The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental
role in the effectiveness, efficiency and responsiveness of health care systems. However,
health care expenditure is a great cause for concern and many nations around the world
struggle to contain rising health care costs.
Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation
review (DUR) and disease management have emerged as control tools to ensure cost effective
selection and use of medicine. These managed care instruments are often used to determine
whether new strategies or interventions, such as the implementation of a managed medicine
reference price list, are appropriate and have "value".
The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the
private health care sector of South Africa.
The research design used in this study was retrospective, non-experimental and quantitative.
The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31
April 2003) from the central medicine claims database of Medschem&. Data was analysed
according to prevalence, cost and original (innovator) or generic medicine items. For the
purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and
"others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations,
quinolones, chloramphenicol and aminoglycosides.
The results of the empirical investigation showed the total number of medicine items claimed
during the study period amounted to 49098736 medicine items having a total expenditure of
R7150344897.00. There was a decrease in the prevalence of original (innovator) products
during the two-year period. The prevalence of generic products increased from 25.87% to
32.47%.
A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43
representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the
two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics
constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original
(innovator) products contributed 62.32% and generic products 37.68% to the total cost of all
antibiotics claimed.
It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed
(n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43)
for the two-year period. The average cost of beta-lactam items ranged between R112.88 *
69.95 and R122.18 + 81.42.
The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference
pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of
composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine
expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics
claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of
all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed
R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at
the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved.
Cost analysis indicated that it is possible to reduce health care costs by implementing strategies
with the aim to reduce medicine cost. Further research, however, is necessary and in this
regard recommendations for further research were formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nwu/oai:dspace.nwu.ac.za:10394/91 |
| Date | January 2004 |
| Creators | Coetzee, Renier |
| Publisher | North-West University |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
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