ABSTRACT
Background: Hypertension and diabetes mellitus are both chronic disorders and when they occur as co-morbidities create havoc by presenting with a plethora of morbidity and mortality. Both require drug treatment over a long period of time, which calls for stringent analysis of prescribing trends of the same. Objectives: The present study was intended to analyze prescribing pattern and establish prescribing trends of anti-hypertensive drugs (AHD) in hypertensive diabetic patients. Methods: The present study was a record based, randomized, non-interventional study of 2 years duration conducted at a tertiary care hospital of central India. Prescriptions from 400 case records of hypertensive diabetics were obtained from the medical record section. Demographic details, blood pressure, and AHDs prescribed were systematically entered in pre-validated case record form. All data were thoroughly analyzed for fallacies and appropriateness. Results: Among 400 patients, 221 were males, and 179 were females. Monotherapy was used in 366 (91.5%) patients while combination therapy was used in 34 (8.5%) patients. Most commonly used combination was angiotensin converting enzyme inhibitor (ACEI)+calcium channel blocker (CCB), while in monotherapy CCB≥ACEI>beta blocker>diuretic>angiotensin II receptor blocker were most commonly prescribed. Conclusion: The present study represents trend and attitude of physicians in prescribing AHDs. On comparing with Joint National Committee 7 guidelines, the majority of the cases deviated from the guidelines, mostly in a choice of AHDs and Fixed dose combination.
ABSTRACT
Background: Diabetes mellitus in early age is on the alarming rise in India, requiring lifelong treatment. There is a wide range of variation in the prices of antidiabetic drugs marketed in India. Hence, we decided to study price variations in the oral antidiabetic drugs available, either singly or in combination, and number of manufacturing companies for each, and to evaluate the difference in cost of different brands of same active drug by calculating percentage variation of cost. Methods: Cost of a particular drug being manufactured by different companies, in the same strength and dosage forms was obtained from “Current Index of Medical Specialties” July-October 2014 and “Indian Drug Review” July 2014. The difference in the maximum and minimum price of the same drug, manufactured by different pharmaceutical companies and percentage variation in price was calculated. Results: Percentage price variation among different group of drugs was found to be as follows: in sulfonylureas, it was highest in glimepiride 2 mg 836.44%, among biguanides - metformin 500 mg 245.55%, among thiazolidionedionespioglitazone 15 mg 600%, among α glucosidase inhibitors - voglibose 284.61% and meglitinides - repaglinide 0.5 mg 181.40%. Among combination therapy glimepiride 1 mg + metformin 500 mg 366.66%, pioglitazone + metformin 207.51%, pioglitazone + glimepiride 268.42% showed maximum variation in price. Conclusion: The average percentage price variation of different brands of the same oral antidiabetic drug manufactured in India is very wide. The appropriate changes in the government policy, sensitizing the prescribers about cost of therapy and proper management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative economic consequences.