scholarly journals Cost analysis and price variation of commonly used drugs in obstetrics and gynecology in Jhalawar district of Rajasthan, India

Author(s):  
Anshul Jhanwar ◽  
Neelam Sharma

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.

Author(s):  
Ajay Kumar Shukla ◽  
Astha Agnihotri

Background: Indian drug market has large numbers of branded formulations for every drug molecule. 1 Cost-sensitive healthcare environment has created a challenging workplace for clinicians. Efficient use of healthcare resources without compromising quality of patient care has been a challenging task for healthcare professionals. There is a wide range of variation in the prices of drugs marketed in India. Thus, a study was planned to analyse out cost variations of antiepileptic drugs available in Indian market.Methods: Minimum and maximum costs in Rupees (INR) of different brands of same generic antipsychotic drugs, in the same strength and dosage forms were compared. The cost ratio and percentage cost variation were calculated for each generic antipsychotic drug. The number of formulations for antipsychotic drugs and number of brands for each of them were also taken into consideration.Results: This study shows that in Indian market, there are wide variations in the prices of different brands of same generic antipsychotic drug. The highest cost ratio and percent cost variation was found for risperidone 2 mg [(1:16.27) and 1527.48], followed by risperidone 4 mg [(1:16.25) and 1525.25], risperidone 3 mg [(1:15.67) and 1467.33], risperidone 1 mg [(1:14.86) and 1386.78], olanzapine 10 mg [(1:12.36) and 1136.84], and olanzapine 5 mg [(1:12.31) and 1130.76]. Highest number of brands of antipsychotic drug available in Indian market are for divalproex sodium 500mg(25) followed by olanzapine 15 mg(23), olanzapine 5 mg(23), olanzapine 2.5mg(14), and risperidone 1 mg (14). Highest numbers of formulations of antipsychotic drug available in Indian market are for olanzapine(06), quetiapine(05), haloperidol(05), and aripiprazole(05).Conclusions: In Indian market, the average percentage price variation of different brands of the same oral antipsychotic drugs is very wide. Treatment with antipsychotic drugs usually has a long course with treatment adherence being a crucial factor for successful treatment. Improved adherence to the drug treatment can be ensured by decreasing the cost of therapy. Decreased drug cost expenditure can be ensured 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.


2015 ◽  
Vol 13 (2) ◽  
pp. 6-9
Author(s):  
Binaya Shrestha

Introduction: Diabetes Mellitus is one of the major causes of morbidity, mortality and needs lifelong treatment. There is a wide range of variation in the prices of antidiabetic drugs marketed in Nepal. Thus, a study was planned to find out price variations in the oral hypoglycemic drugs available singly and number of manufacturing companies for each, also 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 the price list provided by the pharmaceutical companies in Nepal and Indian Drug Review September 2013. 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 of the commonly used drugs found was metformin (500mg) 171.42%, metformin (850mg) 128.42%, metformin (1000mg) 80%, pioglitazone (15mg) 150% pioglitazone (30mg) 188.89%, sitagliptin (50mg) 33.33%, sitagliptin (100mg) 40% acarbose (25mg) 39.58%, acarbose (50mg) 32.60%, gliclazide (80mg) 108%, gliclazide (40mg) 83.33%, glibenclamide (2.5mg) 87%, glibenclamide (5mg), 80%, glimiperide (1mg) 91.67%, glimiperide (2mg) 300%, glimiperide (3mg) 100%, glimiperide (4mg) 36.84%.Conclusion: The average percentage price variation of different brands of the same oral hypoglycemic drugs manufactured in Nepal 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.


Author(s):  
Franklin E. Gbologah ◽  
Angshuman Guin ◽  
Roger Purcell ◽  
Michael O. Rodgers

