Cost saving from the use of generic medicines for the treatment of the most common non-communicable diseases in adults in South Africa.

Abstract

Access to quality and affordable healthcare is a worldwide problem. Making healthcare affordable to the ordinary South African is a priority of the national government and therefore the use of generic medicine is encouraged. Generic medicines are manufactured by pharmaceutical companies without a licence from the innovator company, and are expected to work physiologically in the same manner as the innovator, based on their bioequivalence. These medicines normally cost less than innovator medicines. One method of reducing the costs of healthcare is by the introduction of generic medicine for the treatment of non-communicable diseases. This cross-sectional retrospective study investigated the potential savings from the use of generic medicine for the treatment of the most common non-communicable diseases of adults in South Africa. Five of the most common non-communicable chronic diseases in South Africa were extracted from the Council for Medical Schemes chronic disease list. The innovator drug, along with available generic drugs, was selected and an algorithm was designed to compare the single exit price differences for a treatment period of 30 days. To assess the price changes over a period of time, the innovator and generic medicine prices were compared in 2006 and 2014. This study has shown that there was a major saving potential from the use of generic medicines over innovator medicines for the treatment of the most common non-communicable diseases in adults in South Africa. This has been proven by comparing the single exit price of innovator medicines against that of generic alternatives. However, these

findings confirm that medicine prices between innovator and generic brands vary extensively. A major saving of 97.14% for furosemide, 97.11% for prednisone and 95.70% for glibenclamide existed when generic medicines were used. Minor savings of 8.06% for budesonide and 12.68% for metformin existed when generic medicines were used instead of the innovator product. Secondly, this study has shown that over a period of eight years, most generic drug prices have increased in line with the South Africa’s nominal inflation rate, except for the methotrexate which increased by 75.70%, while simvastatin 10mg and 20mg generics decreased by 69.95% and 72.32% respectively. These results confirm the recommendations that generic medicine can be utilised effectively to ensure accessibility and affordable quality healthcare to all. However, constant monitoring of price changes is needed to ensure that above inflation increases do not erode affordability of quality healthcare achieved with the use of generic medicines.