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Background: Diabetes mellitus (DM) is a chronic progressive metabolic disorder associated with microvascular and macrovascular complications in type 2 DM. Oral anti-diabetic drugs (OADs) play an important role in regulating raised blood glucose levels and compliance to treatment. Aims and Objectives: The aims of this study were to evaluate cost variations of different brands of drug formulations in the management of DM. Materials and Methods: This study was an analytical study. Costs of various OADs were obtained from January to March 2022 edition of current index of medical specialties India. The cost ratio and percentage of variation among different drugs in the treatment of DM available in Indian Market and Manufactured by different pharmaceutical companies were analyzed. Results: The percentage variation in cost among commonly prescribed single OADs was found to be highest for sulfonylurea group of dugs Glimepiride 1 mg tablet (1.366%), followed by Biguanides, Metformin 500 mg tablet (809%), ?-Glucosidase inhibitors, and Voglibose 0.3 mg tablet (571%), while it was lowest for Glibenclamide 5 mg tablet (36%) and Acarbose 25 mg tablet (36%) of sulfonylurea drugs and ?-Glucosidase inhibitors group of drugs, respectively. In combination drug therapy, Glibenclamide and Metformin combination (1.25 + 250 mg tablet) shows maximum variation (132%). Conclusion: There is a wide difference existing in the cost of various oral anti-diabetics available in Indian Market by different brands. The physicians must be aware of these variations and prescribe medicines accordingly, while considering the financial status of patient and also to promote adherence to treatment.
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Background: Dyslipidemic drugs are widely prescribed drugs in atherosclerosis, as it is a chronic illness the long term need of this medication creates a financial burden on the patient, especially with patients of low socioeconomic status. Considering this government of India established Jan Aushadhi medical store with a view to provide cheaper generic medicines, so that a good patient compliance is achieved. Aims and Objectives: The aim of the study was to analyze the cost variation of the dyslipidemic drugs available in Indian market under generic and various brand names manufactured by different pharmaceutical industries. Materials and Methods: This was a cross-sectional study conducted to analyze the cost variation of dyslipidemic drugs available in different formulations in our Indian market. The information on cost of each drug with its dosage and formulation was obtained from “Current index of medical specialties” October 2021–January 2022 India and from Jan Aushadhi Price list W.E.F October 2015. Cost ratio and percentage variation among different strength and formulation in dyslipidemic drugs were calculated. Results: The highest cost difference was seen between the minimum cost brand of simvastatin 20 mg tab with its generic drug cost (142.8). Lowest cost differences between minimum brand cost and generic drug was observed for atorvastatin 10 mg tab (17.48). Conclusion: Knowledge about wide cost difference between branded and Jan Aushadhi dyslipidemic drugs helps clinicians to select budget friendly drugs for patients with low socioeconomic status.
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Background: Amebiasis is a common recurring infection of the gastrointestinal tract caused by Entamoeba histolytica, affecting 15% of Indian population, related to poor sanitation and socioeconomic condition. No studies have been performed yet on cost analysis of antiamoebic drugs. Aim and Objective: The aim of the study was to analyze cost variations of different brands of antiamoebic drugs marketed in India. Materials and Methods: It was an observational and analytical study in which maximum and minimum costs in rupees per 10 tablets/capsules of each antiamoebic drug in same strength, manufactured by different pharmaceutical companies in India, were obtained from the Current Index of Medical Specialties (October 2021–January 2022), Drug Today (October 2021–January 2022), and Indian Drug Review (Issue 5, 2021). Cost ratio and % cost variation were calculated for each antiamoebic drug. Results: Metronidazole 200mg had highest cost ratio of 12.1 and 1110.73% cost variation, while Diloxanide furoate 500 mg had lowest cost ratio of 1.69 and 69% cost variation. Among fixed dose combinations, Tinidazole + Norfloxaxin (600 + 400) mg had highest cost ratio of 17.89 and 1689% cost variation, while Metronidazole + Norfloxacin (600 + 400) mg had lowest cost ratio of 1.21 and 21.22% cost variation. Conclusion: Our study showed significant cost variation in different brands of the same antiamoebic drugs. To lessen economic burden and to improve adherence to treatment, it is desirable for physicians to prescribe cheaper brands/generic drugs, to meet the health-care needs of patients. Furthermore, the government should make regulations to decrease cost variation of different brands of same antiamoebic drugs.
