Percentage Cost Variation 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.

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.

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.

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.

Pharmaco-ecomonic study of oral anti-hypertensive drugs available in Indian pharmaceutical market

Background: Hypertension is a global public health problem. To decrease its morbidity and mortality it needs life-long treatment. There is a wide range of variation in the prices of antihypertensive drugs marketed in India. Thus, a study was planned to evaluate the difference in cost of different brands of same active drug by calculating percentage variation of cost. Methods: The cost of different brands of commonly used anti-hypertensive drugs was sorted out by referring latest CIMS, MIMS and drug today. The cost of 10 dosage forms (tablets/capsules) in INR of each brand, cost ratio and percentage cost variation were calculated and evaluated. Results: The cost of different anti-hypertensive drugs were analysed and minimum and maximum cost of the drugs in a particular dosage are tabulated. The cost variation is analysed with SPSS software 2.0 version with tools of median and interquartile range. The variation in cost of most of the anti-hypertensive drugs is more than 100%. It’s found maximum in amlodipine (5 mg) with cost variation of 625%, atenolol 100 mg with cost variation of 413%. Conclusions: The average percentage cost variation of the same molecules of antihypertensive drugs manufactured by different pharmaceuticals company in India is very wide. So, government, pharmaceutical company, marketing manager and prescribing doctors should think about variation of cost and do needful for providing maximum benefits to the patients receiving antihypertensive drugs.

COST VARIATION ANALYSIS OF ANTIMALARIAL DRUGS : A REVIEW

Background: Malaria has been a major issue in India for ages. There are numerous antimalarial brands available on the market. Costly medications can place an economic burden on patients, resulting in lower compliance or even noncompliance. Noncompliance leads to insufficient therapy, which increases morbidity. Increases in patient pharmaceutical costs were found to be related to worse adherence to prescribed medicine. As a result, this study was conducted to analyze the cost variation of malaria drug-therapy. Methods: Price in Indian rupees (₹) of antimalarial drugs manufactured by different pharmaceutical companies in India, in the same strength and in same dosage form were obtained from Current index of medical specialties (CIMS) January-April 2023. Cost ratio and cost variation percentage were calculated and data was analysed. Results: The highest cost ratio and percentage cost variation were observed for Quinine injection 300mg/ml, with a cost ratio of 7 & a percentage cost variation of 599.65%.The lowest cost ratio was found for Mefloquine tablet 250mg injection, with a cost ratio of 1.01 and a percentage cost variation of 1.35%. Overall, the injectable antimalarial medications showed a considerable cost ratio and cost variation Conclusions: Ceiling cost of drugs are fixed by national pharmaceutical pricing authority (NPPA) government of India in accordance with DPCO 2023.Despite this there exists a wide variation of drug costs within one drug with the availability of various brands

Analysis of fixed dose combinations of expectorants, antitussives, decongestants, antihistamines and mucolytics available in the Indian market for rationality and cost variation

Background: Aim of the current study was to analyze the FDCs of expectorants, antitussives, decongestants, antihistamines and mucolytics available in the Indian market for their rationality, cost, and dosage forms. Methods: FDCs involving expectorants, antitussives, decongestants, antihistamines and mucolytics listed on Drug Today and Jan Aushadhi online portal were analysed for rationality according to the list of banned FDCs by CDSCO published on 01 Jan 2018. The FDCs with EADAM available in Jan Aushadhi online portal are compared with cost of different brands with same composition, strength and dosage form available in the Indian market as per the latest drug today. The cost ratio and percentage cost variation were calculated for each FDC. Results: Out of total 340 oral formulations, 268 were liquid and 72 were solid formulations. 228 were Syrups, 67 were Tablets, 23 were Drops, 17 were Suspension and 5 were Capsules. Out of 47 banned FDCs, branded FDC with Ammonium chloride 50mg, Bromhexine 4mg, Dextromethorphan 5mg and Menthol in syrup form was still available for over-the-counter purchase and for online purchase with prescription. Percentage cost variation between branded and generic FDCs ranged from 99% for Terbutaline 2.5 mg and Bromhexine 8 mg to 1081% for Terbutaline 1.25 mg, Bromhexine 4mg, Guaiphenesin 50 mg and Menthol 2.5 mg. Conclusions: One among 47 Banned FDCs was available at both online apps and drug stores. These irrational FDCs can be risk to human lives. The drug authorities need to tune the price of these FDCs as there is a huge percentage cost variation between generic and branded products.

