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

• Main Authors: Jade C. Bouwer, Shereen Govender, Lesley J. Robertson
• Format: Article
• Language: English
• Published: AOSIS 2021-01-01
• Series: South African Journal of Psychiatry
• Subjects: essential medicines; prescribing patterns; rational use; psychopharmacology; anatomical therapeutic and chemical classification/defined daily doses
• Online Access: https://sajp.org.za/index.php/sajp/article/view/1552
• ISSN: 1608-9685; 2078-6786

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.