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Background - About 58% of India’s health expenditure is out of pocket expenditure. There is a wide variation in the cost of different brands of the same generic drug. Prescription of expensive brands of antibiotics contributes to the development of antibiotic resistanc e. There is literature available on the cost variation and cost ratio of antibiotics but none on the regional disparity. Materials and Methods - An observational cross - sectional study design was adopted. The study was conducted at the medical stores of Ali garh (Uttar Pradesh) and Mumbai (Maharashtra). The maximum and minimum cost/unit in Rupees (INR) of each antibiotic manufactured by multiple pharmaceutical companies was noted. Furthermore, Cost per daily defined dose (cost/DDD) was calculated for the most expensive and least expensive drug. Results - ALIGARH - The highest percent cost variation of 1897.14 and cost ratio of 19.97 was found for Piperacillin 4000mg + Tazobactam 500mg tablets. The least percent cost variation of 48.92 and cost ratio of 1.49 was found for ciprofloxacin 200mg vial. MUMBAI - The highest cost variation of 3031.05 and cost ratio of 31.31 was found for cefixime 200 mg tablets. The least percent cost variation of 6.43 and cost ratio of 1.06 was found for ciprofloxacin 200 mg vial. Concl usions - There is disparity in the cost variation and ratio between the two cities Aligarh and Mumbai in this study, which can be attributed to availability of different brands, under a generic group, in the different regions of the country
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Background: Most fungal infections require long-term therapy significantly increasing cost of therapy. High medical care cost should be of concern for policy makers and service providers. Hence, a study was planned to analyze cost ratio and percentage (%) cost variations of antifungal drugs available in India. Aim and Objectives: The aim of the study was to evaluate cost of different brands of antifungal drugs available in India and to analyze cost ratio and cost variations of different brands of antifungal drugs. Materials and Methods: Maximum and minimum price of each drug was noted in Indian Rupee, using “CIMS” April to July 2021; “Drug Today” April to July 2021 Vol - 1 and 2; and “Indian Drug Review” 2021. Percentage cost variation and cost ratio for individual drugs were compared. Results: Among oral antifungal drugs, Terbinafine 250 mg has highest cost ratio 89.071 and 8807.1% price variation. Griseofulvin 250 mg has lowest cost ratio 1.169 and 16.98% price variation. Among parenteral antifungal drugs, Amphotericin B 50 mg has highest cost ratio 17.088 and 1608.83% price variation. Caspofungin (50 and 70 mg) has least cost ratio and % price variation. Among single drug topical preparations, Clotrimazole 1% powder formulation has highest cost ratio and % price variation 22.48 and 2144.89%, respectively. Ketoconazole 2% solution formulation has least cost ratio and % price variation 1.233 and 23.33%, respectively. Conclusions: Long-term antifungal therapy requires patient compliance and thereby increased adherence to treatment which is achieved by switching to cost-effective regimen and by making Pharmacoeconomics an integral part of Undergraduate and Postgraduate Curriculum.
