n Health SA Gesondheid - Investigation into the prescribing patterns and cost of antidiabetic medicine in South Africa

Volume 12, Issue 3
  • ISSN : 1025-9848



The general objective of this study was to investigate the prescribing patterns and cost of antidiabetic medicine in the private health care sector in South Africa by using a medicine claims database. A quantitative, retrospective drug utilisation study was performed on data for the year 2004. Oral antidiabetic medicine accounted for 81% (n = 143 447) and 39% (R29 734 360.61) respectively of the total prevalence and cost of all antidiabetic products prescribed. Metformin was the most frequently prescribed oral antidiabetic medicine, with an average cost of R58.42 (SD = 31.78). The three most frequently prescribed classes of insulin (insulin lispro; soluble insulin and isophane; and soluble insulin aspartame and protamine) together accounted for 63% of all the insulin prescribed, and 67% of the total cost of prescribed insulin. Almost 39% (n = 62 717) of the "combination therapy" prescriptions were for a sulfonylurea in combination with a biguanide plus at least one other antidiabetic product. A trend towards combination therapy away from monotherapy was observed. Prescribed Daily Doses (PDDs) calculated for oral antidiabetic medicines were more or less in line with recommended treatment guidelines. Drug utilisation review studies thus provide valuable insight into the treatment of diabetes - indicating areas of possible over- and under usage, providing decision-makers with critical information to curb unnecessary costs.

Die algemene doelstelling van hierdie studie was om die voorskryfpatrone en koste van antidiabetiese medisyne in die private gesondheidsorgsektor van Suid-Afrika te ondersoek. 'n Kwantitatiewe, retrospektiewe medisyneverbruikstudie is op data van die jaar 2004 uitgevoer. Orale antidiabetiese medisyne het onderskeidelik 81% (n = 143 447) en 39% (R29 734 360.61) van die totale voorkoms en koste van antidiabetiese medisyne verteenwoordig. Metformien was die mees algemene voorgekrewe orale antidiabetiese middel, met 'n gemiddelde koste van R58.42 (SA = 31.78). Die mees algemene voorgeskrewe insuliene (insulienlispro, oplosbare insulien en isofaan, en oplosbare insulienaspartaam en protamien), het saam 63% van die voorgeskrewe insuliene se voorkoms en 76% van die totale voorgeskrewe insuliene se koste verteenwoordig. Ongeveer 39% (n = 62 717) van die voorskrifte vir "gekombineerde terapie" was vir 'n sulfonielureum in kombinasie met 'n biguanied, met ten minste nog een ander antidiabetiese produk. 'n Neiging na gekombineerde terapie weg van enkelterapie is waargeneem. Voorgeskrewe Daaglikse Dosisse (VDD) wat bereken is vir orale antidiabetiese medisyne was ongeveer in lyn met aanbevole behandelingsriglyne. Medisyneverbruiksevalueringstudies verskaf dus waardevolle insig in verband met die behandeling van diabetes, insluitende indikasies vir moontlike oor- en onderverbruik, wat aan besluitnemers kritiese inligting verskaf om onnodige kostes te voorkom.

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