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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: 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: 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: 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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Resumo Este artigo avalia a relação de custos entre a saúde pública e a implementação do saneamento básico na capital da Guiné-Bissau. Analisaram-se seis cenários, incluindo três opções para o sistema de esgotamento sanitário (sistema coletivo com rede coletora e estação elevatória de esgoto, sistema simplificado individual por latrina e sistema coletivo completo com rede coletora, estação elevatória e estação de tratamento de esgoto) e duas para o sistema de abastecimento de água (captação direta e sistema completo com captação, reservação e distribuição). Quanto à saúde pública, consideraram-se os custos com recursos humanos e programas de assistência social, medicamentos, vacinas e internações relacionados às doenças de veiculação hídrica, malária e cólera. A relação de custos de 4,29 no cenário mais eficiente de saneamento básico foi similar ao valor encontrado na literatura da área. Em outras palavras, para cada dólar investido no saneamento básico existe uma economia aproximada de 4,3 dólares com a saúde. Além disso, as curvas potenciais da relação de custos, em razão do cenário, são muito úteis em países pobres da África, Ásia e América Latina, regiões que carecem de dados relacionados aos gastos com saúde pública e saneamento básico.
Abstract This paper has assessed the relationship between public health costs and the implementation of basic sanitation in the capital of Guinea-Bissau. Six scenarios have been analyzed, including three sanitary sewage system options (a collective system with a collection network and a sewage collection station, an individual simplified pit latrine system and a full collective system with a collection network, and a lift station and sewage treatment plant), and two water supply system scenario options (direct collection and a complete system with collection, storage, and distribution). Regarding public health, the costs with human resource and social assistance programs, medicaments, vaccines, and hospitalizations related to malaria and cholera waterborne diseases have been considered. The cost ratio of 4.29 for the most efficient basic sanitation scenario was similar to the numbers found in literature. In other words, for every dollar invested in basic sanitation, the approximate savings in health are 4.3 dollars. Also, potential cost-scenario ratio curves are very useful in poor countries in Africa, Asia, and Latin America, because of the lack of public and basic sanitation expenditure data for these regions.
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Humans , Male , Female , Water Supply , Sewerage , Public Health , Basic Sanitation , Costs and Cost AnalysisABSTRACT
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: 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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In this economic evaluation of environmental epidemiological monitoring projects, we analyzed the economic feasibility of these projects by determining the social cost and benefit of these projects and conducting a cost/benefit analysis. Here, the social cost was evaluated by converting annual budgets for these research and survey projects into present values. Meanwhile, the societal benefit of these projects was evaluated by using the contingent valuation method to estimate the willingness-to-pay of residents living in or near industrial complexes. In addition, the extent to which these projects reduced negative health effects (i.e., excess disease and premature death) was evaluated through expert surveys, and the analysis was conducted to reflect the unit of economic value, based on the cost of illness and benefit transfer method. The results were then used to calculate the benefit of these projects in terms of the decrease in negative health effects. For residents living near industrial complexes, the benefit/cost ratio was 1.44 in the analysis based on resident surveys and 5.17 in the analysis based on expert surveys. Thus, whichever method was used for the economic analysis, the economic feasibility of these projects was confirmed.
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Budgets , Cost of Illness , Cost-Benefit Analysis , Epidemiological Monitoring , MethodsABSTRACT
A field experiment was conducted during kharif 2011 at College of Agriculture, Rajendranagar. The experiment consisted of 12 treatments laid out in randomized block design with three replications consisting of two pre-emergence herbicides integrated with post emergence herbicides and one hand weeding at 40DAT and two post emergence herbicide, hand weeding twice at 20 and 40 days after transplanting, compared with weed free and unweeded check. The predominant weed flora observed in the experimental field were Echinochloa crusgalli, Panicum repens, Cynodon dactylon, Cyperus rotundus, Cyperus difformis, Eclipta alba and Ammania baccifera. The results revealed that pre-emergence application of Bensulfuron methyl 0.6% + Pretilachlor 6% @ 10 kg granules ha- 1+ Hand weeding at 40 DAT (5455 kg ha-1 and 6345 kg ha-1) and Bensulfuron-methyl 0.6% + Pretilachlor 6% @ 10 kg granules ha-1 + Bispyribac sodium @ 25 g a.i ha-1 recorded significantly higher grain and straw yield (5365 and 6265kg ha-1, respectively) which remained at par with two hand weedings at 20 and 40 DAT (5580 and 6464 kg ha- 1). In terms of economics, highest net returns (Rs. 33,189 ha-1) and B:C ratio (1.40) were also high with the preemergence application of Bensulfuron-methyl 0.6%+ Pretilachlor 6% @ 10 kg granules ha-1+ Bispyribac sodium @ 25 g a.i. ha-1 at 20DAT (1.40) compared to that of two hand weedingds (Rs. 31,952 ha-1) and benefit cost ratio (1.17) .
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OBJECTIVES: Although Electronic Medical Record (EMR) systems provide various benefits, there are both advantages and disadvantages regarding its cost-effectiveness. This study analyzed the economic effects of EMR systems using a cost-benefit analysis based on the differential costs of managerial accounting. METHODS: Samsung Medical Center (SMC) is a general hospital in Korea that developed an EMR system for outpatients from 2006 to 2008. This study measured the total costs and benefits during an 8-year period after EMR adoption. The costs include the system costs of building the EMR and the costs incurred in smoothing its adoption. The benefits included cost reductions after its adoption and additional revenues from both remodeling of paper-chart storage areas and medical transcriptionists' contribution. The measured amounts were discounted by SMC's expected interest rate to calculate the net present value (NPV), benefit-cost ratio (BCR), and discounted payback period (DPP). RESULTS: During the analysis period, the cumulative NPV and the BCR were US$3,617 thousand and 1.23, respectively. The DPP was about 6.18 years. CONCLUSIONS: Although the adoption of an EMR resulted in overall growth in administrative costs, it is cost-effective since the cumulative NPV was positive. The positive NPV was attributed to both cost reductions and additional revenues. EMR adoption is not so attractive to management in that the DPP is longer than 5 years at 6.18 and the BCR is near 1 at 1.23. However, an EMR is a worthwhile investment, seeing that this study did not include any qualitative benefits and that the paper-chart system was cost-centric.
