Percentage Cost Variation Research Articles

Economic Evaluation of Different Brands of Commonly Prescribed Drugs Used in the Management of Angina Pectoris in Indian Market

Introduction: Coronary artery disease (CAD) is one of the most common causes of cardiovascular mortality and morbidity in developing countries like India. Initial management includes use of many anti- anginal drugs. If angina pectoris not managed adequately results in significant morbidity and mortality too due to the complications. Anti-anginal drugs are used for lifelong. Therefore, analysis of the price of different drugs used in ischemic heart disease will help to improve patient compliance. Objective: (1) To assess the cost variation of different drugs available as antianginal agents in India. (2) To assess the cost ratio and percentage price variation of different formulations. Method: The maximum and minimum price of each brand of the drugs given in Indian rupees (INR) was noted by using ‘Drug Today’ (Oct 2022 – Jan 2023, volume II). The cost range, cost ratio, and the percentage cost variation for individual drug brands were calculated. The cost of tablets/capsule was calculated, and the cost ratio and percentage cost variation of various brands was compared. Results: After calculation of cost ratio and percentage cost variation for each brand of anti-anginal drugs, tab Diltiazem (60 mg) had a maximum percentage cost variation of 459.76% and a cost ratio of 5.59 while tab GTN (6.4 mg) had a minimum percentage cost variation of 76.19% and cost ratio of 1.76. Conclusions: There is a wide variation in the price of different brands ofanti-anginal drugs available in India. The clinicians prescribing these drugsshould be aware of these variations to reduce the financial burden of drugtherapy and improve compliance.

Variation in Cost Among Anticancer Drugs Available in India: A Cross-sectional Study

Introduction: Cancer is an abnormal growth of cells, and it encompasses over 100 types of cancers that affect humans. Cancer management often involves a combination of radiation therapy, surgery, chemotherapy, and targeted therapy. Anticancer drugs, in general, tend to be more expensive compared to other categories of drugs, significantly contributing to the overall drug expenditure incurred by patients. Aim: To analyse the percentage variation in cost among different brands of anticancer drugs available in the Indian market. Materials and Methods: A cross-sectional study was conducted in the Department of Pharmacology at Symbiosis Medical College, Symbiosis International University, in Pune, Maharashtra, India. The study duration was six months, from March 2021 to August 2021. Data on the prices of anticancer drugs were collected and analysed using the October 2020 to January 2021 edition of the Current Index of Medical Specialities (CIMS). A total of 29 anticancer drugs with different strengths were considered. The cost of a particular anticancer drug with the same dose and dosage form produced by different companies was compared. Drugs were selected based on their strength and dosage forms. The cost of one tablet, capsule, or injection was calculated in Indian Rupees (INR). The cost of a single unit was compared, and the difference between the maximum and minimum costs was calculated. Subsequently, cost ratios and the percentage of cost variation were determined. The study findings were recorded in both Microsoft Word 2016 and Excel 2016, and they were expressed as absolute numbers and percentages. Results: Bortezomib 3.5 mg was the costliest among anticancer drug which was priced at INR 18,988.00, while the cheapest was methotrexate 2.5 mg tablet, priced at INR 1.886. Among the anticancer drugs, pacilitaxel 260 mg injection had the highest cost ratio of 1 29.3055, whereas cisplatin 10 mg injection had the lowest cost ratio. Regarding cost variation, pacilitaxel 260 mg injection showed the highest percentage of cost variation at 2830.5555%, while cisplatin 10 mg injection showed the lowest at 0%. Conclusion: This study revealed a significant variation in prices, cost ratios, and cost variation among different anticancer drugs, providing insights into the price discrepancies observed in the market. The findings can help physicians and policymakers become aware of the cost variations among these drugs and make informed decisions regarding pricing.

