scholarly journals COST ANALYSIS OF DISEASE MODIFYING ANTI RHEUMATIC DRUGS: THE INDIAN SCENARIO

2020 ◽  
pp. 1-2
Author(s):  
Zarrin Ansari ◽  
Sharmada Nerlekar ◽  
Sagar Karia ◽  
Sudhir Pawar

Background: Rheumatoid arthritis is a chronic, autoimmune and inflammatory disease affecting the joints and cartilages, eventually leading towards deformity and resultant disability. Today’s rheumatologists have an armamentarium of Disease Modifying Anti Rheumatic Drugs (DMARDs) to choose from. The chronicity of the disease, resultant deformities and reduced work capacity adds to the socioeconomic burden of the disease. This study aims to compare the costs of various brands of DMARDs (both biological and non-biological agents), so as the give the readers an idea about the cost range and variation present amongst the available DMARDs. Materials and Methods: Current Index of Medical Specialties (CIMS India) application was accessed in the month of August 2020 to note the cost of various brands of DMARDs. The information was tabulated. The cost difference and percentage cost variation was calculated and compared. Results:The maximum number of brands was available for methotrexate amongst the biological as well as non-biological agents. Least and highest percentage cost variation was observed for 2.5 mg strength of methotrexate and 100 mg of cyclosporine, respectively. In general, biologicals had fewer brands in the market as the cost was considerably higher than the non-biological agents. Conclusion:There is a wide variation amongst the costs of various DMARDs. This has its own advantages. Conscious choice of economical brands can profoundly effect the socioeconomic burden of rheumatoid arthritis management.

Author(s):  
Prashant Wadagbalkar ◽  
Poonam Patel ◽  
Swati V. Raipurkar

Background: Cardiovascular diseases are the most prevalent cause of death and disability in developed and developing countries. There is a wide variation in the prices of antihypertensive drugs marketed in India. Thus, a study was planned to find out variation in cost in the ACE Inhibitors available in India either as a single drug or in combination and to evaluate the difference in cost of various brands of the same ACE Inhibitors and ARBs by calculating percentage variation in cost in Indian rupees.Methods: Minimum and maximum costs in rupees (INR) of antihypertensive agents manufactured by different companies, in the same strength and dosage forms were obtained from “current index of medical specialties” January April 2016 and Drug Today October-December 2016. The cost ratio and percentage cost variation were calculated for each generic antihypertensive agent (ACE Inhibitors and ARBs).Results: This study shows that there is a wide variation in the prices of different brands of same ACE Inhibitors and ARBs in Indian market.Highest cost variation 400% is for Lisinopril (2.5mg), followed by Enalapril (10mg) 394.16%, Telmisartan (20mg) 322.22%.Conclusions: There is a wide difference in the cost of different brands of ACE Inhibitors and ARBs available in India. They have important role in management of hypertension particularly if associated with other morbidities like diabetes. The clinicians prescribing these drugs should be aware of these variations in cost so as to reduce the cost of drug therapy and increase the patient adherence to the therapy.


2010 ◽  
Vol 70 (4) ◽  
pp. 624-629 ◽  
Author(s):  
Martin Neovius ◽  
Julia F Simard ◽  
Johan Askling ◽  

ObjectiveTo provide Swedish nationwide data on the prevalence of rheumatoid arthritis (RA), including variations by age, sex, geography, demography and education level, and assess antirheumatic treatment penetration.MethodsPatients ≥16 years assigned an RA diagnosis were identified from inpatient (n=96 560; 1964–2007) and specialist outpatient care (n=56 336; 2001–2007) in the Swedish National Patient Register, and the Swedish Rheumatology Quality Register (n=21 242; 1995–2007). Data on prescriptions, demography, vital status and educational level were retrieved from national registers.ResultsA total of 58 102 individuals (mean age 66 years; 73% women) assigned an RA diagnosis were alive in Sweden in 2008, corresponding to a cumulative prevalence of 0.77% (women 1.11%, men 0.43%). The 2001–2007 period prevalence was 0.70%. Restriction to patients with ≥2 visits or diagnosis from a rheumatologist/internist reduced the overall cumulative prevalence to 0.68%. Whereas urban/rural differences (crude 0.65–1.00%) were explained by age differences, the age/sex-adjusted prevalence remained higher in patients with ≤9 years education (0.86%) than for those with 10–12 years (0.82%) and >12 years (0.65%). Treatment exposures (76% any disease-modifying antirheumatic drugs (DMARDs) or steroids, 64% any DMARD, 15% biological agents) varied with age; use of biological agents decreased from 22% in 16–59 years olds to 3% in ≥80 years olds. Any DMARD use correspondingly decreased from 71% to 43%. Applying age cut-off points from previous northern European and North American prevalence studies reduced or eliminated between-study differences.ConclusionThis nationwide approach yielded a prevalence of RA similar to previous regional assessments. While displaying only modest geographical variation and no urban/rural gradient, prevalence was associated with educational level. Although most patients received antirheumatic drugs, age was a strong treatment determinant.


