Abstract

In Andhra Pradesh, ApeRx app is a mobile application previously used for reimbursement of tuberculosis drugs under World Health Organisation's strategy to eliminate this disease. Due to the chronic nature of diabetes, out of pocket spending to purchase drugs aggravates the problem leading to low compliance to dosage schedule and also economic impoverishment. So, the current study evaluates the budget impact of reimbursement of a basket of generic drugs for diabetes directly to the bank account of private pharmacists through the ApeRx app from a Andhra government perspective. A cohort-based budget impact model was used to calculate the incremental cost of introducing the basket of generic medicines for diabetes (glibenclamide 5mg, glimepride 1 mg, glimepride 2mg, metformin 500 mg) for a short time horizon of one year. The analysis compared two scenarios: treatment options excluding or including this strategy. Market shares were derived from sales data of private pharmacies and epidemiological data was derived from the literature. Acquisition costs were based on wholesale acquisition costs and costs for diagnosis of diabetes, drug administration and monitoring, and relevant adverse events were included. With an estimated 11,42,810 eligible diabetic patients for the scheme, the budget impact for this strategy was calculated to be 19.02 crores (approx $2.6 M), corresponding to a budget impact of only 166 per treated member. In the state of Andhra Pradesh, use of this new mobile application reimbursement strategy may increase access to life saving drugs for the poor diabetes patients.

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