Evaluating the validity of the national list of essential medicines 2015 for medicines affecting blood in 2022: An observational cost analysis

Objectives: The study aims at evaluating the validity of the national list of essential medicines (NLEM) 2015 for medicines affecting blood in 2022. The study essentially aims at conducting a cost analysis that mainly compares the cost variation between the highest and lowest priced branded variants of the same. Material and Methods: The study takes into account the aforementioned two classes of “Medicines Affecting Blood,” which is 10.1–antianemia medicines and 10.2–medicines affecting coagulation. Data were collected from MedGuideIndia, a database of medicines marketed in India. Both cost ratio and percentage cost variations were calculated. Results: Under 10.1–Antianemia medicines, hydroxycobalamin 2 ml injection (500 mcg/1 ml) has the highest percentage cost variation at 1451.72% and folic acid 5 mg tablets have the lowest percentage cost variation at 20.45%. Under 10.2– medicines affecting coagulation, phytomenadione 1 ml injection (10 mg/1 ml) has the highest percentage cost variation at 3784.46% and heparin 2 ml injection (1000 IU) has the lowest percentage cost variation at 10.4%. Conclusion: This study essentially reasons the need for the central drugs standard control organization and NPPI to intervene and appropriately modify the NLEM 2015 and introduce stricter rules and regulations, while ensuring that the appropriate price caps are both enforced and maintained for essential medicines.

Cost variation analysis of various non-steroidal anti-inflammatory drugs available in the Indian market

Background: Non Steroidal Anti Inflammatory Drugs (NSAIDS) are used to treat a variety of conditions associated with pain and inflammation. Analysis of price variation among different brands of NSAIDS provides a guide for cost - effective prescribing and helps to reduce the financial burden on the patient and improves patient compliance. Aim: To analyze price variation of various single NSAID’s formulations available in the Indian market. Material & Methods: Price of NSAIDs manufactured by different pharmaceutical companies in India of same strength was obtained from Current Index of Medical Specialties, January-March 2022. Difference between maximum and minimum price of the same formulation, cost ratio and percentage cost variation was calculated. Results: Large price variation was seen with Celecoxib 100mg capsule (476.6%) followed by Celecoxib 200mg capsule (402.3%),Nimesulide 100mg tablet (358.33%) and Paracetamol 500mg tablet (285.06).Price variation was lowest for Mefenamic acid 250mg tablet (8%). Among the syrup formulations, it was seen that there was a price variation of 29.5% for Paracetamol 125mg/5ml, 54.15% for Ibuprofen 100mg/5ml and 37.1% for Mefenamic acid 100mg/5ml. Among the injectable NSAID’s, price variation was maximum for Diclofenac 75mg/ml (441.39%). Diclofenac 1%w/w 30gm gel showed price variation of 264.86% among the topical NSAID’s.

Rational use and cost variation analysis of antifungal drugs available in the Indian market: a pharmacoeconomic study

Background: Fungal infections are the 4th most common skin disease affecting 984 million people. Fungal infections are mostly associated with the use of broad-spectrum antibiotics, corticosteroids, anticancer/immunosuppressant drugs, indwelling catheters and implants, and the emergence of AIDS. The aim of this study was to analyze the rational use, cost ratio, and percentage cost variations in different brands of the commonly prescribed antifungal drugs available in the Indian market.Method: The maximum and minimum price of each brand of the drugs given in Indian rupees (INR) was noted by using ‘Drug Today’ (January to April 2021, volume II). The cost range, cost ratio, and the percentage cost variation for individual drug brands were calculated. The cost of tablets/capsule/injection was calculated and the cost ratio and percentage cost variation of various brands was compared.Results: After calculation of cost ratio and percentage cost variation for each brand of antifungal agents, tab Itraconazole 100 mg had a maximum percentage cost variation of 733.33% and a cost ratio of 8.33 while tab Griseofulvin 250 mg had a minimum percentage cost variation of 16.98% and cost ratio of 1.16.Conclusions: The present study shows there was a wide variation in the cost of the different brands of antifungal drugs manufactured by pharmaceutical companies which increases the economic burden. The clinicians prescribing these drugs should be aware of rational use and cost variation to reduce cost of drug therapy and improve patient compliance.

