ABSTRACT
Background: To study cost-effective and cost-benefit analysis of antibiotic prescription in patients who had enteric fever and was given intravenous ceftriaxone. Methods: This was a prospective observational study conducted in a tertiary care hospital. 200 patients who have been diagnosed with enteric fever and were prescribed ceftriaxone were studied and their prescriptions were analyzed. 5 brands of most commonly prescribed ceftriaxone injections were chosen to analyse costeffective and cost-benefit analysis. Our study showed that there was a major difference of prizes between generic and 5 most commonly prescribed brands of the same drug. Use of branded drugs was associated with increase cost of treatment and in many cases was responsible for failure to take complete treatment as prescribed by treating physician. Results: This Study was conducted on 100 patients, 68 males and 32 females, diagnosed with enteric fever. Out of these patients Maximum number of patients were seen between age group of 30-40 years (34) and minimum patients belonged to age group of more than 60 years (8). Analysis of prescriptions revealed that 80 patients were prescribed Branded drugs and 20% were prescribed generic drugs. Out of these 80 patients who were prescribed branded drugs most common 5 brands were studied. The analysis of the cost of single dose of inj ceftriaxone revealed that branded drugs were 3.12 % to 200.84 % more in comparison with generic IV ceftriaxone. Analysis of cost of 1 day of treatment with IV ceftriaxone 1gm revealed similar figures. Total cost of treatment was Rs 595 for generic drug and 1790 for branded drug with maximum MRP. The Analysis of patients who discountinued treatment before completion revealed that most of them belonged to Brand E (30%) and minimum number of patients belonged to Generic group (5%.Conclusion: The cost of most commonly prescribed branded drugs was significantly higher (3%-200%) than generic drug and prescribing branded drugs was associated with failure to take complete treatment as prescribed by treating physician.
ABSTRACT
Background: Hypertension and certain alteration in serum lipoproteins are complementary coronary risk factors. The effect of antihypertensive agents on lipid metabolism exhibits a wide range. Numerous studies have established that vasodilating beta-blockers are associated with more favorable effects on glucose and lipid profiles than non-vasodilating beta-blockers. The study was conducted to study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension. Methods: A prospective, randomized open label single center study was conducted in the Department of Pharmacology in collaboration with Department of Medicine, MGM’s Medical College and Hospital, Aurangabad in newly diagnosed patients of essential hypertension. Sixty patients of either sex in the age group of 30-65 years with blood pressure (BP) of ≥140/90 mmHg with deranged lipid parameters according to National Cholesterol Education Program were randomized into two groups. Group I received metoprolol (50 mg) and Group II received nebivolol (5 mg), both given once daily for 12 weeks. BP and lipid parameters were evaluated at baseline as well as at the end of 12 weeks. Results: There was significant reduction in BP values (p<0.0001) as compared to baseline in both the groups, however no significant difference was observed between two drugs revealing that their efficacy in reducing systolic BP/diastolic BP is comparable. Furthermore, both the drugs had a favorable effect on lipid profile, but more significant results on lipid profile were observed in the nebivolol group as compared to metoprolol group (p<0.0001). Conclusions: In our comparison study, it is seen that the favorable effect of nebivolol on serum lipids and its good tolerability profile make it a good choice for control of hypertension as well as preventing the long-term cardiovascular morbidities and mortalities.