OBJECTIVES: The aim was to investigate the dispensing patterns of prescription-only anti-obesity products (excluding diet products) in South Africa (classified under Anatomical Therapeutic Chemical (ATC) group A08).

METHODS: A retrospective, cross-sectional drug utilisation study using electronic dispensing records of private sector community (or retail) pharmacies in South Africa was conducted. All patients who received one or more anti-obesity products in ATC group A08 in 2015 were included in the study. Outcome measures included the number of patients by age and gender, prescribing frequency and cost, and trends observed.

RESULTS: A total of 32968 patients were prescribed 67583 products at a sales value of R17103909.59 for anti-obesity medication during 2015. The average cost per prescription was R253.08 (SD=R90.62). The average age of patients was 41.55 (SD=11.36) years, with male patients on average older than female patients (46.13 and 39.86 years, respectively). More female patients (73.03%) were dispensed anti-obesity products. Five active ingredients were dispensed. Phentermine was prescribed the most, accounting for 84.99% of anti-obesity prescriptions, followed by D-norpseudoephedrine (8.90%), orlistat (3.61%), phendimetrazine (2.29%), and diethylpropion (0.21%). These results were similar to the findings of a 2013 South African study, except that the prescribing frequency of D-norpseudoephedrine has increased. Orlistat was on average the most expensive per prescription (R 485.75). Most patients (76.73%) received only short-term therapy (one or two prescriptions for an anti-obesity product during the year). A small percentage (0.24%) of young patients (younger than 18 years) received anti-obesity products, despite the fact that the safety of these products in children has not been proven. D-norpseudoephedrine was the only active ingredient showing seasonal patterns, with more products dispensed before the summer months.

CONCLUSIONS: Phentermine was the most commonly dispensed active ingredient, followed by D-norpseudoephedrine which was recently rescheduled in South Arica. Studies on patient outcomes and the cost-effectiveness of these products should be conducted.