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Background: India being the world’s largest supplier of generic drugs provides 50% of the drugs globally. Selective Serotonin Reuptake Inhibitors (SSRI) (hereafter referred to as SSRI) is the most commonly prescribed drugs for depression (prevalence of 5.25%) and Anxiety (prevalence of 5.8%). The cost of these drugs influences the patient compliance with treatment and thereby the clinical outcome significantly. Aim and Objectives: The aim of the study was to analyze the cost-variation of SSRIs available in the Indian market. Materials and Methods: Maximum and minimum costs of various SSRIs used in the treatment of depression and anxiety were obtained from the monthly index of medical specialties (November 2020) online, Jan Aushadhi Sugam App (Generic drugs), and National Pharmaceutical Pricing Authority online. The cost of various SSRI being manufactured by different companies in the same strength and dosage form were compared. Cost ratio (Maximum cost/Minimum cost) and percentage cost variation ([{Max cost–Min cost}/Min cost] × 100) in INR (?) were calculated. Data were analyzed and represented using descriptive statistics. Results: Percentage cost variation was maximum with Fluoxetine 20 mg (3477.85%), followed by Sertraline 50 mg (1631.61%) and Escitalopram 10 mg (1288.89%). Percentage cost variation was minimum with Vilazodone 40 mg (16.31%). Conclusion: This study provides awareness about cost variation among different brands of SSRI used in the treatment of depression and anxiety. Wide variation can cause dissatisfaction, poor compliance, and economic burden among patients. It strengthens the usage of generic drugs among general population and healthcare providers.
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Background: The rheumatologists have several drugs to choose from, either alone or in combination; each with different costs, monitoring protocols, and potential risks and benefits. Pharmacoeconomic analysis results help rheumatologists choose drugs for their patients. Objective: Objective of this prospective observational study was to perform a cost-variation analysis of drugs prescribed for the treatment of rheumatoid arthritis (RA) in a Western-Indian tertiary care teaching hospital. Materials and Methods: This prospective observational study was conducted in the rheumatology department of the study site. Study population included patients of both gender male and female, diagnosed with rheumatoid arthritis and on treatment. Prices of the drugs prescribed to the patients were obtained from different offline and online sources. The lowest and highest cost of brands in rupees (INR) for each drug, the cost ratio, percentage cost variation, and monthly cost for all the prescribed drugs were calculated. Results: In our study, out of total 142 patients, 93 were females and 49 were males and the mean age was 49.11±15.89 years. Most patients were prescribed with Disease-modifying antirheumatic drugs (DMARDs). Frequently used nonsteroidal anti-inflammatory drug (NSAID) was Diclofenac (n=48). A maximum cost ratio (15.6) was observed with prednisolone 5 mg TDS. The costliest and cheapest brand of prednisolone 5 mg TDS accounted for the maximum cost variability (1460%). Mean monthly cost varied among different drug classes. Conclusion: Average cost of illness of patient with RA was estimated to be in the range of 2406/month to 2858/month in the year 2021.
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Background: Osteoporosis is a chronic disease leading to weakened and porous bones which increases the risk of fractures. It is a treatable condition using drugs like bisphosphonates. There is wide variation in the cost among various brands of bisphosphonates in the Indian market, so the objective of the study was to analyse cost of different brands of bisphosphonates.Methods: Cost of both oral and injectable bisphosphonates in the same strength and dosage forms was obtained from CIMS India (January-April 2019). For oral form of the drug, price was calculated per 10 tablets, for injectable form the price per ampoule or vial was calculated and cost ratio, percentage of cost variation was calculated.Results: 15 different formulations of bisphosphonates were analyzed and it was found that cost ratio is found to be highest with 60 mg of pamidronate injection and lowest with 10 mg alendronate tablet, also pamidronate 60 mg injection has highest percentage of cost variation (9632%) and lowest cost variation is seen with 10 mg alendronate (35%). Cost ratio of 11 formulations was found to be very high which was >2 while percentage of cost variation of 11 formulations was found to be more 100.Conclusions: This study concludes that there is wide variation in cost of various brands of bisphosphonates in India. The huge price variation creates unnecessary burden leading on the patients resulting in noncompliance which increases the risk of morbidity and mortality. Therefore, there is an urgent need to regulate the cost of various formulations of bisphosphonates which will reduce the financial burden on the patients.
