Prescribing of meprobamate-containing combination analgesics in South Africa

Abstract

Background: Meprobamate is a constituent of various combination analgesics in South Africa. Due to the lack of recent literature on the prescribing patterns of combination analgesics containing meprobamate and in the light of its possible higher re-scheduling, this study was conducted. The primary aim was to establish the extent of meprobamate-containing combination analgesic prescribing using a prescription claims database.

Methods: A retrospective, cross-sectional drug utilisation study was conducted on prescription data of a medical insurance scheme administrator in South Africa for 2011.

Results: A total of 31,854 patients received 97,491 analgesics during 2011. Within ATC category N02B, 62.10% of prescriptions were for analgesic combinations, of which 20,326 prescriptions were for meprobamate-containing analgesics. A total of 10,404 patients (53.00% males) were prescribed meprobamate-containing analgesics. Overall, 20.85% of all analgesics prescribed were therefore meprobamate-containing analgesics. Patients who received meprobamate-containing analgesics were slightly older (39.52 years) compared with patients who received analgesics in general (33.61 years). Twenty-two trade names of meprobamate-containing analgesics were prescribed. Seventeen of these products contained exactly the same strengths of active ingredients, namely 320  mg paracetamol, 8  mg codeine phosphate, 32  mg caffeine and 150  mg meprobamate. The originator product constituted 3.72% of prescribing frequency (average cost: R30.42) compared with 70.63% for the most popular generic (average cost: R11.65).

Conclusions: Prescribers should be conscious of the benefits and risks of the active ingredient combinations. Further studies including patient and prescriber perceptions of different combinations are recommended.