S African Drug Industry "Does Not Address Needs"

The South African pharmaceutical industry does not pay sufficient attention to the population's health and specifically its drug needs, Bada Pharasi of the University of the Witwatersrand's Centre for Health Policy in Johannesburg has told the inaugural meeting of the South Africa Association of Pharmacists in Industry. Reconciling the industry's interests with the needs of the population will be no simple task, he said; because essential drug policies and other cost-containment measures are need- rather than profit-oriented, an inherent conflict of interest is evident from the outset.

Mr Pharasi said drug costs in South Africa have become a controversial and emotive issue. International comparisons show that South Africans, particularly in the private sector, pay "much more" than most other nations. The concerns of the payers, ie the state, the health funds and the public, relate variously to: - the total spent on drugs as part of overall health expenditure; - the comparative costs of certain drugs; - excessive prescribing; - apparently excessive levels of use of certain drugs or classes of drugs normally regarded as useful eg antibiotics; and - wasted spending on drugs of no proven value.

The industry responds by insisting that other forms of health care spending have risen much more rapidly than drug costs, and should receive greater attention when governments want to economize, he said. "The research-based industry, for example, is strongly against the concept of generic substitution, referring to the inalienable right of the doctor to prescribe the best drug at his sole discretion. The non-research-based industry has not expressed the same concerns, arguing for the freest possible approach to competitive pricing and tendering, so that extensive use will be made of generics." In both cases, "the arguments reveal a natural inclination displayed by any businessmen to fight for the preservation of health profits."