Lighting provides one of the most effective night-time intersection safety countermeasures. However, lighting is also one of the main contributors to intersection maintenance and operation costs. For a public transportation agency with jurisdiction over many intersections, the system-wide lighting costs can significantly deplete already limited funds for other important maintenance projects. A sound framework for conducting benefit-to-cost trade-off analysis would be beneficial to transportation agencies. Unfortunately, published works on the benefit-to-cost analysis are few and mostly dated. This paper outlines a detailed framework for conducting benefit-to-cost analysis for rural intersection lighting. The framework uses intersection lighting simulation models to generate annualized operating and maintenance cost data for different lighting levels. The intersection lighting models were developed with DIALux® professional lighting software. This study used the framework to conduct a case study of rural conventional three-leg and four-leg intersections with at least an annual average daily traffic (AADT) of 500 from Georgia. Based on the available Georgia case study data, this paper finds that for rural intersection locations that require no electrification, basically any illumination level, including those less than the recommended minimum of 8 lux, is likely to be cost-effective for any entering AADT. However, locations that require electrification need to be evaluated based on the overall costs, entering AADT, existing crash rate, and a target benefit-to-cost ratio that signifies the level of cost-effectiveness required by the state Department of Transport (DOT). Consequently, a companion spreadsheet benefit-to-cost model has been developed to facilitate the cost-effectiveness analysis at any rural uncontrolled or stop-controlled intersection.


Author(s):  
Kajal S. Gupta ◽  
Milind L. Pardeshi ◽  
Rajesh S. Hiray

Background: Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary lifestyle, the incidence of DM is increasing. The chronic nature of DM causes significant personal suffering and economic difficulty to families. The was aimed at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various pharmaceutical companies were obtained from current index of medical specialties (CIMS) website, Indian drug review (IDR) 2021 issue and National pharmaceutical pricing authority-pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, metformin 500 mg sustained release showed highest price variation (3668%). Minimum cost variation was found with glipizide 2.5 mg (65%). Amongst the fixed dose combinations, highest cost variation was seen with glimepiride 2 mg+metformin 1000 mg (2703%) while minimum cost variation was found with repaglinide 1 mg+voglibose 0.3 mg (29%).Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all.Background:  Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands   Background:  Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands   Background:  Diabetes mellitus (DM) is a chronic metabolic disorder requiring lifelong treatment. Due to rapid expansion of urbanization, unhealthy diet habits and sedentary life style, the incidence of DM is increasing .The chronic nature of DM causes significant personal suffering and economic difficulty to families. The present study aims at investigating the cost difference in various brands of the same oral anti-diabetic drug.Methods: The minimum and the maximum cost in rupees (INR) of a particular anti-diabetic drug manufactured by various brands were obtained from Current Index of Medical Specialties (CIMS) website, Indian Drug Review (IDR) 2021 issue and National Pharmaceutical Pricing Authority – Pharma sahi daam. The cost ratio and percentage cost variation were noted for each brand.Results: Amongst single drug therapy, Metformin 500mg Sustained Release showed highest price variation (3668%). Minimum cost variation was found with Glipizide 2.5mg (65%).Amongst the fixed dose combinations, highest cost variation was seen with Glimepiride 2mg + Metformin 1000mg (2703%) while minimum cost variation was found with Repaglinide 1mg + Voglibose 0.3mg (29%). Conclusions: A noticeable cost variation was found in different brands of the same anti-diabetic drug. Prescribing a more expensive brand when a cheaper one is available can burden the patient financially and thus reduce patient compliance. In addition, the Government should also include more anti-diabetic drugs under the price control policy to ensure that affordable and efficacious medicines are available to all. Keywords: Anti-diabetic agents, Cost variation, Pharmaco-economics, Adherence, Brands         


Author(s):  
Nagaraja Prasad Sai ◽  
Vedavathi H.

Background: One of the major cost that the patient has to bear during therapy is medication cost Different brands of the same mediations are available leading to considerable price variation. This can affect medication compliance by the patient. The present study was undertaken to evaluate the variation in costs of antiepileptic’s available in India.Methods: Cost of all antiepileptics (tablets/capsules) available in India was obtained from CIMS July to Oct 2016 and from IDR Vol XXII issue No 3, 2016. The percentage cos ratio and percentage variation in cost were calculated and compared.Results: The highest cost ratio and percentage price variation was found with carbamazepine 200mg (1:12 and 1100) followed by acetazolamide 250mg (1:11.38 and 1037.68). Other significant cost variations (>100%) were seen with carbamazepine 100mg, phenobarbital 30mg, divalproex sodium 25mg, lorazepam 1mg, clonazepam 1mg and valproic acid 500mg. Lowest percentage cost variation was seen with oxcarbazepine 450mg (1.09), lacosamide 50mg (2.56), pregabalin 50mg (3.51) and zonisamide 50mg (4.21).Conclusions: The Government of India regulates prices of essential drugs through Drug Price Control Order (DPCO) and this is implemented by National Pharmaceutical Pricing Policy (NPPA). However nearly 80% of medications donot fall into this category. This leads to considerable economic burden on poor patients. There is still considerable price difference among various brands of antiepileptic available in India. The Government of India should take a firm decision and implement them with regard to pricing of medications so as to make them more affordable, especially for diseases which require long term treatment such as epilepsy.