Cost variation analysis of commonly prescribed oral antipsychotic drugs available in India-a pharmacoeconomic perspective

Background: Antipsychotics are commonly prescribed for a variety of psychiatric disorders which require prolonged treatment. If a costly brand is prescribed, it reduces patient compliance, especially in the lower socio-economic groups. Awareness about the cost variation among different brands will guide an economically effective prescription by the treating physician.Methods: The cost of different brands of commonly used oral antipsychotic drugs available in the Indian market manufactured by different companies, in the same strength, number and dosage form was obtained from the latest CIMS, MIMS, and India drug Index. The cost ratio and percentage cost variation were calculated for each. The cost for the same drugs was also noted from the Jan Aushadhi generic medicines portal and a comparison was made. Results: The percentage variation in the cost was above 100% with most of the commonly used antipsychotic drugs like haloperidol (517%), trifluoperazine (504.12%), risperidone (485.27%), chlorpromazine (436.35%), aripiprazole (340.34%), flupenthixol (293.12%), olanzapine (245%), ziprasidone (176.02%), amisulpride (169.44%), quetiapine (163.16%). Percentage cost variation between branded and generic drugs ranged from 400-1050%.Conclusions: There is substantial cost variation among the various brands of antipsychotic drugs. Stigma surrounding generic prescription needs to be addressed. More psychiatric drugs need to be included under National list of essential medicines and DPCO (Drug price control order) so that there can be a ceiling on the maximum price.

Impact of National List of Essential Medicines (NLEM) on Cost Variation of Immunosuppressants available in Indian Market

Published on:August 2022Journal of Young Pharmacists, 2022; 14(3):310-313Original Article | doi:10.5530/jyp.2022.14.61 Authors: Prachitee Borkar, Viraj Shinde, Prasan Bhandari, Ramanand Patil* Department of Pharmacology, Symbiosis Medical College for Women, Symbiosis International University, Lavale, Taluka Mulshi, Pune, Maharashtra, INDIA. Abstract: Background: Immunosuppressants are used commonly in two conditions: to prevent graft versus host rejection in transplantation and autoimmune disorders. Autoimmune diseases are chronic in nature requiring lifelong treatment. Organ transplantation is also expensive. Therefore, affordability of these medicines is crucial. To address the problem of affordability, government caps the prices of drugs included in National List of Essential Medicines. However, even cost variation among various brands of the drugs included in essential medicine list is of concern as majority of prescriptions are written using brand names. Hence this study was undertaken to evaluate impact of essential medicine list on cost variation of these drugs. Materials and Methods: Immunosuppressant drugs were broadly classified into two categories – drugs listed under National List of Essential Medicines and drugs not included. Prices of the drugs belonging to both the groups were obtained from website “Pharma Sahi Dam”. Later, cost ratio, percentage cost variation was calculated. The multiple linear regression analysis was performed to investigate association between percentage cost variation and essentiality/number of brands. Results: Immunosuppressant drugs showed wide cost variation. Overall higher cost variation was seen among drugs not included in essential medicine list. This was further substantiated by multiple regression analysis (β = 0.316, p = 0.021). However, number of brands had no effect on cost variation. Conclusion: Hence, to improve affordability of these drugs which are mainstay in autoimmune disorders and organ transplantation, regulatory bodies should widen the inclusion criteria for essential medicine list. Also, efforts are needed to create awareness of cost variation among prescribers.Keywords: Immunosuppressants, Essential drugs, Economics, Cost analysis, Pharmacoeconomic.

Cost Variation Study of Various Brands of Oral Fluoroquinolones Available in India: An Economic Perspective

Fluoroquinolones are broad-spectrum antibacterial for treating respiratory tract, intra-abdominal, urinary tract, pelvic, joint, bone, soft tissue, and skin infections. The economic burden on patients affects compliance in developing countries like India. Therefore, the prices of drugs should be controlled effectively. Hence, this study was done to assess the cost variation of branded oral fluoroquinolones available in India compared with generic counterparts. The maximum and minimum cost of oral fluoroquinolones (INR per 10 tablets) of the same strength and dosage form manufactured by different companies was obtained from Drug Today April to July 2021 Volume 1, MIMS, and 1mg.com. The cost ratio and the percentage cost variation of individual drug brands were calculated. Prices of generic fluoroquinolones from the Jan Aushadhi scheme (JAS) were compared with branded drugs. Of 11 different oral fluoroquinolones, levofloxacin 500 mg had the highest percentage variation of 11.100%, and three formulations marketed by a few manufacturers have a percentage reduction of less than 100%. Of 23 different combinations available as 33 different dosages, the highest cost variations were observed in Norfloxacin 400 mg plus tinidazole 600 mg combination (1317%). When compared, some generic fluoroquinolones available under JAS were not cheaper than the minimum cost of their branded counterparts. Wide variation in the cost of the different brands of the same oral fluoroquinolones manufactured by other companies was observed. This adds to the economic burden for the patients. Hence, stakeholders should aim to decrease the cost variation among different brands while maintaining therapeutic efficacy

