| Summary: | "Diabetes mellitus" refers to a spectrum of conditions, which all present with hyperglycaemia as
a common medical finding. Diabetes was once thought of as a single disease, but according to
Setter et a/. (2000:378), it includes a heterogeneous group of disorders that are secondary to
various genetic predispositions and precipitating factors. Type 1 diabetes mellitus (DM)
accounts for 10 to 15% of all cases of diabetes mellitus and is clinically characterised by
hyperglycaemia and a propensity to diabetic keto-acidosis. Its control requires chronic insulin
treatment. Although it may occur at any age, it most commonly develops in childhood or
adolescence and is the predominant type of diabetes mellitus diagnosed before age 30 (Beers
& Berkow, 2004). Type 2 DM is usually the type diagnosed in patients older than 30 years of
age. It is also commonly associated with obesity (Berkow, 1992:1108).
The objective of this study was to review the usage and cost of antidiabetic drugs and to
determine the influence of the pricing regulations on the cost of these drugs. This research can
be classified as retrospective and quantitative. Data were obtained from a prescription claims
database, and the study population consisted of all the antidiabetic prescriptions for the year
1 January 2004 to 31 December 2004. The one-year period was divided into three study
periods, namely January to April, May to August and September to December.
Firstly diabetes mellitus was investigated in order to understand the disease and to determine
the prevalence and treatment thereof. It was found that diabetes mellitus is a heterogeneous
disorder acquired from both genetic and environmental factors and that education for the
general population, and in particular for the patients, is the key to preventing and controlling
diabetes and reducing the complications arising from it.
Secondly managed health care, pharmaco-economics and a drug utilisation review were
investigated in order to understand these concepts. The influence of the South African
Government on health care was discussed, including the new pricing regulations of medicine in
South Africa.
Thirdly, the utilisation patterns of antidiabetic drugs were reviewed, analysed and interpreted. It
was determined that the oral antidiabetic agents are relatively less expensive than the insulins
and that they are prescribed more frequently, and secondly that the biguanides presented
almost half (49.4%, n = 116 138) of all the oral antidiabetic agents. It was also determined that
the average cost of the oral antidiabetic drugs was between 21 .O% and 28.0% lower in 2004
than in 1996 - an indication that, despite inflation, the antidiabetic drugs were less expensive in
2004 than eight years ago in 1996. It was also calculated that the total cost savings in
antidiabetic medication could have been R1 448 682.26 if the lower price of antidiabetic agents
had been implemented during the period January to April. And finally it was also determined
that further substantial "cost savings" could have been possible if all the innovator antidiabetic
products had been substituted for less expensive generic antidiabetic products.
Abstract === Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2006.
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