Abstract
Background: A crucial element that restricts access to medicines is price. Generic drugs provide the opportunity for major savings in out of pocket healthcare expenditure since they may be substantially lower in price. However when a generic drug is prescribed, pharmacist decides which brand of the drug to be dispensed. This results in patients paying for single drug at markedly different prices. Aims: To compare costs patient has to bear for psychotropic drugs fluoxetine and risperidone when a generic prescription is presented to a pharmacy. Methods: Pharmacies in 5 urban locations (Kurunegala, Kandy, Anuradhapura, Puttalam, Mahiyangana) in Sri Lanka were evaluated. A generic prescription for Fluoxetine 20 mg and Risperidone 2mg was presented to retail pharmacies and received medications were analyzed for the specific brands dispensed and costs incurred. Results: Price of a fluoxetine 20mg capsule ranged from Rs. 1.72 to Rs. 30.00 and price of risperidone 2mg tablet was from Rs 1.15 to Rs. 23.00. Combined monthly cost for the medications ranged from Rs 86.10 to Rs 1803.00. Approximately 80% prescriptions received brand preparations expensive than the cheapest brand among them. Lowest cost risperidone was dispensed only in 18% of instances. Lowest cost fluoxetine was dispensed only in 24% of instances. Conclusions: 80% of the time patients who get generic psychotropic prescriptions pay more than the cost of the lowest cost product. Knowledge about the price ranges of brands available in market could help in reducing the out of pocket expenditure for pharmaceuticals.
Highlights
A generic prescription containing two commonly prescribed psychotropic medications; risperidone 2 mg once daily at night and fluoxetine 20 mg once daily in the morning for 1 week were presented to pharmacies by volunteers
The Pharmacies located within the 1 km distance from main government hospital were evaluated
Total of 57 pharmacies were assessed, the number of pharmacies assessed in each town is as follows: Town Anuradhapura Kandy Kurunegala Mahiyangana Puttalam
Summary
A generic prescription containing two commonly prescribed psychotropic medications; risperidone 2 mg once daily at night and fluoxetine 20 mg once daily in the morning for 1 week were presented to pharmacies by volunteers. The prescription did not contain any other instructions. The volunteers who visited the pharmacies paid for the medications and collected a receipt and handed over the medication supply and the receipt to the researcher. The researcher noted down the following information for each pharmacy
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