A COST VARIATION ANALYSIS OF ORAL AND TOPICAL ANTIFUNGAL AGENTS AVAILABLE FOR THE TREATMENT OF SUPERFICIAL FUNGAL INFECTIONS IN INDIA – AN INSIGHT TO THE RISING TREATMENT COST

Objective: This study objective was to evaluate the cost variation among systemic and topical antifungal drugs used for superficial fungal infection which is available in India. Methods: This cross-sectional study assembled the cost of individual antifungal agents belonging to the same strength and dosage forms being manufactured by different pharmaceutical companies in India were documented in Indian Rupees (INR). The study tools were the latest edition January–April 2022 of Current Index of Medical Specialties and 1 mg online application. The study parameters were minimum and maximum cost, difference in maximum and minimum cost, and percentage cost variation. Results: A total of 14 antifungal agents, including seven orals and seven topical, were analyzed. Fluconazole 50 mg tablet is manufactured by 67 companies and has the maximum cost variation of 2695.8%. This is followed by capsule itraconazole 100 mg (cost variation – 1900%) and is manufactured by largest number of companies, that is, 1039. Luliconazole 30 g cream has highest cost ratio of 13.75 and cost variation of 1275% which was manufactured by largest number of companies, that is, 211. There was a linear relationship seen in linear regression analysis between number of manufacturing companies and percentage cost variation (p=0.0204). Conclusion: A rationale prescription should always consider the most economical treatment depending on the patient. Adequate information to medical practitioner about cost variation of drugs and strict actions and coordination of regulatory authorities will overcome the problem of huge cost variation.

Prescription analysis and cost of antidepressant drugs in major depressive disorder outpatients at the tertiary care hospital of Pakistan: a prospective approach

ABSTRACT Objectives To assess prescribing care indicators, utilization pattern, cost per prescription, cost ratios, and percent cost variation of antidepressants (ADs). Method A prospective cross-sectional study was carried out at the tertiary care hospital of Peshawar, Pakistan among major depressive disorder (MDD) outpatients from July 2019 to February 2020. The ideal standards for World Health Organization (WHO) prescribing care indicators were used. The ePharma Guide was used to calculate the cost in Pakistani rupees (Rs) and United States dollar (USD) 2021 (exchange rate: 1 USD = 154.43 Rs). Results A total of 296 MDD patients received 846 drugs (average 2.86; range:1–8), of which 366 were ADs (average number ADs/prescription; 1.23). About 23% (n = 68) of patients received more than one AD. Only 21 (5.7%) generic ADs were prescribed, and 346 (94.5%) ADs were prescribed from the hospital formulary list. Selective serotonin reuptake inhibitors (SSRIs) were the most prescribed ADs (67.5%). The average cost of ADs per prescription per month was 700.95 Rs (4.54 USD). Escitalopram (5.69 Rs; 0.04 USD) showed highest cost ratio and maximum percentage cost variation (468.97%). Conclusion This study observed low generic prescribing, a higher prescribing trend of SSRI, wide differences in cost ratio and percentage cost variation among ADs.

