Percent Of Cost Research Articles

Cost variation analysis of disease modifying anti rheumatic drugs in Indian market

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with systemic complications, necessitating treatment to manage inflammation and prevent joint damage. In India, significant cost discrepancies exist among branded formulations of generic drugs, posing a financial burden on patients and impacting treatment adherence. This study focuses on cost differences of disease modifying anti rheumatic drugs (DMARDs) among Indian brands and advocating strict adherence to drug price control order (DPCO) rules and suggests scheduling non-scheduled drugs under DPCO. Methods: This observational study analysed the cost of 6 oral DMARDs across 16 tablet formulations using data from National Pharmaceutical Pricing Authority (NPPA) and DPCO ceiling prices 2024. Number of brands per formulation, cost ratios, percentage variations, and DPCO price violations was analysed. Statistical analysis was performed using Microsoft Excel Office 2021, and Zotero was utilized for managing references. Results: This study highlights significant price variations among DMARDs in the Indian market, with methotrexate 2.5mg exhibiting the highest cost ratio (1:3.63) and percentage cost variation (263.6%). Azathioprine 50mg has the most brands available (23), while sulfasalazine 500mg, sulfasalazine 1000mg, and tofacitinib 11mg are among the formulations with the fewest brands (3 each). Notably, sulfasalazine 500mg and hydroxychloroquine 200mg showed the most frequent instances of pricing violations above DPCO recommendations. Conclusions: Strict regulation for price control and monitoring should be implemented since the DPCO has not yet achieved its goal of enforcing price ceilings, and non-scheduled drugs should be included under DPCO regulations effectively to enhance adherence to RA therapy.

Synchronizing the Supply of Components for Automotive Assembly amid Chip Shortages and Other Supply Delays

The push for more battery-powered electric vehicles, the COVID-19 pandemic, and other global supply chain destabilizing events (e.g., the war in Ukraine) have made it necessary for manufacturers to consider innovative approaches to sourcing and materials management. This study assesses the value of sharing delivery due date updates, which are then used to convert spent time into a fraction of the expected total time for order fulfillment (i.e., progress updates), to synchronize the delivery of components for an automotive manufacturer who, amid long and variable lead times for semiconductor chips, maintains a strategy of waiting for the delivery of all needed parts before commencing production. Having progress updates in a fractional form puts numerical bounds (i.e., 0% to 100%) on the shared information, and this facilitates closed-form analytical comparisons. We develop analytical models to show decreases in expected assembly-related costs based on the progress update information shared between two suppliers—one supplier has a shorter and more reliable order fulfillment lead time than the other. When there are more than two suppliers, we use a simulation model to estimate the expected value of sharing progress updates. Our results show that increasing the frequency of shared progress updates, and having more suppliers share progress updates, results in increased cost-savings percentages. However, the opposite occurs with increasing uncertainty in suppliers’ delivery lead times. The computational study provides support for the existence of a critical mass level of suppliers needed to achieve a given percentage cost saving. This study can help automakers to make informed decisions on encouraging information sharing among suppliers, by first creating a critical mass of suppliers to share progress updates. Our investigations also help show the conditions in which to best leverage such information sharing strategies while waiting for the delivery of all needed components prior to production.

An Analysis of the Cost Variation Among Different Antimicrobial Agents: The Indian Scenario.

Background and objective Infectious diseases pose a substantial global health challenge, especially in developing countries where healthcare accessibility is limited. Pharmaceutical expenses constitute a significant share of out-of-pocket expenditure (60-90%). Hence, the affordability of medications becomes a critical determinant for patient compliance. This study focuses on the economic dynamics of antimicrobial agents. Methodology After collecting data from the Current Index of Medical Specialties (CIMS), different antimicrobial agents (AMAs) were assessed based on their cost per 10 tablets/10 capsules/one vial of injection. A comprehensive analysis was performed to assessthe minimum and maximum costs for each medication across diverse pharmaceutical companies. Cost variation was assessed through both the cost ratio and percentage cost variation.The data were analyzed and represented using descriptive statistics Results Our findings indicate significant cost variations, with nitrofurantoin 100 mg tabletshowcasing a staggering 1498.5% variation, followed by meropenem 500 mg vial at 473.91%. Conversely, the cotrimoxazole (sulfamethoxazole 800 mg + trimethoprim 160 mg) tablet exhibits a minimal 6.05% variation, underscoring the diversity in pricing strategies. The number of brands ranged from two to 62. Conclusions This study underscores the importance of considering cost variations in antimicrobial agents while prescribing the same. Doing so will not only address the economic challenges faced by patients but also help in improvingcompliance and reducing the risk of antimicrobial drug resistance. This approach advocates for a more economically sustainable and patient-centric healthcare ecosystem in India.

