Bouwer Jade C, Govender Shereen, Robertson Lesley J
Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
National Department of Health, Pretoria, South Africa.
S Afr J Psychiatr. 2021 Jan 28;27:1552. doi: 10.4102/sajpsychiatry.v27i0.1552. eCollection 2021.
Access to essential medicines is an integral part of effective health systems. Analysis of medicine procurement may assist with ensuring sustainable access.
To describe the profile and cost of medicines procured for managing mental, neurological and substance use (MNS) disorders during the 2017-2018 financial year.
The study was conducted in the public health sector in the Gauteng province, South Africa.
A secondary analysis of the Gauteng Medical Stores Administration System database was performed. Medicine procurement for managing MNS disorders was analysed descriptively by using the World Health Organization's Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Procurement of each medicine was evaluated in local currency (Rands) and in DDD/1000 population served. The District Health Information System was used to estimate population served.
Of the total provincial medicines expenditure in 2017-2018, 3.73% was for MNS disorders, which is similar to the spending on cardiovascular (4%) and respiratory (3%) disorders. Antivirals for systemic use comprised 44% of the total expenditure, followed by vaccines at 13%. Of the medicines for MNS disorders, 32.5% of DDDs procured were for anti-epileptics (ATC N03A) at 47.5% of expenditure; 26.2% of DDDs were for antipsychotics (ATC N05A) at 30.9% of expenditure; and antidepressants accounted for 30.8% of DDDs at 6% of expenditure.
Less than 4% of provincial medicines expenditure was on medicines for MNS disorders, of which almost 78.4% of expenditure was on anti-epileptics and antipsychotics. With limited financial resources, evaluation of procurement patterns raises awareness of relative costs.
获得基本药物是有效卫生系统的一个组成部分。对药品采购进行分析有助于确保可持续的获取。
描述2017 - 2018财政年度用于管理精神、神经和物质使用（MNS）障碍的采购药品的概况和成本。
该研究在南非豪登省的公共卫生部门进行。
对豪登省医疗用品管理系统数据库进行二次分析。采用世界卫生组织的解剖治疗化学/限定日剂量（ATC/DDD）方法对用于管理MNS障碍的药品采购进行描述性分析。每种药品的采购情况以当地货币（兰特）和每1000名服务人口的DDD数进行评估。利用地区卫生信息系统估算服务人口。
在2017 - 2018年省级药品总支出中，3.73%用于MNS障碍，这与心血管疾病（4%）和呼吸系统疾病（3%）的支出相似。全身用抗病毒药物占总支出的44%，其次是疫苗，占13%。在用于MNS障碍的药品中，采购的DDD数的32.5%用于抗癫痫药（ATC N03A），占支出的47.5%；26.2%的DDD数用于抗精神病药（ATC N05A），占支出的30.9%；抗抑郁药占DDD数的30.8%，占支出的6%。
省级药品支出中用于MNS障碍药品的比例不到4%，其中近78.4%的支出用于抗癫痫药和抗精神病药。在财政资源有限的情况下，对采购模式进行评估可提高对相对成本的认识。
