| Summary: | A large number of people all over the world suffer from skin conditions. Dermatological
problems comprise about 10 % of a general practitioner's caseload and probably more for
pharmacists. The literature furthermore emphasises that skin diseases are becoming a significant
problem in the developing world. There is a need to establish an effective method to achieve
good health and quality of life for patients with dermatological problems.
The general objective of this study was to investigate the usage patterns and cost of
dermatological products in the private health care sector of South Africa by using a medicine
claims database. The focus was specifically on dermatological products with a prevalence of
more than 10 % in the database.
A quantitative retrospective drug utilisation research design was used to evaluate the usage
patterns and costs of dermatological products in three four-monthly intervals of 2001 and 2004.
Data were analysed by using the Statistical Analysis System, 9.1 (SAS). The dermatological
product groups for this study were antibacterial and antifungal drugs, corticosteroids and anti-acne
products and were analysed according to the MIMS classification.
Of all analysed prescriptions issued only 8.57 % (n = 126 447) during 2001 (N = 1 475 380) and
6.82 % (n = 177 122) during 2004 (N = 2 595 254) consisted of dermatological products. Of the
total number of products prescribed, the dermatological products constituted 4.77 %I
(n = 140 701) for 2001 (N = 2 95 1 326) and 3.77 % (n = 199 976) for 2004 (N = 5 305 882). The
total cost of the dermatological products was 4.98 % (n = R18 913 889.92) of the total cost of all
medicine products during 200 1 (N = R379 708 489). During 2004 (N = R66 1 223 146) the total
cost of dermatological products was 4.09 % (n = R27 025 540.48) of the total cost of all
medicine products in the database. The cost-prevalence index for 2001 and 2004 respectively
showed that the dermatological products were relatively expensive with values of 1.03 and 1.09.
The antibacterial and antifungal drugs, corticosteroids and anti-acne products represented 91.92
% (n = 129 336) and 87.97 % (n = 175 9 16) of all dermatological products during 2001 (N = 140
701) and 2004 (N = 199 976), respectively. These dermatological groups named above
represented 91.57 % (n = R17 319 645.61) and 85.85 '% (n = R23 200 594.71), respectively, of
the total cost of dermatological products during 200 1 (N = R18 9 13 889.92) and 2004 (N = R27
025 540.48).
It was further found that the majority of dermatological products prescribed during the research
periods was innovator products. The prevalence of innovator products for 2001 was 86.17 % (n
= 12 1 249) with a total cost representing 94.16 % (n = R17 809 603.12). For 2004 the prevalence
was 82.33 % (n = 164 640) with a total cost representing 91 .O1 '% (n = R24 594 923.72) of all the
dermatological products prescribed. The number of innovator and generic products claimed
during 2001 amounted to 86.17 % (n = 12 1 249) and 13.83 % (n = 19 452) respectively of the
total number of products claimed (N = 140 701). During 2004 the number of innovator and
generic products represented respectively 82.33 % (n = 164 640) and 17.67 O/o (n = 35 336) of the
total number of products claimed (N = 199 976).
The prevalence in the use of the dermatological products during 2004 increased with 55.25 %
from January to April versus September to December. The cost-prevalence index indicated that
the dermatological products were relatively expensive during January to August 2004. During
September to December 2004 the cost-prevalence decreased and indicated that dermatological
products became inexpensive.
The average cost of dermatological products during the 2004 study period showed that the cost
decreased. January to April (before implementation of the new single exit price structure) was
compared to September to December (after implementation of the new single exit price
structure). This comparison indicated that the average cost decreased by 22.88 %.
It can be summarised that the average cost in the last study period decreased due to the changed
price structure. The innovator products' prevalence was high and therefore more generics are
needed in dermatology. If more generics are used the total cost of dermatological products
might also decrease. The number of dermatological prescriptions increased towards 2004, but
this may be because of more members or more medical aids claiming through this database. === Thesis (M.Pharm.)--North-West University, Potchefstroom Campus, 2006.
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