Optimizing Distribution Center Network Design for a Cosmetic Manufacturer: A Case Study on Lightening Series Package Product

Ensuring customer satisfaction while maintaining optimal cost efficiency is paramount in designing a successful supply chain structure. This study explores the vital role of service quality and delivery efficiency in achieving customer satisfaction and a superior overall experience through a cost-effective supply chain structure. Furthermore, the strategic positioning of Distribution Centers (DC) and the geographical distribution of consumers serve as additional determinants in the quest to devise the most effective DC scheme that meets consumer expectations. Four simulation scenarios, each with measurable parameters including response time, lead time, and operational costs, were evaluated to identify the most cost-efficient and responsive solution. These parameters encompassed the performance metrics of the supply chain structure model, namely response time and lead time, in conjunction with the total operational cost of each scenario. Our findings reveal that scenario 1 emerges as the most cost-effective with the lowest distribution costs and shortest customer lead time. This scenario consistently maintains the lowest distribution costs from the first to the seventh year. Despite a surge in forecasted demand in the 7th year, resulting in an increase in total distribution costs to Rp. 3,392,793,440, scenario 1 still prevails with overall vehicle costs decreasing and the smallest percentage cost at 17.50%, thus yielding the most economical outcome compared to alternative scenarios. Scenario 4 offers a similar outcome to scenario 1 but incurs higher daily vehicle operating costs. The cost-effectiveness demonstrated by scenario 4 further highlights the significance of strategic DC placement in achieving optimal supply chain outcomes.

Cost analysis study of price variation among the various brands of proton pump inhibitors available in Benghazi-Libya

Background: A large proportion of patients in developing countries have to pay out of pocket for their medications. The prices of different brands of the same medications vary considerably and may vary from one community pharmacy to another. This study was undertaken to evaluate the variation in costs of proton pump inhibitors (PPI) and histamine H2-receptor antagonists available in Libya. Methods: Prices of various brands of PPI and various formulations were collected from four community pharmacies in the city of Benghazi. Both cost ratio and percentage variation were calculated and compared for various brands of the same strength and number of tablets, capsules, injections, or syrups. Results: The highest cost ratio and percentage price variation were found with omeprazole 20 mg, followed by omeprazole 40 mg. Other significant cost variations (>100%) were seen with pantoprazole 40 mg, Downoprazol (omeprazole + sodium bicarbonate) 40 mg, and esomeprazole 40 mg. Ampoules of omeprazole, cimetidine, and ranitidine had cost ratios of 1:1.7, 1:1.7, and 1:1.8, and cost variation ratios of 71.4, 66.7, and 75, respectively. Variations in prices of PPI and histamine H2 antagonists from the same manufacturer between different community pharmacies were common. The highest percentage cost variation (100) was seen with omeprazole 20 mg. Conclusions: Due to political instability, the prices of all drugs are controlled by importing private companies and the owners of community pharmacies instead of governmental authorities, that leads to cost variations. Therefore, the health authorities exert strict control on pricing of medications.

Cost Variation Analysis of Hypolipidemic Drugs Currently Available in Indian Pharmaceutical Market

42% of all fatalities worldwide resulting from non-communicable diseases (NCD) are attributable to cardiovascular illnesses. The availability of several brands and generic medications causes a wide range in the pricing at which they are sold. This study was conducted to raise awareness among health care workers and patients about the cost difference between different brands of the same hypolipidemic drug, so that, if possible, a cheaper effective brand can be prescribed to ensure better patient adherence. Maximum retail price (MRP) of various hypolipidemic drugs of same strength and dosage forms manufactured by different pharmaceutical companies were obtained from various online and offline sources. The maximum and minimum cost of 10 tablets/capsules were noted. The cost ratio and percentage cost variation were calculated for single drug and fixed dose combinations. The ceiling price (as per DPCO) of hypolipidemics (as per national list of essential medicines) was compared with their maximum cost. Maximum cost variation observed in case of single drug was Atorvastatin 10mg (3043.9393%), and in case of FDC was seen in Rosuvastatin 10mg + Aspirin75mg (561.341%). This study led us to the conclusion that the majority of hypolipidemic medications should be governed by DPCO in order to lessen the economic load of healthcare services on the Indian population. Keywords: Pharmacoeconomic, Cost variation, Hypolipidemic, Statins

