An economic assessment of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries

Hisham S Abou-Auda
Clinical Therapeutics 2003, 25 (4): 1276-92

BACKGROUND: Expenditures for prescription and over-the-counter medications constitute a large percentage of total health care costs. Governments, health care providers, and consumers must work together to find ways to control these costs while continuing to provide quality health care for their nations. To this end, medication wastage is an unnecessary burden on an already fiscally restrained health care system.

OBJECTIVE: This study was conducted to identify the extent of medication use and wastage among families in the Arabian Gulf countries, with an emphasis on Saudi Arabia.

METHODS: A questionnaire was developed and administered to households in 5 regions in Saudi Arabia and other Gulf countries. A total of 1641 households participated in the study (1554 in Saudi Arabia; 87 in other countries).

RESULTS: The mean (SD) family size of household respondents from Saudi Arabia was 6.60 (3.20) members, with 0.32% reporting no medicines present in the household, 81.8% of households reporting 5 or more medicines, and 29.9% of respondents reporting having at least 10 medications at home. Overall, the mean (SD) number of medicines per household in Saudi Arabia was 8.0 (4.3). The most common therapeutic classes of medications kept at home in Saudi Arabia were respiratory medications (16.8%), central nervous system agents (16.4%), and antibiotics (14.3%). The mean (SD) number of drug products unused, deteriorated, or expired was 2.2 (2.7) and 2.7 (1.9) per household in Saudi Arabia and other Gulf countries, respectively. From these data, mean medication wastage was estimated to be 25.8% (Saudi Arabia) and 41.3% (other Gulf countries). When analyzed on the basis of total medication cost, medication wastage was 19.2% and 25.0% in Saudi Arabia and other Gulf countries, respectively. The mean out-of-pocket expenditure (based on the percentage of annual income) for medications was 0.72% for households in Saudi Arabia compared with 0.48% in other Gulf countries.

CONCLUSIONS: Families in Saudi Arabia and other Gulf countries spent a total of approximately US $150 million on medications that were never consumed. However, there appear to be no immediate solutions to the problem of medication wastage's impact on health care costs. The use of generic alternatives should be promoted, and drug use assessments should be implemented on a national level.

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