ABSTRACT
Background: Cancer is one of the most expensive and lethal noncommunicable diseases globally. Availability and affordability of anticancer drugs are the most important factors on which management of cancer depends. The objective of the study was to evaluate the variation of cost among different brands of anti-cancer drugs available in the Indian market.Methods: 揅urrent Index of Medical Specialties� July-October 2018 and 揇rug Update� Sept - 2018 were used to obtain cost in INR* (Indian National Rupees) of anticancer drugs manufactured by different pharmaceutical companies in India, in the same strength and dosage form. Percentage cost variations were calculated by minimum and maximum costs of anticancer drug of different brands.Results: Percentage variation in cost was analyzed for 41 different formulations of 27 anticancer drugs. Highest cost variability seen with Alkylating agent Carboplatin 150 mg injection (1100%) and lowest with Antimetabolite anticancer agent Cytarabine 500 mg injection (6.56%). Three formulations showed more than 500% cost variation, largest with Carboplatin 150 mg injection (1100%) followed by Anastrozole 1 mg tablet (870%) and Letrozole 1 mg tablet (508.42%).Conclusions: Present study finding showed significant cost variation in different brand of many anticancer drugs in India. These results indicated that greater price transparencies required. This price variation issue requires a much more in-depth analysis of the health care system.
ABSTRACT
Background: The main objective of study is to monitor and analyze the adverse drug reactions (ADRs) of ART and to assess causality and severity of the ADRs detected.Methods: It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Causality was assessed by Naranjo’s algorithm. Severity of ADR’s was assessed by modified Hartwig and Seigel scale. Modified Shumock and Thorton criteria used for preventability assessment.Results: In twelve months duration 351 patients on ART were observed for ADRs. Total 166 ADRs detected in 96 patients. Incidence of ADRs was slightly more in female. The common systems involved were gastrointestinal 42.77% followed by nervous system 18.07%, musculoskeletal 15.06% skin/mucous membrane 07.83%, metabolic and nutritional 04.82%, red blood cell disorders 01.20 %, endocrinal 00.60 % and others 09.64%. The causality assessment as per Naranjo’s scale showed that out of 166 ADRs, 28.92% were probable and 71.08% were possible. Severity assessment by modified Hartwig and Siegel scale showed that 83.34% ADRs were mild and 15.66% were moderate. 46.39 % ADRs were probably preventable.Conclusions: Considering the magnitude of ADR related problems, there is a need for greater awareness among health care professionals, to detect and report them. These ADRs if recognized in time and managed properly can prevent treatment interruption.
ABSTRACT
The main objective of study is to compare the adverse drug reactions (ADRs) of Zidovudine and Stavudine containing regimens. It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Standard scales were used for assessment of ADRs. In twelve months duration total 263 patients on ART were observed for ADRs. 128 patients on Stavudine based regimen and 135 patients were on Zidovudine based regimen. Total 72 ADRs detected in 68 patients. Incidence of ADRs was more in Zidovudine based regimen. Zidovudine associated with early and mild ADRs while Stavudine associated with late and distressing ADRs. Considering the magnitude of ADR related problems, results support the discontinuation of Stavudine based regimens