Abstract
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.
Highlights
Depression affects the popula on by its occurrence, distress, ill health and economic burden which is o en unrecognized, misdiagnosed and/or undertreated.[1]
Costs of an depressants had wider varia ons depending on the manufacturers and availability of different dose and brands
Nepali markets are flooded with large number of an depressant drug formula on and the same formula ons are sold under different brand with wide varia on in cost. 8,9 The commonly prescribed an depressant drugs are escitalopram, paroxe ne, sertraline, fluoxe ne, amitriptyline, etc.[10,11]
Summary
Depression affects the popula on by its occurrence, distress, ill health and economic burden which is o en unrecognized, misdiagnosed and/or undertreated.[1]. Nepali markets are flooded with large number of an depressant drug formula on and the same formula ons are sold under different brand with wide varia on in cost. 8,9 The commonly prescribed an depressant drugs are escitalopram, paroxe ne, sertraline, fluoxe ne, amitriptyline, etc.[10,11] The cost of an depressant medica on corresponds to approximately 8% of the daily wage of a day laborer.[12,13,14] Evalua ng the total cost of treatment is important as evalua ng the treatment for depression because if the pa ent took the treatment as a financial burden it will hamper the compliance of the drug as well as it might exaggerate the ongoing episode of depression.[15, 16] There is necessity of study involving the cost of an depressant drugs of different brands and total cost of the treatment before prescribing the drugs so that the pa ent can afford and have be er compliance as well as prescriber have clear idea regarding the afford ability of treatment.[15,16,17] the study was conducted to analyze the prescrip ons for varia on in cost of different brands of same medicine for treatment of depression at a ter ary care hospital of Nepal
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