Percentage Cost Variation Research Articles

A pharmacoeconomic study of different brands of commonly prescribed antihypertensive drugs

Background: The hypertension is the most common chronic disease, therefore treatment should be affordable. The antihypertensive drugs of same strength are available in market at different costs. This study was undertaken to create awareness among health care workers and patients, about cost difference among different brands of same antihypertensive drug. So that whenever possible, a cheaper effective brand can be prescribed to ensure better patient adherence.Methods: Maximum retail price (MRP) of various antihypertensive drugs of same strength, manufactured by different pharmaceutical companies was obtained from various offline and online sources. The minimum and maximum cost of 10 tablets/capsules noted. The cost ratio and percentage cost variation was calculated for single drug and fixed dose combinations. The ceiling price (as per DPCO) of essential antihypertensives (as per national list of essential medicines) was compared with their maximum cost.Results: The formulations of single antihypertensive drugs (41) and fixed dose combinations of two drugs (19) and three drugs (9) were included in the study. Among the single antihypertensives analyzed the highest cost difference was of eplerenone (50 mg) and high cost ratio and cost variation percentage was of amlodipine (5 mg). Among fixed dose combination of two drugs analyzed highest cost difference was found that of hydrochlorothazide (12.5 mg)+olmesartan (40 mg) combination and highest cost ratio and percentage cost variation was of amlodipine (5 mg)+telmisartan (40 mg).Conclusions: There was a huge price variation among the antihypertensive drugs manufactured by various companies. Some measures must be taken by the government to bring the uniformity in the price that will help to reduce the economic burden on the patients.

Cost variation analysis of different brands of oral anti-epileptic drugs available in India

Background: Epilepsy is a group of neurological disorders, characterized by seizures, loss of consciousness, muscular contraction. Prevalence of epilepsy in India is about 1%. High medical care cost should be cause of concern for policy makers and service providers. Hence, a study was planned to analyse cost ratio and percentage cost variations of oral antiepileptic drugs available in India.Methods: An analytical study with maximum and minimum price of 10 tablets/capsules and syrup of one bottle of available strength of each drug was noted in Indian Rupee, using “Current Index of Medical Specialties” July to October 2020; “Drug Today” July To October 2020 volume-1 and “Indian Drug Review” 2020 volume-26 issue 6. Percentage cost variation and cost ratio for individual drugs was compared.Results: Significant cost variations were found in different brands of same drug. Among established oral antiepileptic drugs, Divalproex sodium 250 mg has highest cost ratio 16.071 and 1507.14% price variation and Clonazepam 0.25 mg with cost ratio 16.005 and 1500.55% price variation. Diazepam 2 mg has lowest cost ratio 1.024 and 2.43% price variation. Among newer oral antiepileptic drugs, Levetiracetam 500 mg has highest cost ratio 66.389 and 6538.93% price variation; least is Oxcarbazepine 450 mg with cost ratio 1.317 and 31.75% price variation.Conclusions: Epilepsy has long course of treatment. Increased adherence to treatment is achieved by switching to cost-effective therapy and by making Pharmacoeconomics an integral part of Undergraduate and Postgraduate Curriculum.

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

Background: The objective of this study was to analyze cost variations of oral antidiabetic drugs available in Indian market.Methods: An observational study was carried out using CIMS (current index of medical specialities), (July 2020 to October 2020) and 1 mg.com, where difference in the maximum and minimum price of a particular drug, manufactured by different pharmaceutical companies, in the same strength, number and dosage form was compared and the percentage variation in price was calculated. Data was analyzed using descriptive statistical analysis.Results: The minimum and maximum percentage price variation for different classes of drugs respectively is as follows- in single drug therapy, the price variation between a sulfonylurea group of drugs glibenclamide (5 mg) shows maximum price variation of 400%, while glipizide (2.5 mg) shows variation of 81.8%. In biguanides, thizolidinediones and DPP4 inhibitor groups of drugs, metformin (500 mg), pioglitazone (30 mg) and vildagliptin show maximum price variation of 334.78%, 307 % and 264.6% respectively. In α- glucosidases inhibitor group of drugs voglibose (0.2 mg) shows maximum price variation of 284%. In meglitinides group of drugs, nateglinide (60 mg) shows maximum price variation of 284.6 %. In combination drug therapy, glimepiride and metformin combination (2+500 mg SR) shows the maximum variation up to 352.8%.Conclusions: The percentage cost variation of different brands of the same drug manufactured in India is very wide and the reason behind marketing a drug should be directed towards maximizing the benefit of therapy and minimizing negative personal and economic consequences.