A critical evaluation of contents, labeling, and cost of hand sanitizers marketed in India during COVID-19 pandemic

ABSTRACT Background: Antiseptics were introduced a long time ago, but their significance was noteworthy during the COVID-19 pandemic. Hand sanitizer plays a pivotal role as a preventive measure. Multiple national authorities have advocated for the application of Alcohol-Based Hand Sanitizers (ABHS). During the pandemic, a surge in demand and limited supply prompted numerous manufacturers to ramp up production. Consequently, it is imperative to scrutinize the composition, labeling, and price of hand sanitizers. Aims and Objective: To assess the contents, labeling, and price of hand sanitizers available in the Indian market. Methodology: Hand sanitizers, both online and offline, marketed in India between May 2019 and May 2022 were included. Hand sanitizers by local manufacturers without labeling were excluded. Contents and labeling of hand sanitizers were evaluated as per World Health Organization (WHO) recommendations. Price was assessed as a percentage cost variation. Result: Out of 79, the majority (98.73%) were ABHS, and 28.20% of them met the recommended criteria for “Adequate” alcohol concentration. Ethyl alcohol emerged as the most prevalent (69.23%), often accompanied by emollients, humectants, fragrances, and color additives. Notably, 69.62% of the hand sanitizers featured comprehensive labeling, while incomplete labels lacked essential details under “Warning and Cautions.” The average price of hand sanitizers was Rs 505.11 ± 255.36. Conclusion: Choosing ABHS with appropriate alcohol concentrations in line with recommendations is crucial. To ensure the proper and safe use of hand sanitizers, individuals should follow the instructions provided on the product labels; both manufacturers and regulators are responsible for adhering to standards for hand sanitizers made available to the public.

I-125 eye-plaque seed economics: To re-use or to not re-use? A single institutional cost savings analysis of re-using I-125 radioactive seeds for eye—Plaque brachytherapy

INTRODUCTIONIodine-125 (I-125) seeds, commonly used in low-dose rate brachytherapy for ocular malignancies, are often discarded after a single use. This study examines the potential cost savings at an institution with high ocular melanoma referrals, by re-using I-125 seeds for eye-plaque brachytherapy. METHODSIn this single-institutional retrospective analysis, data was collected from I-125 seed orders from 8/2019 through 10/2022. Information including number of seeds ordered per lot, number of plaques built per lot, and number of seeds used per lot were collected. Cost per lot of seed was assumed to be the current cost from the most recent lot of 35 seeds. RESULTSDuring the study, 72 I-125 seed lots were ordered bi-weekly, with a median of 35 seeds per lot (Range: 15–35). Each seed was used on average 2.26 times prior to being discarded. The average duration of each seed lot used was 62.2 days (Range: 21–126). Each seed lot contributed to the construction of an average of 8.4 eye plaques (Range: 2–20). With seed recycling, 2,475 seeds were used to construct 608 eye-plaques. Without re-using practice this would require 5,694 seeds. This resulted in a percentage cost savings of 56.5%, with a total seed cost reduction of $344,884, or $559 per eye-plaque on average. CONCLUSIONThis is the first study to evaluate cost savings relative to re-using I-125 seeds for eye plaques. The data demonstrates how an institution can decrease costs associated with I-125 radiation seeds used for eye-plaque brachytherapy by re-using them.

Joint optimization of inventory replenishment and rationing policies for an omnichannel store with both in-store and online demands

Boosted by the COVID-19 pandemic, omnichannel retail has become a popular retail model and is expected to further grow. We study inventory replenishment and rationing of a product in an omnichannel store that fulfils both in-store and online demands. Both demands follow Poisson process. As each in-store demand must be satisfied immediately whereas each online order has a delivery time window, the two demand classes have different behaviors facing stockout: offline demand is lost while online order is backlogged with backorder cost charged only if it is delivered late. The inventory replenishment and rationing between the two demand classes in this omnichannel inventory system are controlled by a continuous review (Q, r) policy and a critical level policy, respectively. The intertwined nature of inventory replenishment and rationing in this system makes its analytical cost evaluation and its joint optimization of the two policies challenging. After deriving an analytical formula for evaluating the expected cost of the system, two heuristic algorithms are proposed to jointly optimize the two policies. Numerical experiments on randomly generated instances demonstrate that the multi-start local search algorithm and the scatter search algorithm can obtain a near-optimal solution quickly with percentage cost gap no larger than 0.81% and 0.18%, respectively, and the critical level policy can yield cost savings up to 10.91% compared to the first-come, first-served policy. Finally, a sensitivity analysis is conducted to evaluate the influences of system parameters on the optimal critical level.