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Background: Indian pharmaceutical industry is one of the growing pharmaceutical markets in the world having number of formulations available with large difference in prices. Price variations of such drugs which are used by large number of population have major economical implication. Hyperlipidemia is major risk factor for ischaemic heart diseases. So we planned this study to find out variation in cost of oral hypolipidemic drugs available in India either as a single drug or as fixed dose combination (FDCs) and to compare cost of their generic version with brands.Methods: The prices of single and FDCs of hypolipidemic drugs were taken from 揑ndian Drug Review 2018� and 揅urrent Index of Medical Specialities during October 2018 to December 2018�. Maximum and minimum prices of various hypolipidemic drugs of same strength and dosage forms manufactured by different companies were taken.Results: Minimum cost variations are 3.62% (pravastatin 10 mg) and 3.37% (rosuvastatin 5 mg and fenofibrate 67 mg). Maximum cost variations are 500% (simvastatin 5 mg) and 500.32% (atorvastatin 10 mg and fenofibrate 160 mg). Wide variations are found in cost of brand drug with generic version of same strength components. None of the pharmaceutical companies are selling drugs cheaper than or equal to the cost of generic drugs of same strength.Conclusions: Most of hypolipidemic drugs should come under control of Drug Price Control Order so that financial burden of healthcare services on Indian population can be reduced and by adherence to treatment will improve health status of the community.
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Background: There are numerous brands of antimalarial existent in the market. Expensive drugs could result in financial drain that causes reduced compliance or even non-compliance. Non-adherence to therapy could consequently cause partial treatment that leads to higher morbidity and in certain cases mortality too. Thus this evaluation was conducted to measure the cost disparity of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in Indian rupee rate was noted by using the latest edition of current index of medical specialities. The cost ratio and the percentage cost variation for individual drug brands were calculated.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Chloroquine DS 500 mg showed the highest cost ratio and cost variation (cost ratio=15.3 and % cost variation=1434). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents.Conclusions: The maximum variation shown by oral antimalarial was found to be for chloroquine DS 500 tablet. But there was significant price variation among injectable antimalarial. Injectable antimalarials are often the choice of drug when dealing with critically ill malaria patients specially when suffering from complicated malaria. So, such significant price variation creates burden on poor patients economically which leads to non-compliance and hence increased morbidity and mortality due to incomplete treatment.
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Background: The objective of the present study was to analyse price differences between parenteral antibiotics available in a tertiary care teaching hospital.Methods: The study was done in the Department of Pharmacology of S. D. M. College of Medical Sciences, Dharwad, Karnataka. Latest volume of current index of medical specialties or Indian Drug Review was used to analyze the prices of parenteral antibiotics.Results: Overall, prices of 17 single drug antibiotics available in 37 strengths marketed and 8 fixed-dose combinations available in 16 strength marketed were analyzed. It was observed that the maximum cost variation among the single ingredient parenteral antibiotic was with cefpirome 1000 mg. The price difference being Rs. 283 and the cost variation being 90.7%. The minimum price variation was seen with Ampicillin 100 mg of Rs. 4.3 and the cost variation being 40.2%. Additionally the highest price difference was also seen teicoplanin 400 mg i.e., Rs. 610 and its cost variation being 68.5%. Among the fixed-dose combination (FDC抯) the maximum price variation was observed in the combination of cefoperazone+sulbactum 1000+1000 of Rs. 340. Whereas the cost variation of the same was 212.5 %. The minimum price variation among the FDC抯 was of the combination of ceftriaxone 250 mg + tazobactum 31.25 mg Rs. 3.3 and its cost variation being 7.9 %.Conclusions: Pharmacoeconomics facets must be taken into deliberation by healthcare practitioners while prescribing antibiotics to the patients for infectious disease treatment. This will assist compliance, reduce antibiotic resistance and treatment failure.
