ISSN: 1608-9685