An Exploration of Multitasking Scheduling Considering Interruptible Job Assignments, Machine Aging Effects, the Influence of Deteriorating Maintenance, and Symmetry

The unique topic of allocating and scheduling tasks on a single machine in a multitasking environment is the main emphasis of this research, which also takes into account the effects of worsening maintenance and job-dependent aging effects. In this scenario, the performance and efficiency of the machine in handling different tasks should be symmetric, without significant bias due to the nature or size of the tasks. In a multitasking environment, waiting for jobs can disrupt the processing of the primary job being currently handled. As a result, the actual time required to complete a task becomes erratic and contingent upon the duration of the disruption. In addition to figuring out the best time for maintenance, where to put the due-window, and how big it should be in a multitasking environment, the primary objective is to minimize the costs associated with meeting due-window regulations. To tackle this problem, we propose two optimal algorithms. Additionally, we conduct numerical experiments to compare our approach with the classic due date assignment problem. Interestingly, we observe that in most cases, the average and minimum percentage costs tend to increase as the quantity of jobs increases. However, it is noteworthy that, when the number of jobs is relatively small, specifically when it does not exceed 20, there are instances where these costs decrease with an increase in the number of jobs.

Cost Analysis Study of Topical Anti-Acne Drugs Currently Available in Indian Pharmaceutical Market

Acne vulgaris is a chronic inflammatory skin disease that affects approximately 90% individuals between puberty and 30 years of age at some point with peak prevalence in adolescence. According to Global Burden of Disease study conducted in 187 countries in 2010, acne is among top ten most prevalent disease worldwide and skin conditions are top cause of years lived with disability. The aim of the study was to analyze cost variations of different brands of topical medications used in Acne vulgaris in India. This analytical study was conducted in the Department of Pharmacology at Assam Medical College and Hospital over a period of 3 months. ‘‘Current Index of Medical Specialities (CIMS)’’ April - July, 2023 and “Drug Today India April –July 2023’’ drug manuals were used to compare cost of different formulations of topical acne medications. Drugs manufactured by only 1 company were excluded. Cost ratio (Maximum cost/ Minimum cost) and percentage cost variation ([{Max cost – Min cost}/ Min cost] *100) were calculated. For single preparations, the percentage cost variation was maximum for Clindamycin 1% 20 grams gel (1126.66%) with maximum cost ratio followed by Tretinoin 20 gm 0.025% (cream) 721.428. Percentage cost variation was minimum with Adapalene 0.1 % cream 15gm (32.69). Among the combination topical drugs, the percentage cost variation was maximum for Clindamycin 1% + Adapalene 0.1% 15 grams gel (1843.589) and it had maximum cost ratio of 19.43. Percentage cost variation was minimum with combination of Benzoyl Peroxide 2.5% + Clindamycin 1% 20gm gel(41.025).This study highlights price variation among different brands of drugs in CIMS, Drug Today and Pharma Sahi Daam app. Keywords Cost Analysis, Acne vulgaris, Percentage Cost­Variation, Pharma Sahi Daam

PHARMACOECONOMIC STUDY OF VARIOUS BRANDS OF ANTI-EPILEPTIC DRUGS AVAILABLE CURRENTLY IN INDIA

Objectives: (a) Compiling a comprehensive list of the available dosage forms and strengths of various antiepileptic drugs marketed in India. (b) Calculating the percentage cost variation of individual drug formulations produced by different pharmaceutical companies. (c) Evaluating the percentage cost variation of these drugs. Methods: The cost of an exact drug (cost per 10 tablets) in the same strength and amount of forms being manufactured by different companies were got from the latest editions of “Current Index of Medical Specialties” and “Indian Drug Review.” The percentage price difference and cost ratio for each formulation were intended. Result: Among single drugs, the highest price variation was found in the drug pregabalin available in the form of capsules (75 mg and 150 mg), and a cost ratio of 6.64 and 5.87 was calculated which was significant. Among combination drugs, tablet Na valproate+valproic acid with the cost ratio of 1.91 was found to be the highest. Conclusion: Our study shows that there is very high price variation in some of the brands of anti-epileptic drugs. Generic prescribing should be promoted in the whole country by creating awareness and implementing proper regulatory guidelines.