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Background: topical eye preparations are very commonly used in India for different eye diseases hence their prices should not be much different in Indian pharmaceutical industry. The common man therefore has to shell out more money with medicine prices spinning out of his reach. Aim of this study was to compare the cost of drugs of the different brand of topical ophthalmic drugs.Methods: cost of various topical eye preparations was compared using “Current Index of Medical Specialties” (CIMS) January-April 2019 and cost variation was recorded. Drugs were categorized into anti-infective and antiseptics, topical corticosteroids, mydriatics, anti-glaucoma drugs, anti-inflammatory and lubricants.Results: That of the 26 drug formulations studied, the percentage cost variation of 10 drug formulations was more than 100%, out of which one formulation of moxifloxacin had more than 1000% variation. Cost ratio of 10 drug formulations were more than two. Moxifloxacin 0.5% eye drops had maximum percentage cost variation of 5610.66% and cost ratio of 57.11, followed by ofloxacin 0.30% eye drops (310.92%, 4.11), timolol 0.50% eye drops (263.64%, 3.64), ciprofloxacin 0.30% eye drops (142.42%, 2.42), tobramycin 0.30% eye drops (120.14%, 2.20).Conclusions: There is a significant variation in the price of various topical eye preparations. As most of the preparations being prescribed on an out-patient basis, which was not covered under most of the insurance program. Out of pocket expenditure adversely affects the drug compliance in the long run. There should be a comprehensive action from policymakers, regulatory authorities, government agencies, doctors, pharmacists, and the general public to solve this issue of cost variation of drugs.
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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.
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Background: Ocular drug delivery is a complex drug delivery system, and topical administration being the most frequently employed route of drug delivery in eye diseases. Many topical eye preparations are sold under brand names. The variation in the costs of the same drug and inadequate information on quality and bio-equivalence makes it difficult for the physician to prescribe the most cost-effective treatment. The objective of this study was to analyse the cost variation in different brands of commonly used topical eye preparations in India.Methods: The minimum and the maximum cost in Rupees (INR) of particular topical eye preparations manufactured by various pharmaceutical companies in the same strength were noted. The percentage cost variation and cost ratio were calculated for each brand.Results: The costs of the total of 19 topical eye preparations available in 26 different formulations in India were analysed and a substantial variation in cost was observed. Of 19 drug formulations studied, the percentage cost variation of 10 drug formulations was more than 100% out of which one had more than 1000% variation. Cost ratio was also observed to be very high and 10 drug formulations had this ratio more than two.Conclusions: There is a wide variation in the prices of different brands, so there is an urgent need to raise the awareness of physicians about cost variation to lower the financial burden on patients.
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Background: Diabetes Mellitus is a chronic metabolic disorder, one of the major causes of morbidity, mortality and needs lifelong treatment. There are large numbers of oral anti-diabetic drugs available for the treatment of type 2 diabetes mellitus. There are numerous brands available for each of the individual oral anti-diabetic drug. Thus, a study was planned to find out cost variation among different brands of same active oral anti-diabetic drug.Methods: Cost of a particular drug being manufactured by different companies, in the same strength and dosage forms was obtained from the price list provided by the pharmaceutical companies in Current Index of Medical Specialities (CIMS) (October 2017- January 2018). The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in price was analyzed.Results: Percentage cost variation of the commonly used drugs found was seen highest with Sulfonylureas (Glimepiride - 562%) followed by Metformin (492%) which was followed by Pioglitazone (488%), DPP-4 inhibitor Teneligliptin (231%), α- glucosidase inhibitors (Voglibose 284%), Meglitinides (Repaglinide 0.5mg 154%) and lowest was seen with Repaglinide 2mg (15%).Conclusions: There is very wide cost variation among different brands of the same oral anti-diabetic drugs manufactured in India. The average percentage cost variation of different brands of the same oral anti diabetic drugs manufactured in India is very wide. The appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences.