Author(s):  
Kiran B. ◽  
Kala P. ◽  
Chitra N. S. ◽  
Jamuna Rani R.

Background: Skeletal muscle relaxants are structurally distinct drugs prescribed for reducing muscle spasms, pain, and hyperreflexia. Centrally acting skeletal muscle relaxants are manufactured by various pharmaceutical companies with variable price. The present study, aimed to analyze the cost variation of various brands of centrally acting skeletal muscle relaxants, so as to help the physician to choose the cost effective treatment.Methods: Current index of medical stores (CIMS) April 2018 and online literature were used as information guide to review the prices of drugs used in the treatment of musculo skeletal pain and spastic neurological disorders.Results: Among anti spasmodic group, thiocolchicoside 4 mg shows maximum price variation of 337.5%, whereas carisoprodol 350 mg shows the least variation of 0.1%. It is evident from antispastic group that baclofen 10 mg shows maximum price variation of 93.91% and 5 mg of Baclofen shows the least variation of 11.22%. It is observed that, among anti spastic group, a percentage prize variation of 93.91 for 10 mg and 11.22 for 5 mg baclofen. Largest % prize variation is seen in metaxalone + diclofenac sodium (400+50) mg as 525% and the least variation is observed in tolperisone+ paracetamol (150+325) mg as 3.88%.Conclusions: Centrally acting orally effective skeletal muscle relaxants are commonly prescribed for painful musculoskeletal and spastic neurological disorders. Physicians should give due importance for the cost of the drugs while selecting appropriate drug for musculo skeletal disorders.


Author(s):  
Nagavishnu Kandra ◽  
Rajesh B.

Background: Epilepsy is a group of neurological disorders, characterized by seizures, loss of consciousness, muscular contraction. Prevalence of epilepsy in India is about 1%. High medical care cost should be cause of concern for policy makers and service providers. Hence, a study was planned to analyse cost ratio and percentage cost variations of oral antiepileptic drugs available in India.Methods: An analytical study with maximum and minimum price of 10 tablets/capsules and syrup of one bottle of available strength of each drug was noted in Indian Rupee, using “Current Index of Medical Specialties” July to October 2020; “Drug Today” July To October 2020 volume-1 and “Indian Drug Review” 2020 volume-26 issue 6. Percentage cost variation and cost ratio for individual drugs was compared.Results: Significant cost variations were found in different brands of same drug. Among established oral antiepileptic drugs, Divalproex sodium 250 mg has highest cost ratio 16.071 and 1507.14% price variation and Clonazepam 0.25 mg with cost ratio 16.005 and 1500.55% price variation. Diazepam 2 mg has lowest cost ratio 1.024 and 2.43% price variation. Among newer oral antiepileptic drugs, Levetiracetam 500 mg has highest cost ratio 66.389 and 6538.93% price variation; least is Oxcarbazepine 450 mg with cost ratio 1.317 and 31.75% price variation.Conclusions: Epilepsy has long course of treatment. Increased adherence to treatment is achieved by switching to cost-effective therapy and by making Pharmacoeconomics an integral part of Undergraduate and Postgraduate Curriculum.