Cost variation analysis of various oral cephalosporins available in the Indian market

Background: Cephalosporins stand as one of the most frequently prescribed antibiotics for combating infectious diseases. This group has proven to be effective in the treatment of both gram positive and gram negative infections. Analysis of price discrepancies among various brands of oral cephalosporins. Offers guidance for prescribing cost-effectively, which turns out to be beneficial for both the patient and the prescribing physician. A cost-effective prescribing pattern ensures good patient compliance and better treatment outcome. Aims and Objectives: The objectives of the study were to analyze price variation of various single oral cephalosporin formulations available in the Indian market. Materials and Methods: The prices of oral cephalosporins, produced by different pharmaceutical companies in India, with the same strength, were acquired from the current index of medical specialties, January-April 2023. The cost of generics was obtained from the official website janaushadhi.gov.in. The disparity between the highest and lowest prices of the identical formulation manufactured by different companies, the difference between the maximum and minimum prices of brand-name versus generic versions of the identical formulation, as well as the cost ratio and percentage cost variation, were computed. Results: Total number of brands range from 3 to 79 for various drugs. A large price variation was seen across the different brands. The maximum price variation 521.11% was seen with 100 mg of Cefixime and minimum price variation of 14.13% was seen with 125 mg of cefdinir. Conclusion: With the high variation in prices seen among the different drugs it is important to consider the affordability of the patient before prescribing the drug to ensure completion of the course and better treatment outcome.

Cost Variation Analysis of Branded Generics Used for Initial Treatment of Type 2 Diabetes, Hypertension and Dyslipidemia in India: A Pharmacoeconomic Perspective

Background: Branded generics are off-patent medications with proprietary names which are bioequivalent to the innovator medications. Cardiovascular diseases, driven by diabetes, hypertension, and dyslipidemia, are major health concerns, where patient compliance is crucial for long-term management. This analysis investigates cost variations of first-line branded generics for these conditions in Indian primary care settings.
 Methods: First-line medications preferred for type 2 diabetes, hypertension, and dyslipidemia were identified through an online survey of prescribers. Data from 1mg.com, an Indian online pharmacy, was used to compile a list of available brands for each medication. The study compared the prices of the five most prescribed brands, the three lowest-cost and one highest-cost brand per medication, and calculated the percentage cost difference.
 Results: First-line medications preferred for type 2 diabetes, hypertension, and dyslipidemia in India include Metformin 500mg, Enalapril 5mg, Telmisartan 40mg, Amlodipine 5 mg, and Atorvastatin 20mg. The analysis reveals significant cost disparities among commonly prescribed brands, with Metformin, Enalapril, Telmisartan, and Atorvastatin being notably more expensive (up to 1177%) than lower-cost alternatives, potentially placing a financial burden on patients. Amlodipine, however, exhibits modest cost variation (26-113%), with commonly prescribed brands leaning toward lower-cost options.
 Conclusion: Cost disparities among commonly prescribed brands could harm patient compliance and outcomes, emphasizing the need for cost-effective medication selection. This study offers crucial insights into cost variations in India's treatment of Type 2 Diabetes, Hypertension, and Dyslipidemia, underscoring the importance of cost awareness for improved patient compliance and healthcare system sustainability.

Pharmacoeconomic evaluation of Levothyroxine in the treatment of Hypothyroidism in Nepal

INTRODUCTION: Hypothyroidism, is an endocrine disorder, wherein the thyroid gland does not make enough thyroid hormones to meet the body’s needs. Levothyroxine is the mainstay of hormone replacement therapy for hypothyroidism. This study was aimed to evaluate the cost ratio and percentage cost variation, of different brands of levothyroxine, available in the Nepali market. MATERIALS AND METHODS: This observational pharmacoeconomic study was carried out at Department of Pharmacology of Janaki Medical College, Janakpurdham, Nepal from 5 April to 30 May, 2023. Maximum retail price (Cost) in Nepalese currency (NRs), of various brands of levothyroxine available in Nepali market, of same dosage form, strength and number was reviewed for calculating the cost ratio and the percentage cost variation of levothyroxine manufactured by Nepali and Indian Pharmaceutical companies. RESULTS: For 120 tablets of levothyroxine, maximum cost ratio of 1.37 and percentage cost variation of 37.14% was observed with 50 mcg of levothyroxine. For 100 tablets of levothyroxine, maximum cost ratio of 1.65 and percentage cost variation of 65.44% was observed with 50 mcg of levothyroxine. CONCLUSIONS: The findings of this study can be used by a treating physician for prescribing an alternative cheaper brand of levothyroxine for better compliance and for reducing the total health-care cost. Continuous pharmacoeconomic analysis, if carried out at government level, can greatly minimize the cost variation as well as reduce the overall treatment cost for hypothyroid patients in Nepal.