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Background: In now days proton pump inhibitors are prescribing more and more by Indian physicians not only in peptic ulcer,gastroesophageal reflux disease, gastritis but also along with non steroidal anti-inflammatory drugs to overcome the side effects as gastric irritation and discomfort by non steroidal anti inflammatory drugs.There are many brands of PPI drugs available in Indian market. Costly drugs can lead to economic burden which results in decreased compliance or even non-compliance. Non 朿ompliance leads to incomplete treatment which tends to increase morbidity.Increase in the patient medication cost was found to associated with decreased adherence to prescription medication.Hence this study was done to assess the cost variation of proton pump inhibitors [PPI] drugs.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition Drug Today April to June 2018 Vol-1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of 10 tablets/capsules was calculated in case of oral drug and the cost of one 1 vial or ampoule was noted in case of injectable drug. At last the cost ratio and percentage cost variation of various brands was compared.Results: Percentage variation in cost for proton pump inhibitors marketed in india was found to be tablet/capsule Esomeprazole [20mg]:141.17, tablet/capsule Esomeprazole [40mg]:196.29, capsule/tablet Omeprazole[20mg]: 569.53, Tablet/capsule Pantoprazole[40mg]: 248.8, tablet /capsule Rabeprazole[20mg]: 815.78, capsule/tablet Lansoprazole[30mg]: 173.33, Inj. Esomeprazole [40mg] 1 vial: 81.81, Inj. Omeprazole[40mg] 1vial: 47.95, Inj. Pantoprazole[40mg] 1vial: 66.66, Inj.Rabeprazole [20mg] 1vial: 176.625.Conclusions: Tablet Rabeprazole[20mg] shows highest cost ratio and percentage cost variation as 9.15 and 815.78. While Inj. Omeprazole[40mg] 1 vial shows lowest cost ratio and percentage cost variation as 1.47 and 47.95.
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Background: Acquired immunodeficiency syndrome (AIDS) is a disorder caused by the human immunodeficiency virus (HIV). Main characteristic feature of AIDS includes severe immunosuppression which leads to opportunistic infections which is a main cause of death and requires a lifelong therapy. There exists wide range of cost variation in antiretroviral drugs that are marketed in India. The current study aims to view the existing situation of antiretroviral drugs, by collecting data about the cost of common antiretroviral drugs available either singly or in combination and to evaluate the difference in cost of different brands of same active drug by calculating percentage cost variation.Methods: Data for calculating cost ratio and percentage price variation of various antiretroviral drugs was obtained from 揅urrent Index of Medical Specialties� October 2017-January2018.Results: Zidovudine 100mg shows maximum cost ratio and price variation followed by Lamivudin 100mg in the single drug therapy. Lamivudine 150mg + Zidovudine 300mg shows maximum price variation in combination drug therapy.Conclusions: Indian market shows wide price variation of different brands of the same generic antiretroviral drug. To decrease the wide cost variation among different brands of antiretroviral drugs; it is time to create awareness among healthcare professionals about impact of cost effectiveness of drug regimen and decrease the financial burden on the patients.
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Background: Indian pharmaceuticals market stands third and thirteenth largest in terms of value and volume in the Global Pharmaceutical Industry respectively. Anxiety disorders are one of the most common mental illnesses affecting more than 15% of the population at some point in their life span. Treatment of anxiety disorders usually follows a long term treatment. Cost of the treatment is an important factor determining the adherence to the treatment.Methods: Data relevant to various brands of anxiolytic drug available in the Indian market particular drug obtained from “Current Index of Medical Specialties” (CIMS) October 2017 - January 2018 was used to calculate the cost ratio and percentage cost variation.Results: There are 16 anxiolytic drugs in the form of 44 different formulations and 384 brands available in the Indian market. Among anxiolytic drugs, highest cost ratio and percent cost variation is for diazepam 5mg, followed by alprazolam 1mg and hydroxyzine 10mg. Highest number of brands of anxiolytic drugs available in Indian market are for clonazepam 0.5mg followed by alprazolam 0.5mg and escitalopram 10mg.Conclusions: In Indian market, there is availability of large number of brands with wide and variable cost variations among the various brands of the anxiolytic drugs.