Moodley Lirosha, Suleman Fatima, Perumal-Pillay Velisha Ann
Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa.
J Pharm Policy Pract. 2021 Sep 21;14(1):78. doi: 10.1186/s40545-021-00362-3.
South Africa faces a heavy burden of disease, which impacts resource allocation. The needs of South Africa require efficient translation into pharmaceutical expenditure for medicine provision, to ensure availability of medicines. Given that South Africa faces various challenges with medicine provision accompanied by rising pharmaceutical expenditure, this study aimed to report on the considerations and methods used to determine the healthcare budget for South Africa, and how it is translated into pharmaceutical expenditure for medicines provision on the Standard Treatment Guidelines and Essential Medicines List and non-essential medicines in the public sector.
Qualitative, semi-structured interviews guided by a discussion guide were conducted with seven pharmaceutical officials involved in the budget and resource allocation process, between October 2019 and March 2020. Interviews were recorded and transcribed verbatim. Once the interviews were coded by the first author they were verified by the other authors. Data were thematically analysed.
This study depicted the knowledge and participation of pharmaceutical services in the budget process. The National and Provincial Department of Health have improved pharmaceutical budgeting by making strides towards a collaborative, informed, and more evidence-based approach. Pharmaceutical services have roles in advising on requirements; commenting where necessary, constantly monitor and taking accountability for their budget. The main considerations that determined the budget included population size and growth, historical expenditure, the extra heavy burden of disease and incidence rate, demand data and forecasting. The local and provincial pharmacy and therapeutics committee play a vital role in monitoring the budget and expenditure; ensuring adherence to guidelines; controlling the extent to which non-Essential Medicine List items are used and advising accordingly.
This was the first study to report on the decision and thought processes of the healthcare budget and its translation into pharmaceutical expenditure for medicine provision in South Africa. Many factors were considered to inform the budget, with the Standard Treatment Guideline and Essential Medicines List being the principal guide for medicine provision. This process was well-controlled and monitored by the pharmaceutical therapeutics committee. Documenting the South African experience can assist other countries in their budget decisions for medicines.
南非面临着沉重的疾病负担，这对资源分配产生了影响。南非的需求要求有效地转化为用于药品供应的制药支出，以确保药品的可及性。鉴于南非在药品供应方面面临各种挑战，同时制药支出不断增加，本研究旨在报告用于确定南非医疗保健预算的考虑因素和方法，以及如何将其转化为用于根据标准治疗指南和基本药物清单在公共部门提供基本药物和非基本药物的制药支出。
2019年10月至2020年3月期间，对七名参与预算和资源分配过程的制药官员进行了以讨论指南为指导的定性、半结构化访谈。访谈进行了录音并逐字转录。访谈内容由第一作者编码后，由其他作者进行核实。对数据进行了主题分析。
本研究描述了制药服务在预算过程中的知识和参与情况。国家和省级卫生部通过朝着协作、知情和更基于证据的方法迈进，改进了制药预算编制。制药服务在提供需求建议、必要时发表评论、持续监测以及对其预算负责方面发挥着作用。决定预算的主要考虑因素包括人口规模和增长、历史支出、疾病的额外沉重负担和发病率、需求数据以及预测。地方和省级药房与治疗委员会在监测预算和支出、确保遵守指南、控制非基本药物清单项目的使用程度以及提供相应建议方面发挥着至关重要的作用。
这是第一项报告南非医疗保健预算的决策和思维过程及其转化为用于药品供应的制药支出的研究。在确定预算时考虑了许多因素，标准治疗指南和基本药物清单是药品供应的主要指南。这一过程由制药治疗委员会进行了良好的控制和监测。记录南非的经验可以帮助其他国家在药品预算决策方面提供参考。