A STUDY OF DRUG UTILIZATION AND COMPARATIVE PHARMACOECONOMIC ANALYSIS OF ANTIDIABETIC DRUGS IN A TERTIARY CARE HOSPITAL

Background: Diabetes Mellitus is a chronic metabolic disorder that is one of the major causes of morbidity and requires lifelong treatment. Aim and Objectives: This study was conducted to determine prescribing pattern and frequency of single and combination antidiabetic drugs prescribed for type 2 DM and to compare their percentage cost variation. Materials and Methods: This was a prospective observational study carried out among in-patients of the general medicine department of a tertiary care hospital for a period of 6 months. Results: A total of 246 subjects were analyzed showing the main age group was between 60-70 years (28.9%). Polypharmacy was evident in the study as 178 (72.4%) prescriptions had greater than 5 drugs. Metformin 500mg in 38 (33.04%), Metformin 500mg + Glimepiride 2mg in 36 (25.35%) subjects and Insulin soluble 30% + Isophane 70% were the most prescribed single, combination, and insulin preparation respectively. The highest percentage cost difference was seen with Vildagliptin 50 mg (72.88%) out of 15 single antidiabetic drugs, Metformin 500mg + Dapagliflozin 10mg (79.93%) out of 20 combination antidiabetic drugs and Insulin soluble 30% + Isophane 70% (28.28%) out of 6 insulin preparations. Conclusion: Oral dosage form was the most prescribed and there is inclination towards prescribing combination therapy. The study concluded that inclusion of generic drugs to the therapy will be economical for the patient, as it can reduce the wider price variation of antidiabetic drugs by different brands available in the hospital pharmacy. KEYWORDS: Type 2 Diabetes mellitus, Anti-diabetic drugs, Drug utilization study, Polypharmacy, Comparative Pharmacoeconomics analysis, Cost analysis.

Pharmacoeconomic analysis of Oral & Injectable Proton Pump Inhibitors available in India

Introduction: Proton pump inhibitors (PPIs) effectively suppress acid secretion and play an essential role in peptic ulcer disease and gastroesophageal reflux disease. There is a genuine concern about overutilizing PPIs, leading to significantly high costs and undesirable outcomes. An increase in the patient medication cost was associated with decreased adherence to prescription medication. Hence, this study assessed the cost variation of proton pump inhibitors (PPI) drugs.
 Methods: The cost of different brands of commonly used PPIs was sorted out by referring latest “Monthly Index of Medical Specialties” October – December 2021, and 1mg online pharmacy. The cost of 10 dosage forms (Tablets/capsules) in INR of each brand, Cost Ratio, and Percentage Cost Variation for individual drug brands was calculated in the case of an oral drug, and the cost of one vial or ampoule was noted in the case of injectable drug. At last, the cost ratio and percentage cost variation of various brands was compared.
 Results: The data analysis showed a significant variation in the costs of different brands of proton pump inhibitors available In the Indian market. Percentage variation in cost for oral preparations of proton pump inhibitors marketed in India was found to be tablet/capsule Rabeprazole 20mg (1540%), Omeprazole 20 mg(718.18%), Pantoprazole 40mg (504.16%), Esomeprazole 20mg (173.68%), Lansoprazole 15 mg (84.90 %), Omeprazole 40 mg (60.34%) and with injectable preparations IVR abeprazole 20mg (1090.90%), Omeprazole 40 mg (347.36%), Esomeprazole 40mg (216.66%), Pantoprazole 20mg (164.44 %), Pantoprazole 40mg (51.16%).
 Conclusion: There is a wide variation in the prices of proton pump inhibitors available in the market. Regulatory authorities, pharma companies, and physicians should maximize their efforts to reduce the cost of drugsThe need to search for reliable process indicators for the effectiveness of anti-diabetic therapy has been expressed in the literature. Process indicators have been described as essential processes that contribute to achieving outcomes