A Cost Variation Analysis of Hypolipidemic Drugs Available in the Indian Market

Background: Cardiovascular diseases are amongst the prime reasons of increasing morbidity as well as mortality worldwide. Dyslipidemia is an important and modifiable risk factor of CVD and statins are extremely endorsed in its treatment. Method: Data was acquired from the online edition of “Current Index of Medical Specialties” (CIMS), 1mg, netmeds. The percentage cost variation as well as cost ratio were calculated. Result: Percentage cost variation was recorded highest in atorvastatin 10mg (3668.50%) whereas, the least percentage cost variation was recorded for pravastatin 10mg (3.61%). Conclusion: To reduce the burden on patients, the government should cover as many as possible drugs under the drug price control order (DPCO) and develop uniformity in the pricing of the drugs. Keywords: Hypolipidemic drugs, cardiovascular diseases, cost variation, statins, brands

A COST VARIATION ANALYSIS OF DRUGS PRE-SCRIBED FOR THE TREATMENT OF RHEUMATOID ARTHRITIS

Background: The rheumatologists have several drugs to choose from, either alone or in combination; each with different costs, monitoring protocols, and potential risks and benefits. Pharmacoeconomic analysis results help rheumatologists choose drugs for their patients.
 Objective: Objective of this prospective observational study was to perform a cost-variation analysis of drugs prescribed for the treatment of rheumatoid arthritis (RA) in a Western-Indian tertiary care teaching hospital.
 Materials and Methods: This prospective observational study was conducted in the rheumatology department of the study site. Study population included patients of both gender male and female, diagnosed with rheumatoid arthritis and on treatment. Prices of the drugs prescribed to the patients were obtained from different offline and online sources. The lowest and highest cost of brands in rupees (INR) for each drug, the cost ratio, percentage cost variation, and monthly cost for all the prescribed drugs were calculated.
 Results: In our study, out of total 142 patients, 93 were females and 49 were males and the mean age was 49.11±15.89 years. The majority of patients were prescribed with Disease-modifying antirheumatic drugs (DMARDs). Frequently used non-steroidal anti-inflammatory drug (NSAID) was Diclofenac (n=48). A maximum cost ratio (15.6) was observed with prednisolone 5 mg TDS. The costliest and cheapest brand of prednisolone 5 mg TDS accounted for the maximum cost variability (1460%). Mean monthly cost varied among different drug classes.
 Conclusion: Average cost of illness of patient with RA was estimated to be in the range of 2406/month to 2858/month in the year 2021.

Pharmacoeconomic analysis of oral and injectable proton pump inhibitors available in India

Introduction: Proton pump inhibitors (PPIs) effectively suppress acid secretion and play an important role a lot of gastrointestinal disorders. PPIs are generally used long term by the patients. This can cause an increase in patient cost and subsequent decrease in adherence to the prescription. Hence, this study was done to assess the cost variation of PPIs. Methods: The cost of different brands of commonly used PPIs (10 capsules/tablets for oral drugs and one ampoule/vial for injectable drugs) was tabulated by referring to the “Monthly Index of Medical Specialties” October – December 2021, and 1mg online pharmacy. The cost ratio and percentage cost variation for various brands of a particular strength and dosage form was calculated and compared. Cost ratio >2 and cost variation >100% was considered significant. Results: The results showed a huge variation in costs of different brands with the highest being Rabeprazole 20mg (Cost ratio-16.4, Percentage cost variation-1540%) in oral formulation and Rabeprazole 20mg (11.9, 1090%) in the injectable formulation. Among oral drugs, Omeprazole 40mg has the lowest cost ratio and percentage cost variation (1.60, 60.34%) and Pantoprazole 40mg (1.51, 51.16%) in case of injectable formulations. Conclusion: There is a wide variation in the prices of PPIs available in the market. Huge demand for the commonly orally prescribed drugs like Omeprazole 20mg and Pantoprazole 40mg could be the reason for the high cost. Among injectable preparations, Pantoprazole 40mg is the most commonly prescribed but it has an acceptable cost ratio which is a positive sign.

Pharmacoeconomic Analysis of Fixed-Dose Combinations of Proton Pump Inhibitors Available in India.