Author(s):  
Shweta Agrawal ◽  
Neelesh Arya ◽  
Mehul Agrawal

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.


2020 ◽  
Vol 5 (2) ◽  
pp. 1006-1010
Author(s):  
Anjan Khadka ◽  
Pradeep Manandhar ◽  
Nagendra Katuwal ◽  
Mahesh Khatri

Introduction: Depression often remains unrecognized, misdiagnosed and/or under treated. There are multiple drugs from multiple companies which are available for treatment of depression. The prices of same drug with different brands are variable which questions the afford ability of treatment to the patients and their compliance. Objective The study was conducted to analyze the cost variation of different brands of antidepressant drugs prescribed in a tertiary care hospital of Nepal. Methodology This study design was cross-sectional and method was quantitative method and conducted at department of pharmacology of a tertiary care hospital from September 2018 to January 2019 after getting approval from institutional review committee. The commonly prescribed antidepressant drugs were recorded from prescription records of department of psychiatry and their cost, cost ratio and percentage variation were calculated as per current index of medical specialties and National index of medical specialties. The data were recorded in MS excel and presented as simple descriptive statistics. Result The study included seven commonly prescribed antidepressants obtained from 214 prescription records. The cost of one course of citalopram 40 mg tablet was found to be higher and the cost of one course of imipramine 25 mg tablet was found to be lower. The maximum and minimum cost ratio was 2.46 and 1.08 with fluoxetine 20 mg capsule and dothiepin 50 mg tablet respectively. The maximum and minimum percentage of cost variation was with fluoxetine 20 mg capsule and dothiepin 50 mg tablet. Conclusion Costs of antidepressants had wider variations depending on the manufacturers and availability of different dose and brands.


2017 ◽  
Vol 44 (7) ◽  
pp. 973-980 ◽  
Author(s):  
Matt D. Stevenson ◽  
Allan J. Wailoo ◽  
Jonathan C. Tosh ◽  
Monica Hernandez-Alava ◽  
Laura A. Gibson ◽  
...  

Objective.To ascertain whether strategies of treatment with a biological disease-modifying antirheumatic drug (bDMARD) are cost-effective in an English setting. Results are presented for those patients with moderate to severe rheumatoid arthritis (RA) and those with severe RA.Methods.An economic model to assess the cost-effectiveness of 7 bDMARD was developed. A systematic literature review and network metaanalysis was undertaken to establish relative clinical effectiveness. The results were used to populate the model, together with estimates of Health Assessment Questionnaire (HAQ) score following European League Against Rheumatism response; annual costs, and utility, per HAQ band; trajectory of HAQ for patients taking bDMARD; and trajectory of HAQ for patients using nonbiologic therapy (NBT). Results were presented as those associated with the strategy with the median cost-effectiveness. Supplementary analyses were undertaken assessing the change in cost-effectiveness when only patients with the most severe prognoses taking NBT were provided with bDMARD treatment. The costs per quality-adjusted life-year (QALY) values were compared with reported thresholds from the UK National Institute for Health and Care Excellence of £20,000 to £30,000 (US$24,700 to US$37,000).Results.In the primary analyses, the cost per QALY of a bDMARD strategy was £41,600 for patients with severe RA and £51,100 for those with moderate to severe RA. Under the supplementary analyses, the cost per QALY fell to £25,300 for those with severe RA and to £28,500 for those with moderate to severe RA.Conclusion.The cost-effectiveness of bDMARD in RA in England is questionable and only meets current accepted levels in subsets of patients with the worst prognoses.


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):  
Manju K. Nair ◽  
Neha M. S.

Background: Several brands of antihypertensive drugs are available in the Indian market with huge price variations. This study was undertaken to find out the percentage cost variation and cost ratio of antihypertensive drugs acting through renin angiotensin aldosterone axis modulation.Methods: Costs of different brands of renin angiotensin aldosterone axis modulatory drugs with antihypertensive action for the same dosage form and strength were found out using current index of medical specialties-134, July-October 2016. The maximum and minimum price of different brands of each drug was noted. Data was entered in Microsoft excel 2010. Percentage cost variation and cost ratio was calculated for each drug.Results: 16 antihypertensive drugs were analysed. Most of them were tablets. Ramipril and Valsartan were available as capsules also. Among tablets, percentage cost variation was highest for Atenolol 12.5 mg (683.93%) and least for Bisoprolol 2.5 mg (3.6538%). Valsartan capsules (160 mg) had no difference in the costs between the available 2 brands. Cost ratio ranged from 1.04 to 7.84 among the tablet form of drugs.Conclusions: There is a huge difference in the cost of antihypertensive drugs manufactured by different companies in the same strength and dosage form. To promote rational drug use and cost effective therapy, it is essential to create an awareness among clinicians regarding the availability of multiple brands for these drugs and the discrepancies in their costs.


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

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’s) 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’s 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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