PHARMACOECONOMIC ANALYSIS OF VARIOUS BRANDS OF COMMONLY PRESCRIBED ORAL ANTIHYPERTENSIVE MEDICINES IN INDIAN MARKET

Objectives: The objective of the study was to analyze the percentage cost variations among various brands of the commonly prescribed antihypertensive medicines in India. Methods: Cost of a particular medicine (cost per 10 tablets) in the same strength and dosage forms being produced by various pharmaceutical companies was taken from Current Index of Medical specialties and Drug Today. Difference between the highest and lowest cost of the same drug manufactured by various pharmaceutical industries was obtained and percentage cost variation was calculated. Results: The percentage variation in the price was above 100% with almost all of the commonly prescribed antihypertensive medicines. The cost of a total of 23 drugs (14 single and nine combination preparations), available in forty nine different formulations were studied. Overall, Amlodipine (5 mg) shows highest price difference of 982.3%, while Nifedipine (5 mg) shows lowest price difference of 39%. Telmisartan + Hydrochlorthiazide (80+12.5 mg) combinations shows highest price variation of 318.9%, while Amlodipine + Losartan (5+50 mg) shows lowest price difference of 50%. Conclusion: The average percentage price difference of the same antihypertensive medicine manufactured by various pharmaceuticals company in India is very huge. Hence, Government, Pharmaceutical companies, prescribing health care workers should educate themselves about huge variation in price of brand drugs in comparison with their cheap generic counterpart to provide maximum benefits with minimum financial burden to the patients receiving antihypertensive drugs.

Cost variation analysis of oral anti-diabetic drugs available in Indian market

Background: Diabetes mellitus (DM) is a chronic progressive metabolic disorder associated with microvascular and macrovascular complications in type 2 DM. Oral anti-diabetic drugs (OADs) play an important role in regulating raised blood glucose levels and compliance to treatment. Aims and Objectives: The aims of this study were to evaluate cost variations of different brands of drug formulations in the management of DM. Materials and Methods: This study was an analytical study. Costs of various OADs were obtained from January to March 2022 edition of current index of medical specialties India. The cost ratio and percentage of variation among different drugs in the treatment of DM available in Indian Market and Manufactured by different pharmaceutical companies were analyzed. Results: The percentage variation in cost among commonly prescribed single OADs was found to be highest for sulfonylurea group of dugs Glimepiride 1 mg tablet (1.366%), followed by Biguanides, Metformin 500 mg tablet (809%), α-Glucosidase inhibitors, and Voglibose 0.3 mg tablet (571%), while it was lowest for Glibenclamide 5 mg tablet (36%) and Acarbose 25 mg tablet (36%) of sulfonylurea drugs and α-Glucosidase inhibitors group of drugs, respectively. In combination drug therapy, Glibenclamide and Metformin combination (1.25 + 250 mg tablet) shows maximum variation (132%). Conclusion: There is a wide difference existing in the cost of various oral anti-diabetics available in Indian Market by different brands. The physicians must be aware of these variations and prescribe medicines accordingly, while considering the financial status of patient and also to promote adherence to treatment.

Evaluation of drug utilization pattern, quality of life and pharmaco-economics in patients of contact dermatitis: a prospective observational study

<p class="abstract"><strong>Background: </strong>Contact dermatitis (CD) is a common inflammatory skin condition due to T-cell mediated immune reaction on exposure to different allergens. The disease significantly affects Quality of Life (QoL) and all over impact can be seen in Pharmacoeconomics.</p><p class="abstract"><strong>Methods: </strong>This is the prospective observational study done between October 2019 to February 2020 at Dermatology outpatient department (OPD) of a tertiary care teaching hospital. Patients diagnosed with CD aged eighteen years or older of either gender and willing to give written consent were included in study. The impact of CD on the QoL of affected persons was assessed using the Dermatology Life Quality Index (DLQI). Direct, indirect and total cost as well as percentage variation in cost of individual drugs was calculated for Pharmacoeconomics analysis.</p><p class="abstract"><strong>Results:</strong> The study population consisted of 180 patients. The most commonly prescribed drugs were corticosteroids (47.44%). The average score of DLQI at baseline was 8.97±4.85. The DLQI score was significantly more impaired in women as compared to men (12.91versus 4.93) (p=0.0001). Average income per month was 11,611.11±230.34₹. The average direct, indirect and total cost was 131.55±70.55 ₹, 136.44±16.93 ₹ and 168.11±74.08₹ respectively. The percentage variation of cost was largest for prednisolone 5 mg tablet and least for clobetasol cream (0.05%).</p><p class="abstract"><strong>Conclusions: </strong>The impact of CD on QoL and Pharmacoeconomic burden is significant and requires specific attention in health care facilities. </p>