Introduction The global proton pump inhibitors (PPIs) market wasvalued at US$ 2.9 billion in 2020 and is expected to exhibit a compound aggregated growth rate of 4.30% during the forecast period (2020-2027), as they are regularly prescribed for many gastrointestinal disorders, and the treatment usually lasts for a longer period. PPIs are usually combined with antiemetics and prokinetic drugs. The price of PPIs for the same combination varies a lot, which can lead to a lot of financial burden on the patients. Objective To evaluate the cost ratio and percentage cost variation of commonly used PPIs in various combinations. Methodology The cost of different brands of commonly used PPIs in combination with other drugswas analyzedin our study. A total of21 different combinations (10 capsules/tablets for oral use) were tabulated by referring to the "Monthly Index of Medical Specialities" October-December 2021, and 1mg online pharmacy. The cost ratio and percentage cost variation for various brands of a particular strength and dosage form were calculated and compared. Cost ratio > 2 and cost variation > 100% were considered significant. Results The results showa huge variation (1788.88%)in costs of different brands with the highest being rabeprazole 20 mg and domperidone 10 mg (cost ratio: 18.88, percentage cost variation: 1788.88%) in oral formulation, followed by pantoprazole 40 mg and itopride 150 mg. The minimum cost ratio (1.35) and percentage cost variation (1.35%) is for pantoprazole 40 mg and levosulpiride 75 mg. Logistic regression analysis between the number of brands and percentage cost variation gives an R2 value of 0.0923. Conclusion There is a wide variation in the prices of PPIs available in the market, which can inadvertently increase the financial burden of therapy on patients. Physicians need to be made aware of these price differences so that they can choose the best available alternative for patients, which can help in increasing compliance with the prescribed drugs.

A Pharmacoeconomic Outlook of the Biological Drugs Marketed in India: A Cost Variance Analysis.

Introduction Biologic drugs are used to treat various illnesses like autoimmune diseases, cancers, hormonal irregularities, anemia, etc., and to prevent various diseases as vaccines. Though various biologic drugs are already available, they are still not within reach of the common man due to financial constraints. Through many search engines, studies evaluating the cost variation of different brands of biologics were investigated; however, only a few studies that address this problem were found. Hence, this study was planned with the objective of addressing the cost variation of various brands of biologic medicines available in the Indian market. Methods The website for the Current Index of Medical Specialties (CIMS) for India's location was used to obtain the prices of the different brands of biologic medicines in Indian National Rupee (INR) currency, which different manufacturers market with identical forms in strength and dosage. The percentage cost variation and cost ratio were calculated with the help of the minimum and maximum prices of various brands of biologic drugs. Results The prices of biologics belonging to six different classes that are available in 23 formulations were analyzed. The highest cost variability was shown by pegfilgrastim 6 mg at 1,022.92%, and the minimum-cost variation was shown by darbepoetin alfa 200 mcg at 13.07%. Conclusion Our research found a vast variance in the costs of various brands of biologic medicines in India. The government should address this cost variation problem by developing various policies, such as breaking the monopoly of manufacturers, providing tax incentives to nonprofit generic medicine manufacturers, and incorporating more biologic drugs under the protection of the Drugs Prices Control Order (DPCO).

Evaluating the validity of the National List of Essential Medicines 2015 for “anesthetic agents” in 2022: An observational cost analysis

BACKGROUND AND AIMS: The concept of essential medicines (EMs) was introduced in 1977 by the World Health Organization. The most recent National List of EMs (NLEM) is the NLEM 2015, comprising 376 drugs. The following study was undertaken due to the lack of similar studies conducted on anesthetic agents and aims at evaluating “Section 1 – anesthetic agents” of NLEM 2015 and the relevance of EMs in India.MATERIALS AND METHODS: The study takes into account the drugs under Section 1 anesthetic agents. Data were collected from MedGuideIndia, a database of medicines marketed in India. Both cost ratio and percentage cost variations were calculated.RESULTS: Under Section 1 – anesthetic agents, atropine 1 ml injection (0.6 mg/1 ml) at 654.72% and lignocaine + adrenaline 30 ml injection has the lowest percentage cost variation at 6.26%. It was identified in the current study that the average percentage cost variation and cost ratio of all the 24 variations of the drugs is 164.51% and 2.64%, respectively. 1.3 – preoperative medication and sedation for short-term procedures have the highest price variation drug, atropine and 1.2 – local anesthetics have the lowest price variation drug, lignocaine + adrenaline.CONCLUSION: This study mainly discusses the large price variations comparing the lower versus the higher priced branded variants under Section 1 anesthetic agents. Appropriate physician education is required and newer pricing regulations require enforcement.