Study of the cost variation analysis of anti-epileptic drugs available in different brands in Indian pharmaceutical market

Background: The aim of this study was to analyze the cost ratio and percentage cost variations in different brands of the commonly prescribed anti-epileptic drugs available in Indian pharmaceutical market.Methods: The maximum and minimum price of each brand of the drug given in Indian rupees (INR) was noted by using CIMS January to April 2020 edition and drug today April to June 2020 volume 1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of one bottle in case of 100 ml syrup and 10 tablets/capsules was calculated in case of oral drugs and the cost of one 1 vial or ampoule was noted in case of injectable drugs. At last 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-epileptic drug tablet clonazepam (2 mg) shows highest cost ratio and percentage cost variation as 10.41 and 941.66, carbamazepine (200 mg SR tablet) shows lowest cost ratio and percentage cost variation as 1.09 and 9.32.Conclusions: Epilepsy is the most common neurological disorder and epileptic drugs are to be prescribed for prolonged period. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. There is a wide difference in the cost of different brands of anti-epileptic drugs available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy.

Study of price variation analysis of fluoroquinolones eye drops manufactured by various pharmaceutical companies in India

Background: Fluoroquinolone eye drops is being prescribed by Opthalmologist in many ocular diseases as conjunctivitis, keratitis, bacterial corneal ulcers etc in more and more amount. There are many brands of fluoroquinolones drugs available in Indian market. Costly drugs can lead to economic burden on patients. Modifications in pharmaceutical policy are required, and prices of the drug should be controlled in effective way for all the drugs. Hence this study was done to assess the cost variation of fluoroquinolones opthalmic solutions available in Indian market.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2020 edition and Drug Today April to June 2020 volume 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 fluoroquinolones eye preparations marketed in India was found to be Eye drop Ciprofloxacin (0.3%) of 5 ml:210.39, Eye drop Ciprofloxacin (0.3%) of 10 ml:162, Eye drop Gatifloxacin (0.3%) of 5 ml:156, Eye drop Moxifloxacin (0.5%) of 5 ml:196.95, Eye drop Ofloxacin (0.3%) of 5 ml:245.16, Eye drop Ofloxacin (0.3%) of 10 ml:62.5, Eye drop Norfloxacin (0.3%) of 5 ml:120.68, Eye drop Sparfloxacin (0.3%):8.31, Eye drop Lomefloxacin (0.3%):16.17.Conclusions: There is a wide difference in the cost of different brands of fluoroquinolones eye preparations available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy.

Price Dispersion of Vitamin D Supplements Over Time: An Initiative for Prescriber Education.

Objectives:High prevalence of vitamin D deficiency mandates prescribing an appropriate form of vitamin D that allows attainment of sufficiency in a cost-effective manner. We aimed to compare vitamin D products in Indian market in terms of composition and cost in 2020 with 2013 to understand price dispersion over 7 years.Methods:Constituents, formulations, and prices of ‘branded’ and generic vitamin D products were sourced from various drug information compendia and online sources. Price per defined daily dose (DDD), percentage cost variation, and change in prices over 7 years (2020 vs. 2013) was determined.Results:There has been a disproportionate increase in the number of brands and cost variation of cholecalciferol and calcitriol in the last 7 years. The percentage cost variation increased almost 10 times for calcitriol and 4.4 times for alfacalcidiol tablets and cholecalciferol granules. An analysis of >1,100 products in 2020 showed that the predominant form was calcitriol which was combined with calcium in >90% of the products with huge cost variation (>3000%). Ergocalciferol and cholecalciferol were available in 22 and 15 different strengths respectively. Median price/unit of cholecalciferol (60,000IU) was lower for tablets/capsules compared to other formulations; but with >1000% cost variation.Conclusion:A wide cost variation exists with the use of different vitamin D brands and preparations with conventional cholecalciferol tablets and capsules being a low-priced alternative. Quality control measures and strict enforcements of existing regulations are essential to ensure that competitive prices of branded generics are translated into availability and affordability for the population.