Cost variation analysis of commonly prescribed anti-diabetic drugs available in Indian market: a pharmaco-economic study

Cost variation analysis of commonly prescribed anti-diabetic drugs available in Indian market: a pharmaco-economic study

Rational use and cost variation analysis of antitussive-expectorants available in the Indian market: a pharmacoeconomic study

Background: Antitussive-expectorants are among the most frequently prescribed drugs by physicians in clinical practice. Upper respiratory tract infections, such as common cold, acute pharyngitis and acute trachea-bronchitis, are the most common of all communicable diseases and significantly increase OPD burden. This study aimed to assess the rational use, cost ratio, and percentage cost variations in different brands of the commonly prescribed antitussive-expectorants available in the Indian market.Methods: The cost of antitussive-expectorant manufactured by different pharmaceutical companies was obtained by using drug today Jan-April 2021 vol 2. The maximum and minimum price was noted down, cost ratio and percentage cost variation of the individual formulation were analysed. Results: Analysis of cost ratio and percentage cost variation for each formulation of the antitussive-expectorants drug, syrup (100 ml) chlorpheniramine (2 mg), dextromethorphan (10 mg), phenylephrine (5 mg) combinations show the highest cost ratio and percentage cost variation as 5.30 and 430.25 respectively, and syrup (100 ml) dextromethorphan (10 mg), guaifenesin (100 mg), phenylephrine (25 mg), chlorpheniramine (4 mg) combinations show lowest cost ratio and percentage cost variation as 1.17 and 17.69 respectively.Conclusions: There was a wide variation in the cost of different brands of antitussive-expectorant drugs available in the Indian market. So, clinicians should be aware of rational use and variations in cost to reduce the treatment cost and increase patient compliance.

Evaluation of drug use heath related quality of life and pharmacoeconomics in autoimmune skin disorders: focus on blistering skin disorders-a prospective observational study

Background: Autoimmune skin disorders (ASDs) are complex diseases triggered by autoantibodies action against epidermal antigens or the dermo epidermal junction. Although rare, they present high morbidity, affecting the quality of life (QoL) of patients and financial status of patient.Methods: This prospective, observational study was carried out in department of dermatology for 2-3 months after ethical approval. Drug usage pattern, heath related QoL (HRQOL) by using DLQI (Dermatology life quality index) and cost were evaluated in patients with ASDs. Statistical analysis was done using Microsoft excel office 2019 and rechecked with SPSS (version 23.0). P<0.001 was considered as statistically significant.Results: Out of 73 patients enrolled, 32 were male and 41 were female with the mean age was 48.27±14.93 years; 55% patients had autoimmune blistering skin disorders (AIBDs) and 45% having other ASDs (OADs). Pemphigus vulgaris (PV) (35%) being the most common among all ASDs. Systemic steroid (60.27%), topical steroid (79.45%), levocetirizine (63%) were most commonly prescribed drugs. Mean DLQI score at baseline and after treatment was 11.64±2.49 and 6.8±2.75 respectively. It was highly significant statistically (p<0.0001). Total cost of illness per month was 813.64±481.21 INR. Maximum percentage variation in cost was seen with prednisolone (1706.28%).Conclusions: ASDs have a female bias and inflict severe impairment to the QoL of patients. Appropriate drug therapy with corticosteroids and other adjuvant drug lead to positive impact on QoL. There was very wide price variation of different brands of the same generic most commonly prednisolone and levocetirizine.

Cost variation analysis of statins available in India

Background: The current study aimed to find out the percentage cost variation among the various brands of statins marketed in India. Statins are HMG-CoA reductase inhibitors which are widely prescribed as blood cholesterol lowering agents and hence reduce illness and mortality in those who are at high risk of cardiovascular disease. There are numerous brands of statins are marketed in India.Methods: Cost of a particular drug manufactured by different companies in the same strength and the dosage form was obtained from the price list provided by the pharmaceutical companies in current index of medical specialities (CIMS) (42nd year January to April 2021). The difference in the maximum and the minimum price of the same drug manufactured by different pharmaceutical companies, cost ratio and the percentage variation in price were analysed.Results: The percentage cost variation of statins was seen highest with tablet atorvastatin 20 mg (564.06%), followed by combination of capsule atorvastatin 10 mg+aspirin 75 mg (325%) which was followed by combination of film coated tablet atorvastatin 10 mg+fenofibrate 160 mg (267.4%), tablet rosuvastatin 20 mg (171.1%), tablet lovastatin 10 mg (108.9%), combination of tablet rosuvastatin 10 mg+fenofibrate 160 mg (87.34%) and lowest was seen with tablet simvastatin 20 mg (6.0%).Conclusions: There is a very wide cost variation among different brands of statins marketed in India. The percentage cost variation was found to be the highest among the moderate intensity statins.

