scholarly journals Variation of cost among anti-malarial drugs available in Indian market

Author(s):  
Prasan R. Bhandari ◽  
Apeksha Bhandary

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.

Author(s):  
Lalit Kumar ◽  
Jyoti Kumar Dinkar ◽  
Lalit Mohan ◽  
Harihar Dikshit

Background: Malaria has been a problem in India for centuries. There are innumerable brands of antimalarial present in the market. Malaria can be extremely fatal if not treated promptly. Costly drugs can lead to economic burden which results in decreased compliance or even non-compliance. Non-compliance leads to incomplete treatment which tends to increase morbidity. Increase in the patient medication cost was found to be associated with decreased adherence to prescription medication. Hence this study was done to assess the cost variation of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2017 edition and Drug Today January to March 2017, Vol 2. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of 10 tablets was calculated in case of oral drug and the cost of 1 ampoule or vial was noted in case of injectable drug. At last the cost ratio and % cost variation of various brands was compared.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Artemether injection showed the highest cost ratio and cost variation (cost ratio = 16.96 and % cost variation = 1596). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents. Chloroquine which is one of the most used antimalarial showed very low values for cost variation and cost ratio.Conclusions: The analysis showed that there is not much significant price variation among oral antimalarial drugs. The maximum variation shown by oral antimalarial was found to be for fixed dose combination of Artemether and Lumefantrine [cost ratio>2 (2.03) and % price variation >100 (103.7)]. 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.


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.


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):  
Sushma V. Naidu ◽  
Vibha Rani

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.


Author(s):  
Saiyadali A. Allisabanavar ◽  
Narayana Reddy S.

Background: Epilepsy is a common neurological disorder affecting about 10 million persons in India. The compliance to a particular antiepileptic drug is highly dependent on the cost of the drug which directly translates into success or failure of therapy. Hence there is a need for all clinicians to keep themselves updated with the latest prices and price variation of the commonly prescribed drugs. This study aims to analyze cost variation of various brands of anti-epileptic drugs currently available in Indian pharmaceutical market.Methods: Current Index of Medical Specialities July-October 2016 edition was referred to know the maximum and minimum price in INR of various brands of anti- epileptic drugs in India. Further analysis was done by using Percentage Cost Variation.Results: There is wide variation in the prices of different brands of same antiepileptic agents in Indian market. The highest % cost variation was found for diazepam 5mg tablet (374.42), followed by lorazepam 2mg tablet (213.63), carbamazepine 100mg syrup/5ml-100ml (172.58), levetiracetam 1000mg FC-tablet (168.57), lamotrigine 25mg DIS- tablet (150), clobazam 10mg tablet (147.37), clonazepam 0.5mg tablet (145.90), oxcarbazepine 150mg tablet (89.46), gabapentin 300mg capsule (71.67), valproic acid 200mg FC-tablet (58.62), divalproex sodium 500mg ER-tablet (47.82), topiramate 50mg tablet (41.66) and lowest % cost variation was of phenytoin sodium 300mg tablet (0.23).Conclusions: The average percentage price variation of different brands of same oral anti-epileptic drug in Indian market is very wide. To counter act such cost variation, physicians should be encouraged to prescribe a medication brand with low cost. This in turn reduces the unnecessary economic burden to the patients.


Author(s):  
Pramod Kumar Manjhi ◽  
Sunil Kumar Singh ◽  
Chakrapani Kumar ◽  
Akhilesh Kumar Rana

Background: Antitussive-expectorants are among the most frequently prescribed drugs by physicians in clinical practice. Upper respiratory tract infections, such as common cold, acute pharyngitis and acute trachea-bronchitis, are the most common of all communicable diseases and significantly increase OPD burden. This study aimed to assess the rational use, cost ratio, and percentage cost variations in different brands of the commonly prescribed antitussive-expectorants available in the Indian market.Methods: The cost of antitussive-expectorant manufactured by different pharmaceutical companies was obtained by using drug today Jan-April 2021 vol 2. The maximum and minimum price was noted down, cost ratio and percentage cost variation of the individual formulation were analysed.  Results: Analysis of cost ratio and percentage cost variation for each formulation of the antitussive-expectorants drug, syrup (100 ml) chlorpheniramine (2 mg), dextromethorphan (10 mg), phenylephrine (5 mg) combinations show the highest cost ratio and percentage cost variation as 5.30 and 430.25 respectively, and syrup (100 ml) dextromethorphan (10 mg), guaifenesin (100 mg), phenylephrine (25 mg), chlorpheniramine (4 mg) combinations show lowest cost ratio and percentage cost variation as 1.17 and 17.69 respectively.Conclusions: There was a wide variation in the cost of different brands of antitussive-expectorant drugs available in the Indian market. So, clinicians should be aware of rational use and variations in cost to reduce the treatment cost and increase patient compliance.


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):  
Rabi Bhushan ◽  
Anupam Kishore ◽  
Akash Chandra ◽  
Ajay Kumar ◽  
Haribansh Kumar Singh

Background: In now day’s 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–compliance 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 Drug Today January to April 2020 edition, 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. 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]: 297.65, tablet/capsule Esomeprazole [40mg]: 344.41, capsule/tablet Omeprazole [10mg]: 74.51, capsule/tablet Omeprazole [20mg]: 542, Tablet/capsule Pantoprazole [40mg]: 3297.33, tablet/capsule Rabeprazole [10mg]: 1160, tablet/capsule Rabeprazole [20mg]: 1101.05, capsule/tablet Lansoprazole [15mg]: 306.69, capsule/tablet Lansoprazole [30mg]: 336.33,   capsule/tablet Dexlansoprazole [60mg]: 7.69.Conclusions: Capsule Pantoprazole [40mg] shows highest cost ratio and percentage cost variation as 33.97 and 3297.33. While capsule Dexlansoprazole [60mg] shows lowest cost ratio and percentage cost variation as 1.07 and 7.69.


Author(s):  
Akash Chandra ◽  
Manish Kumar ◽  
Lalit Kumar ◽  
Harihar Dikshit

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 –compliance 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.


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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