Cost variation analysis of various brands of selective serotonin reuptake inhibitors currently available in the Indian market: An observational study

Background: India being the world’s largest supplier of generic drugs provides 50% of the drugs globally. Selective Serotonin Reuptake Inhibitors (SSRI) (hereafter referred to as SSRI) is the most commonly prescribed drugs for depression (prevalence of 5.25%) and Anxiety (prevalence of 5.8%). The cost of these drugs influences the patient compliance with treatment and thereby the clinical outcome significantly. Aim and Objectives: The aim of the study was to analyze the cost-variation of SSRIs available in the Indian market. Materials and Methods: Maximum and minimum costs of various SSRIs used in the treatment of depression and anxiety were obtained from the monthly index of medical specialties (November 2020) online, Jan Aushadhi Sugam App (Generic drugs), and National Pharmaceutical Pricing Authority online. The cost of various SSRI being manufactured by different companies in the same strength and dosage form were compared. Cost ratio (Maximum cost/Minimum cost) and percentage cost variation ([{Max cost–Min cost}/Min cost] × 100) in INR (₹) were calculated. Data were analyzed and represented using descriptive statistics. Results: Percentage cost variation was maximum with Fluoxetine 20 mg (3477.85%), followed by Sertraline 50 mg (1631.61%) and Escitalopram 10 mg (1288.89%). Percentage cost variation was minimum with Vilazodone 40 mg (16.31%). Conclusion: This study provides awareness about cost variation among different brands of SSRI used in the treatment of depression and anxiety. Wide variation can cause dissatisfaction, poor compliance, and economic burden among patients. It strengthens the usage of generic drugs among general population and healthcare providers.

Cost analysis of fixed-dose combinations of proton- pump inhibitor drugs available in the Indian market

Background: Proton-pump inhibitors (PPIs) are among the most prescribed drugs for acid-related gastrointestinal disorders. Various guidelines are available for the clinical use of PPIs; however, their non-judicious use has been reported. PPIs combined with other agents as fixed-dose combinations (FDCs) are available but there is an acute lack of data about cost incurred on their use. This is important since health-care expenditure in India is borne primarily by patients. Aim and Objective: This study aims to evaluate the cost of FDCs of PPIs of different brands and to analyze the price variation among those available in the Indian market. Materials and Methods: An observational, analytical study was carried out in which price of FDCs of PPI in INR manufactured by different Indian pharmaceutical companies was obtained from CIMS (July–September 2020) and IDR (August 2020). Percentage variation and cost ratio were calculated. Results: A total of 842 brands of six PPIs in various FDC were evaluated. Maximum percentage variation in cost and maximum cost ratio was found for rabeprazole + domperidone (20 mg + 30 mg), that is, 633.33% and 7.3, respectively, while minimum percentage variation in cost and minimum cost ratio was found for ilaprazole + domperidone (10 mg+30 mg), that is, 30.30% and 1.3, respectively. Conclusion: This study showed wide variation in prices of FDCs of PPIs available in Indian market. There should be combined efforts from the government and pharmaceutical companies to reduce such a price variation so the prescribing physician can provide maximum benefits to patients.

Cost variation analysis of different brands of antifungal drugs available in India

Background: Most fungal infections require long-term therapy significantly increasing cost of therapy. High medical care cost should be of concern for policy makers and service providers. Hence, a study was planned to analyze cost ratio and percentage (%) cost variations of antifungal drugs available in India. Aim and Objectives: The aim of the study was to evaluate cost of different brands of antifungal drugs available in India and to analyze cost ratio and cost variations of different brands of antifungal drugs. Materials and Methods: Maximum and minimum price of each drug was noted in Indian Rupee, using “CIMS” April to July 2021; “Drug Today” April to July 2021 Vol - 1 and 2; and “Indian Drug Review” 2021. Percentage cost variation and cost ratio for individual drugs were compared. Results: Among oral antifungal drugs, Terbinafine 250 mg has highest cost ratio 89.071 and 8807.1% price variation. Griseofulvin 250 mg has lowest cost ratio 1.169 and 16.98% price variation. Among parenteral antifungal drugs, Amphotericin B 50 mg has highest cost ratio 17.088 and 1608.83% price variation. Caspofungin (50 and 70 mg) has least cost ratio and % price variation. Among single drug topical preparations, Clotrimazole 1% powder formulation has highest cost ratio and % price variation 22.48 and 2144.89%, respectively. Ketoconazole 2% solution formulation has least cost ratio and % price variation 1.233 and 23.33%, respectively. Conclusions: Long-term antifungal therapy requires patient compliance and thereby increased adherence to treatment which is achieved by switching to cost-effective regimen and by making Pharmacoeconomics an integral part of Undergraduate and Postgraduate Curriculum.

