Further Potential Savings Attributable to Maximum Generic Substitution of Antidepressants in South Africa: a Retrospective Analysis of Medical Claims

The main objective of the study was to calculate potential cost savings that could have been generated by maximum generic substitution of antidepressants within the private health care sector of South Africa from 2004 to 2006. Data on computerized medicine claims of patients receiving one or more antidepressants during three consecutive years (i.e. 2004; 2005 and 2006) were elicited from a South African pharmaceutical benefit management company. The total study population consisted of 292 071 items (N = 5 982 869) on 273 673 prescriptions (N = 5 213 765) at a total cost of R56 183 697.91 (N = R1 346 210 929.00). A quantitative; retrospective drug utilization review was conducted; and data were analyzed using the Statistical Analysis Systemr programme. Potential cost savings were computed for criteria-eligible substances in the study population. Generic medicine constituted 58.7(N = 292 071) of all antidepressants claimed; at a total cost of 28.2(N = R1 346 210 929.00) of all incurred costs. With total substitution of the average price of all criteria-eligible innovators; a potential saving of 9.3(N = R56 183 697.91) of the actual antidepressant cost over the study period was calculated. In developing countries with limited health care resources; generic medicines can be cost-saving treatment alternatives

Prescribing patterns of medicine classified as 'antidepressants' in South African children and adolescents

The main objective of this study was to characterise prescribing patterns of medicine classified as 'antidepressants' (hereafter simply referred to as antidepressants) in children and adolescents in the private health care sector of South Africa. A retrospective drug utilisation design was used to identify patients aged 19 years and younger from a South African pharmaceutical benefit management company's database; whom were issued at least one antidepressant between 1 January 2006 and 31 December 2006. Prescribed daily dosages (PDDs) were calculated using the Statistical Analysis Systemr program. A total of 1 013 patients received a mean number of 2.88 (SD 3.04) prescriptions per patient. Females received more prescriptions than their male counterparts; with the highest prevalence in the 15 = 19 years age group. The pharmacological groups most prescribed were the selective serotonin reuptake inhibitors (43.0) and the tricyclics (42.7); with imipramine (22.04) and amitriptyline (19) as the most commonly prescribed drugs. Approximately 30(n = 2 300) of all antidepressants in the study population were prescribed off-label. Amitriptyline and clomipramine were prescribed at daily dosages higher than recommended in children and adolescents aged 9 = 15 years. Lithium; trimipramine; trazodone and sulpiride were prescribed at sub-therapeutic dosages in adolescents. This study provided insight in the prescribing patterns of medicine classified as antidepressants in South African children and adolescents. These drugs; however; have many indications. Further research is needed to determine reasons why specific drugs are prescribed in this population

Investigation into the Prescribing Patterns and Cost of Antidiabetic Medicine in South Africa

"The general objective of this study was to investigate the prescribing patterns and cost of antidiabetic medicine in the private health care sector in South Africa by using a medicine claims database. A quantitative; retrospective drug utilisation study was performed on data for the year 2004. Oral antidiabetic medicine accounted for 81 (n =143 447) and 39 (R29 734 360.61) respectively of the total prevalence and cost of all antidiabetic products prescribed. Metformin was the most frequently prescribed oral antidiabetic medicine; with an average cost of R58.42 (SD = 31.78). The three most frequently prescribed classes of insulin (insulin lispro; soluble insulin and isophane; and soluble insulin aspartame and protamine) together accounted for 63 of all the insulin prescribed; and 67 of the total cost of prescribed insulin. Almost 39 (n = 62 717) of the ""combination therapy"" prescriptions were for a sulfonylurea in combination with a biguanide plus at least one other antidiabetic product. A trend towards combination therapy away from monotherapy was observed. Prescribed Daily Doses (PDDs) calculated for oral antidiabetic medicines were more or less in line with recommended treatment guidelines. Drug utilisation review studies thus provide valuable insight into the treatment of diabetes - indicating areas of possible over- and under usage; providing decision-makers with critical information to curb unnecessary costs."