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The status of generic substitution in South Africa Posted 29/04/2011

In South Africa only around 13% of the population live in what we would call ‘first world’ conditions. More than half the population (around 48 million people) live in developing world conditions according to researchers from the School of Pharmacy at the North-West University, South Africa.

In the period of this research (2005−2006), South Africa spent approximately 8.7% (approximately South African Rand 135 billion) of its gross domestic product on the healthcare sector. Approximately 86% of the population is covered by public health care; however private health care, which covers a minority of the population, also receives medical aid from the government. This amounted to more than half (56%) of healthcare spending between 2005 and 2006.

One of the main reasons for increases in costs in the private healthcare sector in South Africa has been medicines, accounting for 18.3% of total expenditure. The three medicine classes of antihypertensives, hypolipidaemic agents and antidepressants were the main culprits in 2004–2006 for contributing the most to medicine expenditure.

In order to attempt to control expenditure on medicines, South Africa implemented mandatory generic substitution in May 2003.

Research into cost savings from generic prescribing and substitution in South Africa has shown that, depending on the drug involved, savings range from 9.9–59.7% (mean 41.1%). It has also been reported that further savings of 10% could be gained if generic prescribing and substitution are practised to maximum capacity in South Africa.

While other reports have estimated that only approximately 45% of innovator products in the South African market are currently substituted for less expensive generics, compared to 54% in the US, there is therefore still some room for potential further savings to be made, which the authors discuss in their research.

The following series of three articles discuss generic substitution and the potential savings that may be generated from generic substitution of antidepressants in South Africa.

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van der Westhuizen E, Burger JR, Lubbe MS, Serfontein JHP. Further potential savings attributable to maximum generic substitution of antidepressants in South Africa: A retrospective analysis of medical claims. Journal of Interdisciplinary Health Sciences. 2010;15(1):1-5.

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