Health economics and effectiveness analysis of generic anti-diabetic medication from jan aushadhi: An ambispective study in community pharmacy

Background and aimsThe pharmacotherapy of diabetes mellitus has a colossal economic burden, which demands cost-effective therapy, as the patients have to be on treatment lifelong. Thus, our study aimed to study cost variation and effectiveness analysis among type 2 diabetic patients. MethodologyWe conducted ambi-spective research for the adult type 2 diabetes patients who underwent substitution of branded anti-diabetic therapy with the generic alternative from “Jan Aushadhi” for more than one month and were not using any other anti-diabetic medicines. ResultsAmong the monotherapy, glimepiride (2500%) and vildagliptin (20%) were found to have wide and narrow percentage cost variation respectively whereas, metformin Hcl 500 mg plus voglibose 0.2 mg was estimated to have the highest (891.7%), and teneligliptin 20 mg plus metformin 500 mg with the lowest (137.29%) cost variation in case of combined therapy. Similarly, generic substitutions were cost-effective in most patients, whereas the increased cost of brand drugs didn't justify its effectiveness. There was no significant difference between glycated hemoglobin (HbA1c) of brand and generic anti-diabetic drugs (t = 0.774, p = 0.22). ConclusionThe adaptation of generic drugs can significantly reduce the economic burden of treatment. Thus, healthcare professionals should promote generic medicines by prescribing & dispensing generic drugs and erasing misconceptions prevailing among patients.

STUDY ON COST VARIATION OF ORAL ANTIHYPERTENSIVE MEDICATIONS AVAILABLE IN RETAIL STORES ACROSS CHITWAN

Background: Antihypertensive medications reduce blood pressure and decrease cardiovascular dis­ease morbidity and mortality. A number of antihypertensives with same formulation but different prices are available in the market. In the present study we aim to study such price variations of antihypertensive drugs currently available in the Nepalese market. Methods: We obtained the marked price of different antihypertensives manufactured in Nepal and India from various medicine stores within Chitwan from February to June 2021. Cost ratio (CR) and percentage cost variation (%CV) was calculated using Microsoft Office Excel-2019. Results: We observed a high percentage of cost variation in Amlodipine 5mg (CR: 3.33 %CV: 233.33) among Nepali and Losartan 50mg (CR: 32.31 %CV: 3131.47) among Indian antihypertensives. Conclusions: A wide percentage cost variation was observed among antihypertensive medications cur­rently available in the Nepalese market. Regulatory bodies could address the issue to ensure affordability of essential antihypertensive medications.

Analysis of the variations in price of anti-glaucoma eye preparations available in Indian pharmaceutical market

Background: The aim of the study was to analyze the percentage cost variations among different brands of the commonly prescribed anti–glaucoma drugs.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition Drug Today April to June 2018 Vol-1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of each eye drop was calculated. At last the cost ratio and percentage cost variation of various brands was compared.Results: Percentage variation in cost for anti-glaucoma eye preparations marketed in india was found to be eye drop timolol maleate (0.5%) of 5 ml:263.63, eye drop dorzolamide (2%) of 5 ml:9.77, eye drop pilocarpine (2%) of 5 ml:160.40, eye drop Betaxolol (0.5%) of 5 ml:56.54, eye drop Latanoprost (50 mcg/ml) of 2.5ml:135.88, eye drop Brimonidine tartarate (0.15%) of 5 ml:183.9, eye drop Levobunolol (5 mg/ml) of 5 ml:32.38.Conclusions: Glaucoma is the most common ocular disease and eye drops are to be prescribed for prolonged period. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy.