Controlling South Africa's private health care expenditures : the perceptions and experiences of private health care providers about generic medicines in the Mafikeng district, North West Province, South Africa

Abstract

This was a study which sought to investigate the perceptions and experiences of private health care providers in Mafikeng, North West Province about generic medicines. The escalating cost of medicine in South Africa and elsewhere in the world has necessitated government intervention to come up with strategies to make health care accessible and affordable to the majority of the people. In South Africa, the Medicine and Related Substances Control Amendment Act (Act I0I of 1965), was implemented in May 2003. The Act makes it compulsory for pharmacist to offer patients generic medicines, apart from exceptions listed by the Medical Control Council and, if substitution takes place, to inform the doctor. The study was a prospective, cross- sectional survey of private health care providers in the greater Mafikeng area using a self- administered structured questionnaire. Participants received a structured questionnaire by hand mail and were given the same time to complete it. The questionnaires were them collected from their respective rooms. The main outcome measures were age, level of education, current occupation/profession and their perception and experiences about generic medicines. The total number of respondents was thirty two (32) out of forty (40) private health care providers who received the copies of the questionnaires. One questionnaire was incompletely answered and was therefore excluded from the final analysis. Seven questionnaires were returned unanswered. Age ranged from 26 to 51 and all had one or two university degrees. On average, private health care providers in Mafikeng perceived generic medicines and patent medicines to be identical and bioequivalent. Majority of the respondents prescribed generic medicines as their first line of treatment and were aware of the mandatory generic substitution law. According to the respondents, the majority of patients were not well informed about generic medicines. Majority of respondents were satisfied with the safety, quality, performance characteristics, intended use and route of administration of generic medicines. There is a need for a common essential drug list that will be used by all medical aids schemes in South Africa, wider generic prescribing in both the public and private health sector, speeding up the process of manufacturing generics, health care providers complying fully with the mandatory generic substitution law, parallel importation of generic medicines when a need arises and a widespread promotional campaigns targeting mainly consumers and health professionals.