Background: It is essential to manage and budget for primary health care in order to deliver a sustainable, accessible and quality health service to the majority of the population. The aim of the study was to establish the cost per script at the Heidedal Community Health Centre (HCHC) and at the National District Hospital (NDH) in Bloemfontein and to evaluate prescribing patterns, the protocols and use of the Essential Drug List (EDL) and Standard Treatment Guidelines (STGs) and to budget more accurately for medicine.

Methods: During a two-month period, every fifth script dispensed at HCHC and NDH was included in the study and analysed until we had included 1 000 scripts from each facility.

Results: The mean number of items per script at the CHC was 3.3 and at the DH was 4.1, and the mean cost was R14.66 versus R64.69 respectively. At HCHC, 62 025 prescriptions were dispensed and at NDH 56 312 were dispensed at an estimated total value of R 4.5 million during 2002.

Conclusion: Many problem areas and incorrect prescribing patterns were identified and need to be addressed. Although the cost per script at primary care level is not high, the number of patients that need treatment is enormous. Primary health care is actually very expensive and good quality control is necessary.