ABSTRACT
Background: Evaluation of the pattern of fixed dose combinations (FDCs) prescribing among the practitioners in India. Aims and Objectives: Aims and objectives of the study was to find out prevalence, prescribing pattern and rationality of FDCs in Jhalawar district of Rajasthan. Materials and Methods: Photocopies of one thousand prescriptions of general practitioners, containing 800 FDCs were randomly collected from few big pharmacies of Jhalawar district of Rajasthan and analyzed for the different pattern of prescribing and rationalism. Results were expressed as percentages. After excluding the repetitions, the numbers of FDCs were 218, which were considered for final analysis. Results: Out of 218 FDCs, the most commonly prescribed FDCs were of anti-microbial agents followed by anti-inflammatory drugs and anti-hypertensive drugs. The FDCs were maximum from the department of medicine (30.2%), followed by surgery (20.2%) and Obstetrics (16.9%). Out of 218 FDCs, only 13.3% were rational, and rest of the FDCs was irrational. 94% of all FDCs prescribed with brand names. Conclusions: In our study, most of the prescriptions contains irrational FDCs. Physicians have no knowledge about the essential drugs and FDCs. Therefore, physicians and regulators should be educated regularly by seminars and conferences. Government laws should be made mandatory. Implementation of central drug standard control organizations guidelines on industries for manufacture of FDCs must be made compulsory.
ABSTRACT
Background: Drugs used in obstetrics and gynecology are strong selling drugs in pharmaceutical market but they are the least studied drugs in terms of cost analysis and price variation.Methods: Cost of most commonly used Obstetrics and Gynecology drugs in Jhalwar district manufactured by different pharmaceutical companies, in the same strength and dosage forms was obtained from Drug Today (January-March 2018). The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in cost per 10 tablets/10 capsule/1 injection/1 protein packet/1 sachet were analysed.Results: In Obstetrics drugs, the highest cost ratio (1:9.5) and percentage price variation (848) was found for Ferrous Salt + Folic acid combination followed by Cefixime (1:4.3, 330), Nifedipine (1:3.7, 270), Folic acid (1:3.67, 266), Paracetamol. Amoxicillin was having least cost ratio (1:1.4) and percentage price variation (37). Maximum number of brand available for Ferrous Salt + Folic acid combination (41) followed by Paracetamol, Calcium Salt + Vitamin D3 combination. In Gynecological drugs, the highest cost ratio (1:35) and percentage price variation (3433) was found for Ethinylestradiol + Levonorgetral combination followed by Doxycycline (1:8.9, 793), Fluconazole. Metronidazole was having least cost ratio (1:1.3) and percentage price variation (27). Maximum number of brand available for Omeperazole (27) followed by Ethamsylate (22).Conclusions: This study shows that the average percentage price variation of different brands of the same drugs were very wide. Improved adherence to the drug treatment can be ensured by decreasing the cost of therapy, which can be done by changes in the government policies and regulations, integrating pharmacoeconomics as part of medical education curriculum, and creating awareness among treating physicians for switching to cost effective therapy.
ABSTRACT
Background: Package Insert is the primary source of drug information for the patient. It is a printed leaflet that contains information based on regulatory guidelines for the safe and effective use of a drug. Studies on package inserts in India had shown that crucial information was often missing, and they lacked uniformity.Methods: 100 oral drugs used in Obstertrics and Gynecology from different brands were collected from big pharmacies located at Jhalawar and available package inserts were analysed according to Sections 6.2 and 6.3 of Schedule D of Drugs and Cosmetics Rules, 1945.Results: Out of 100 oral drugs studied, package inserts were found in 72 drugs, most available information in therapeutic indicators was Posology and method of administration (100%) followed by contra-indications (94.4%), use in pregnancy and lactation (83%), interactions (77.8%) whereas less information about antidote and least about ability in driving and use of machine. In pharmaceutical indicators, it is instruction for use (86%), followed by special precautions for storage (76.4%), shelf life in the medical product as packaged for sale (52.8%).Conclusions: This study showed that many information relevant to the safe and effective use of medication was lacking in the analyzed package inserts. It is, therefore, recommended to update the existing package inserts based on criteria mentioned in the Schedule D of Drug and Cosmetic Act, 1945.