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

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.

Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data

“…A secondary analysis of the Gauteng Department of Health pharmaceutical database was conducted using the ATC and DDD methodology. A brief outline of the methods is provided here; the reader is referred to Bouwer et al 15 for a more detailed explanation.…”

“…One medicine in class N06B (caffeine citrate injection) that is not used in the treatment of MNS disorders was excluded from this analysis, although it was captured in the data-collection process. 15 …”

“…The study was conducted in partial fulfilment of a master’s in medicine degree. 14 The costs and DDDs of each medicine procured are reported in Bouwer et al, 15 the first publication from the study. In this article, the evaluation of medicines procured for MNS disorders in proportion to the population served at each service level is presented.…”