Author(s):  
Pooja C. Upasani ◽  
Rohidas M. Barve ◽  
Rajesh S. Hiray

Background: The hypertension is the most common chronic disease, therefore treatment should be affordable. The antihypertensive drugs of same strength are available in market at different costs. This study was undertaken to create awareness among health care workers and patients, about cost difference among different brands of same antihypertensive drug. So that whenever possible, a cheaper effective brand can be prescribed to ensure better patient adherence.Methods: Maximum retail price (MRP) of various antihypertensive drugs of same strength, manufactured by different pharmaceutical companies was obtained from various offline and online sources. The minimum and maximum cost of 10 tablets/capsules noted. The cost ratio and percentage cost variation was calculated for single drug and fixed dose combinations. The ceiling price (as per DPCO) of essential antihypertensives (as per national list of essential medicines) was compared with their maximum cost.Results: The formulations of single antihypertensive drugs (41) and fixed dose combinations of two drugs (19) and three drugs (9) were included in the study. Among the single antihypertensives analyzed the highest cost difference was of eplerenone (50 mg) and high cost ratio and cost variation percentage was of amlodipine (5 mg). Among fixed dose combination of two drugs analyzed highest cost difference was found that of hydrochlorothazide (12.5 mg)+olmesartan (40 mg) combination and highest cost ratio and percentage cost variation was of amlodipine (5 mg)+telmisartan (40 mg).Conclusions: There was a huge price variation among the antihypertensive drugs manufactured by various companies. Some measures must be taken by the government to bring the uniformity in the price that will help to reduce the economic burden on the patients.


Author(s):  
Dinesh Prasad Sinha ◽  
Bhuwaneshwari Sinha ◽  
Santosh Kumar ◽  
Akash Chandra

Background: Fluoroquinolone eye drops is being prescribed by Opthalmologist in many ocular diseases as conjunctivitis, keratitis, bacterial corneal ulcers etc in more and more amount. There are many brands of fluoroquinolones drugs available in Indian market. Costly drugs can lead to economic burden on patients. Modifications in pharmaceutical policy are required, and prices of the drug should be controlled in effective way for all the drugs. Hence this study was done to assess the cost variation of fluoroquinolones opthalmic solutions available in Indian market.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2020 edition and Drug Today April to June 2020 volume 1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of each eye drop was calculated. At last the cost ratio and percentage cost variation of various brands was compared.Results: Percentage variation in cost for fluoroquinolones eye preparations marketed in India was found to be Eye drop Ciprofloxacin (0.3%) of 5 ml:210.39, Eye drop Ciprofloxacin (0.3%) of 10 ml:162, Eye drop Gatifloxacin (0.3%) of 5 ml:156, Eye drop Moxifloxacin (0.5%) of 5 ml:196.95, Eye drop Ofloxacin (0.3%) of 5 ml:245.16, Eye drop Ofloxacin (0.3%) of 10 ml:62.5, Eye drop Norfloxacin (0.3%) of 5 ml:120.68, Eye drop Sparfloxacin (0.3%):8.31, Eye drop Lomefloxacin (0.3%):16.17.Conclusions: There is a wide difference in the cost of different brands of fluoroquinolones eye preparations available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy.


Author(s):  
Nishita P. Shah ◽  
Aparna S. Chincholkar ◽  
Ranjit J. Wagh ◽  
Waseem A. Siddiqui

Background: Pricing of drugs plays a very important role in a developing country like India especially in the management of chronic conditions. There exists a huge price variation among the different brands of the same drug. Hence this study was planned to find out variation in prices of antipsychotic drugs marketed in India. The objective was to compare the percentage price variation and cost ratio of various formulations of oral and parenteral antipsychotic drugs available in the Indian market.Methods: Cost of oral and parenteral antipsychotic drugs available in the Indian market manufactured by different companies, in the same strength, number and dosage form was obtained from http://www.medguideindia.com. The percentage price variation and cost ratio of each formulation was calculated.Results: Among the typical group of antipsychotic drugs, Tab Haloperidol 0.25mg shows maximum price variation of 650% and a cost ratio of 7.5 followed by Tab Trifluoperazine 1mg having a price variation of 555.5% and a cost ratio of 6.55. Among the atypical group of drugs, tab Risperidone 3mg shows a price variation of 2282.35% with a cost ratio of 23.82 followed by Tab Risperidone 4mg with a price variation of 1976.92 % and a cost ratio of 20.76.Conclusions: There is a wide variation between the minimum and maximum cost among the different brands of the same drug in the same formulations. Combined efforts are needed from the regulatory authorities, pharmaceutical companies, physicians and pharmacist towards controlling the prices and attaining maximum economic benefits for the patient.


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