Moodley Rajatheran, Suleman Fatima
Discipline of Pharmaceutical Sciences, School of Health Sciences, Westville Campus, University of KwaZulu-Natal, Private Bag X54001, Durban, KZN 4000 South Africa.
J Pharm Policy Pract. 2020 Aug 7;13:28. doi: 10.1186/s40545-020-00232-4. eCollection 2020.
Following the democratic elections in 1994 the South African private pharmaceutical services were mostly in metropolitan centred with a scattering of pharmacies in less densely populated areas. The Government introduced regulations relating to the ownership and licensing of pharmacies on the 25th of April 2003 to improve access to pharmaceutical services by removing ownership restriction to only pharmacists.
To assess the outcomes of the policy implementation in improving access to pharmacies.
The register of pharmacies at the South African Pharmacy Council was analysed from 1994 to 2014. Each registration was assigned GPS coordinates using Q-GIS(V3.6) and mapped per province at a district level, following clean-up and verification of the register. New registrations were also categorised as either corporate or independent pharmacy. Population census was obtained from Statistics South Africa and used to determine the number of pharmacies per 100,000 population.
Number of active pharmacies; Number of independent pharmacies; number of pharmacies in each district.
The number of active pharmacies increased from 1624 at the end of 2003 to 3021 by 2014. The closure rate decreased from 137 to 86 pharmacies per year post regulations, a 37.23% reduction with a net gain of approximately 127 pharmacies per year. About 38.30% of all pre-2003 pharmacies (622 of 1624) closed by 2014. The population increase in the study period was approximately 20.66% but the overall growth of pharmacies was only 1.88 pharmacies per 100,000 population (3.55 to 5.43). Following the regulations in 2004, 23.9% of pharmacies active within the system closed between 2004 and 2014, of which, 91.7% of them were independent pharmacies.
Opening up of pharmacy ownership in South Africa increased the number of pharmacies in the country but did not result in increased access in previously less populated areas. There was still clustering of pharmacies in a well resourced areas, with a steady growth in corporate pharmacy (35%) ownership.
1994年民主选举后，南非的私营制药服务大多集中在大都市，人口密度较低地区仅有少数几家药店。2003年4月25日，政府出台了有关药店所有权和许可证的规定，通过取消仅允许药剂师拥有药店的限制来改善药品服务的可及性。
评估该政策实施在改善药店可及性方面的效果。
分析了1994年至2014年南非药房理事会的药店登记册。在对登记册进行清理和核实后，使用Q-GIS（V3.6）为每个登记信息分配GPS坐标，并按省份在地区层面进行绘制。新登记的药店也被归类为连锁药店或独立药店。从南非统计局获取人口普查数据，用于确定每10万人口的药店数量。
活跃药店数量；独立药店数量；每个地区的药店数量。
活跃药店数量从2003年底的1624家增加到2014年的3021家。法规实施后，药店关闭率从每年137家降至86家，下降了37.23%，每年净增约127家药店。到2014年，2003年前所有药店中的约38.30%（1624家中的622家）关闭。研究期间人口增长约20.66%，但药店的总体增长仅为每10万人口1.88家（从3.55家增至5.43家）。2004年实施相关规定后，2004年至2014年期间系统内活跃的药店中有23.9%关闭，其中91.7%为独立药店。
南非放开药店所有权增加了该国的药店数量，但并未使此前人口较少地区的可及性得到提高。资源丰富地区仍存在药店聚集现象，连锁药店所有权稳步增长（35%）。