A Cost Variation Analysis of Oral Contraceptive Pills Available in the Indian Market

Background: Oral Contraceptive Pills (OCPs) are highly effective contraceptives if used regularly and adequately, and they also have added non-contraceptive benefits. This gives way to their increasing use in recent years, which has led to the introduction of numerous brands of drugs with different costs in the Indian market. Hence the current study was conducted to analyze the cost ratio and cost variation of different brands of OCPs available in the Indian market and to compare the cost of branded and generic drugs.
 Materials and Methods: The cost of the drugs was obtained from the Current Index of Medical Specialties (CIMS) - 44th Year April – July 2022 and from the website https://www.mims.com/india/. The Cost Ratio (CR) and Percentage Cost Variation (CV) was calculated. The cost of generic drugs was obtained from the website http://janaushadhi.gov.in/SortingView.aspx.
 Results: 124 brands of various OCPs were available in the Indian market. Among all the regular OCPs available, the CR and CV were highest for Ormeloxifene 30mg at 10.19 and 919.4%, respectively, and they were lowest for Dienogest +Ethinylestradiol which comes under combined OCPs with the results of 1.007 and 0.73% respectively. The cost of all generic OCPs was lesser when compared with brand OCPs, and the difference in cost was maximum for Ulipristal.
 Conclusion: There is wide variation in the cost of Oral Contraceptive Pills available in the Indian market, and the cost of brand drugs is higher than their generic counterparts. Physicians have to be made aware of this price difference so that they can prescribe drugs that are more affordable to the patients to improve their adherence to the regimen.

Assessment of Cost and Time Performance of Tertiary Educational Trust Fund (TETFund) Construction Project in South-West Nigeria

Funds have been allocated to TETFund annually for infrastructural development in Nigeria to address decays of educational facilities and create an enabling environment for teaching and learning. This study evaluates time and cost performance of public building construction projects funded by TETFund in South-West Nigeria. The study adopted questionnaire survey by self-administering two hundred and fifty (250) questionnaires to project clients, consultants and contractors engaged in TETFund projects in South-West Nigeria. One hundred and eighty-six 186 (74.4%) of the questionnaires were retrieved from the respondents and were used in the study. Also, record of project cost and duration were purposively obtained from two hundred and fifty-four (254) TETFund sponsored projects from Institutions in South-West Nigeria. Mean Score (MS) was used to rank the various items and components while regression analysis was used to forecast future project cost and time. The top three factors that influence cost and time based on the perceptions of the respondents are client satisfaction with the project (MS= 3.86), construction time predictability (MS= 3.85) and construction cost predictability (MS= 3.83). From the TETFund project records analysed, a total sum of ₦10,856,167,497.14 was spent on TETFund building construction projects in South-West Nigeria from 2003-2013 with a contingency sum of ₦163,248,265.44. The average percentage cost overrun for TETFund projects was 1.62% and that of time overrun was 112.23%. Regression analysis of the predicted project time and cost was significant and can be used to forecast time and cost of future TETFund projects. Therefore, it was recommended that accurate cost estimate, adequate project planning and good specification should be carried out by project stakeholders before contracts are awarded to enhance construction project performance. Also, the developed regression model of estimated project cost and time can be used to predict cost and time of future construction projects.

Feasibility Study Of Bapak Gunoto's Know Business In Lebong District

The purpose of this study was to determine the feasibility study of Mr. Gunoto's Tofu Business in Lebong Regency. The analytical method used is a feasibility study analysis from the financial aspect which includes Net Present Value (NPV), Internal Rate of Return (IRR), and Gross Benefit Cost Ratio (Gross B/C).The results of the Net Present Value (NPV) research show a positive number of Rp. 339,819,380,-, meaning that the expansion of Mr. Gunoto's Tofu Business in Lebong Regency can be said to be feasible for development. IRR (Internal Rate of Return) is known to be 30% greater than the percentage cost of capital (loan interest), namely 12% or 16%, meaning that business expansion is feasible for development. This shows that if funds for investment are saved or deposited in a bank with an interest rate of 12% and an interest rate of 16%, then the capital will grow faster if it is made into tofu business capital because it will grow at an interest rate equivalent to 30. Gross B/C greater than 1 (1.69 > 1) means that the development of Mr. Gunoto's tofu business in Lebong Regency is feasible for development.