Boyce D, Bartlett G
TPS Drug Information Centre, Health Economics Section, Johannesburg.
S Afr Med J. 1990 Aug 4;78(3):147-51.
Medicine prices in South Africa have increased significantly in recent years. Furthermore, a consideration of expenditure on medicines by medical schemes shows that this component of health care costs had grown to 26.1% in 1988, which is high by comparison with other Western economies. The use of generic medicines offers one possible solution to rising expenditure. For savings to be optimised, however, generics need to be used on a planned and structured basis. The maximum medical aid price (MMAP) system of the Pharmaceutical Society of South Africa provides such a programme. MMAP is a programme through which certain medical schemes elect to pay only a specified maximum price for off-patent products that have generic equivalents. Although MMAP does not require substitution by generic medicines, it does have the effect of encouraging their use. Two case studies measuring the savings that can be achieved through adoption of MMAP by medical schemes are reviewed. Although they differ in their respective methodologies, their results are consistent and show that savings of about 9.3% were possible in 1989. Medical schemes with higher proportions of older members tend to show greater savings. The studies also show that the potential for achieving savings through the use of MMAP increases with the passage of time.
近年来，南非的药品价格大幅上涨。此外，对医疗计划药品支出的一项研究表明，1988年医疗保健成本的这一组成部分已增长到26.1%，与其他西方经济体相比，这一比例很高。使用非专利药品为支出增加提供了一种可能的解决方案。然而，为了实现最大程度的节省，需要有计划、有组织地使用非专利药品。南非制药协会的最高医疗救助价格（MMAP）系统提供了这样一个方案。MMAP是一项计划，通过该计划，某些医疗计划选择只为有非专利等效物的专利过期产品支付规定的最高价格。虽然MMAP并不要求用非专利药品替代，但它确实有鼓励使用非专利药品的作用。本文回顾了两项案例研究，这些研究衡量了医疗计划采用MMAP所能实现的节省。尽管它们各自的方法不同，但结果是一致的，表明1989年可能节省约9.3%。老年成员比例较高的医疗计划往往节省更多。研究还表明，随着时间的推移，通过使用MMAP实现节省的潜力会增加。
