Initiatives in South Africa to enhance the prescribing of generic proton pump inhibitors: findings and implications

There have been multiple reforms in South Africa to conserve resources including policies to enhance generic use, such as compulsory generic substitution and copayments. However, there are concerns with the limited knowledge of their impact. The objective of this paper was to determine utilization and expenditure of different proton pump inhibitors (PPIs). A retrospective drug utilization study was conducted on a prescription database of a medical aid administrator in 2010. The limited prescribing of single-sourced PPIs accounted for 21.5% of total prescriptions. The limited use of originators omeprazole and lansoprazole accounted for 1.8 and 1.4% of total prescriptions for the molecule, respectively. Generic prices accounted for 36-68% of the originator in 2010. Patients received on average 2.91 PPI prescriptions during the year.
Policies to enhance prescribing of generics appear working. Opportunities exist to further lower generic prices given low prices in some European countries.