The treatment of asthma : a managed pharmaceutical care approach

Abstract

During 2004 the South African Pharmaceutical sector experienced a drastic change in the pricing system of pharmaceuticals. The aim of this study was to analyse the usage and cost associated with asthma medication according to a medicine claims database. A quantitative retrospective drug utilisation research design was used to evaluate the usage patterns and costs associated with asthma-related drugs. The asthma-related drugs included for this study were the bronchodilators and the anti-asthmatics. The data for one year (1 January 2004 to 31 December 2004) were extracted from a medicine claims database. The study period was divided into three time periods, namely January to April, May to August and September to December. From January to April there were no limitations on the pricing structure of medicine (pre-single exit price). The new legislation came into effect in May 2004 and changed the pricing structure of medication. May to August is referred to as the interim period, where the new regulations was to be phased in. As from September 2004 the new pricing regulation was "fully" implemented, therefore September to December can be referred to as the post-single exit price period. Asthma is diagnosed on the basis of certain signs and symptoms, which can be substantiated by a clinical investigation. Asthma medicine represented 4.46% (N = 115 684) of medicine prescribed on the medicine claims database (N = 2 595 254) and 18.40% of all respiratory system medicine (N = 628 754). In comparison with the total database (33.49%, N = 5 305 882), the generic substitution of asthma medication is far less, representing 24.18% of medication prescribed for asthma. The data clearly indicate the decrease in average price per item for both groups of asthma-related medication. The price showed a decrease of 19.53% with the implementation of the single exit price for the bronchodilators and 10.40% for anti-asthmatics. A further decrease from the SEP price of the bronchodilators and the anti-asthmatics, respectively 14.74% and 13.64%, indicates the price reducing effect of the legislation on medicine cost.