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Humans , Adoption , Cost-Benefit Analysis , Electronic Health Records , Electronics , Electrons , Hospitals, General , Investments , Korea , Outpatients , Tertiary HealthcareABSTRACT
Objective To find out the benefit and cost of color ultrasonic devices in our hospital after the drop of large equipment examine fee.Methods Data of benefit and cost on 7 color ultrasonic devices in using are collected and analyzed by using Benefit Cost Ratio(BCR) method.Results The higher valuable the equipments are,the more fixed cost they have with lower BCR.Conclusion Buying cheaper equipment is the only way to increase the pure benefit under the precondition of normal diagnosis by devices.
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This study was surveyed to provide the information on current operational practices and issues of contract-managed foodservice companies. Questionnaires were distributed to 79 contract-managed foodservice companies (eight large-size, 48 mid-size, 23 small-size companies) from March to May in 2002. The contract-managed foodservice companies provided averages of 269,184 (range 140,036~503,500), 14,837 (range 450~75,269), and 4,065 (range 930~8,050) meals daily from large, medium, and small-size companies, respectively. The companies managed to averages of 268.2 (160~619) foodservice contracts at large-size companies, 21.9 (5~63) contracts at mid-size companies, and 4.7 (1~10) contracts at small-size companies. The average numbers of dietitians were 298.6 (range 104~671) in large-size companies, 22.2(6~86) in mid-size companies, and 3.8(1~9) in small-size companies. The averages of sales were 156.5 billion at large-size companies, 6.7 billion at mid-size companies, and 1.7 billion at small-size companies in 2001. The contract was two types including management fee contract(5%), and profit and loss contract(95%). The cost ratios for office foodservice were 59.5% at food cost, 24.2% at labor cost, 6.3% at profit, and 10.1% at other cost. For hospital foodservice, the ratios were 54.0% at the food cost, 34.6% at labor cost, 3.0% at profit, and 11.8% at other cost. For high school foodservice, the ratios were 62.2% at the food cost, 21.5% at labor cost, 5.4% at profit, and 11.2% at other cost. When the contractors managed to the foodservice, the most important matters were the sanitation management and customer satisfaction. Also, the difficult problems were excess investment of equipments and low meal prices.
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Humans , Commerce , Fees and Charges , Investments , Meals , Nutritionists , Surveys and Questionnaires , Republic of Korea , SanitationABSTRACT
Environmental pressures from such sources an economic condition, the government and inter-institutional competition create managerial challenges. Economic pressures may be forcing dietetic dept, in hospital to utilize cost, benefit analysis to assist them in their problem solving. Cost, benefit analysis have been widely used in business, industry and many other fields with only limited application to foodservice. Due to the lack or this information the purposes of this study were to identify use of cost, benefit analysis in hospital foodservice system to evaluate the economic efficiency of alternatives, and to make recommendation for operation system change. Using the cost?benefit method, cash flows are separated into cost and benefits. For an alternative to be selected, indicators, such as NPV, benefit-cost ratio (B/C ratio) with 5% discount rate per annum. The sensitivity analysis was also conducted with difference rate 3%, 7% respectively and reduced employee payroll change. The result of this study can be summarized as follows : 1. The total cost of investment for operation system change was 390,570 thousand won and the total benefit through operation system change was 865,808 thousand won. 2. Net present value(NPV) for 5 years was 475,239 thousand won and benefit-cost ratio was 2.22. 3. In sensitivity analysis with different discount rate 3%, 7%, benefit-cost ratio was 2.25, 2.18 respectively, with total reduced employee payroll change, benefit-cost ratio was 2.86. In conclusion, total benefits were exceeded total costs. Therefore, the project of operation system change in hospital foodservice was found to be economically efficient.
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Commerce , Cost-Benefit Analysis , Investments , Problem SolvingABSTRACT
Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.
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Humans , Budgets , Compensation and Redress , Cost-Benefit Analysis , Health Care Costs , Low Back Pain , Occupational Injuries , Pain Clinics , Rehabilitation , Return to WorkABSTRACT
Objective To evaluate economic benefits of maintenance for medical equipment.Methods According to the maintenance tour records taken by Institute of Drug and Instrument Control in 2007,economic benefits of 21 kinds of normal medical maintenance were analyzed by using the database of Excel 2003.Result The total benefit cost ratio was 2.73.Conclusion Investment in maintenance for medical equipment has great economic effect.
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Objective: To evaluate economic benefits of military medical measurement. Methods: According to the record of the metrological verification from the measurement station in Nanjing military region from 2000 to 2004, database is set up by Excel 2003 and the economic benefits from 14 kinds of measuring standard are analyzed. Results In a 5-year-lifetime cycle, the NPV of 10 kinds of measuring standards were over 0, 4 kinds less than 0, the average pay back period was 4.43year, and total benefit cost ratio was 2.73. Conclusion Economic benefits have been gained obviously in the investment of military medical measurement.