Pharmaceutical Policy in South Africa

Abstract

South Africa has implemented a number of important medicine policies in the post-apartheid era, informed by the 1996 National Drug Policy. Despite considerable resistance, firstly from the transnational pharmaceutical industry but later from a wider range of stakeholders, a number of legal reforms have been successfully implemented. In the public sector, medicine use is governed by standard treatment guidelines and essential medicines lists. However, these do not apply in the more fragmented private sector. Nonetheless, generic utilisation in the private health sector has increased over time. Maximum dispensing fees have also been introduced in the private sector but may need to be complemented by more sophisticated professional remuneration models that more effectively advance the responsible use of medicines. Greater use of pharmacoeconomics will help to inform rational selection and reimbursement policies, especially as the country moves towards universal health coverage in the form of National Health Insurance. The state tender system will also need to be reconsidered, as the separation between public and private healthcare financing and delivery becomes blurred. Major changes are in progress at the national medicines regulatory authority, which faces a considerable backlog in applications for marketing authorisation.