Cost variation analysis of nonsteroidal anti-inflammatory drugs available as single formulation in the Indian market

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed and over the counter (OTC) used drugs worldwide for their analgesic, anti-inflammatory, and anti-pyretic properties. India being a hub for pharmaceutical industries, manufacture large number of branded and generic drugs. Thus, there is wide variation in their cost. Prescribing drug without considering the cost of therapy may result in loss of compliance or imposes economic burden on patient. Aim and Objective: The aim of the study was to evaluate existing price variation of different single NSAIDs formulations available in Indian market. Materials and Methods: Price of NSAIDs manufactured by different pharmaceutical companies in India, in the same strength, was obtained from Current Index of Medical Specialties, January-April 2020, Drug Today October-December 2019, and 1 mg.com. Difference in the maximum to minimum price of the same formulation manufactured by different pharmaceutical companies and percentage cost variation was calculated. Results: price of 14 NSAIDs that are available in 56 different formulations and manufactured by different pharmaceutical companies was obtained and evaluated. Study shows largest variation with Nimesulide 100 mg (5476.74%), piroxicam DT 20 (3071.46%), piroxicam 20 mg (2853.36%), diclofenac 50 mg (2786%), Aceclofenac 100 mg (2345.6%), and ibuprofen 400 mg (1198.70%) and minimum variation was seen with Aspirin 150 mg (90.47%) in oral formulations. All formulations of Diclofenac injection show very high price variation. Diclofenac 1% gel shows maximum price variation of 778.66% while Nimesulide 1% gel shows minimum variation of 159.32%. Conclusion: Our study finding showed significant cost variation in different brand of NSAIDs available in India. The physician must choose the drug on the basis of cost and rationality rather than on the basis of claims done by various pharmaceutical companies. Modifications in pharmaceutical policy with strict control on huge price variations are the need of time.

Cost Excursion Study of Various Insulin Preparations Available in India

Introduction: Poor drug compliance affects clinical outcome and increases healthcare costs in various disease setting. Several type II diabetes mellitus patients, not controlled on oral hypoglycaemics eventually require insulin therapy. Antidiabetic treatment is to be taken lifelong and in such a setting insulin price variation imposes a huge economic burden on poor diabetic patients. Moderating drug cost is associated with improved adherence to the medication regimen. Aim: To study the variation in cost amongst various brands of insulin analogues. Materials and Methods: This was an observational, cross-sectional study. Data regarding the 116 formulations and cost of 18 types of insulin preparations was collected from sources like Current Index of Medical Specialties (CIMS), National Pharmaceutical Pricing Authority (NPPA), Government of India official website (https://nppaimis.nic.in/nppaprice/pharmasahidaamweb.aspx) and compared with its lowest counterpart. The cost ratio and percentage cost variation was analysed and expressed as percentages. Results: This study showed a noticeable variation in the prices of insulin analogues. The highest percentage of cost variation was found for Insulin (Highly Purified) Zinc-40 IU (135.17%), followed by Insulin (Analogue) Glargine-100 IU (109.31%). The lowest percentage were for: Insulin (Human-Isophane Recombinant)-40 IU (1.40%), and Insulin (Analogue) Aspart- 100 IU (6.26%). Conclusion: A noticeable variation in cost prices was observed especially in commonly used intermediate acting insulin that help basal glycaemic control. Similarly, the lowest variation was observed with recombinant counterparts as an effect of pre-existing high prices of each. Need for vital medication like insulin at affordable costs has incited national and global efforts to make it cheaper and accessible to maximum beneficiaries.

Prescription pattern and cost analysis study of various drugs in patients with sexual disorders in a tertiary care hospital

Background: Sexual disorders are very much prevalent in clinical practice and mainstay of treating them is medications. Cost of medicines used to treat them is very high. Furthermore, different kinds of formulations are available to treat them in market. Compliance to treatment depends on various factors one being related to medicines prescribed. Aim and Objectives: The objective of the study was to evaluate prescription patterns and cost analysis of various drugs used in the treatment of sexual disorders. Materials and Methods: This was a cross-sectional, observational study undertaken from January 2018 to January 2019 after taking permission from Institutional Ethics Committee. The demographic profile, diagnosis, drugs prescribed along with their dose, frequency, written instructions regarding drug instillation, and its precautions were recorded on a semi-structured case record form. Results: The most commonly diagnosed sexual disorder was ED with PME (31.10%) in male and orgasmic sexual dysfunction (1.22%) in female. Most commonly prescribed class of drugs was Vitamins (20%) along with Phosphodiesterase Inhibitors PDEIs) (17%). About 79% drugs were prescribed by brand names were and 21% by generic names. The most frequently prescribed oral formulation was a tablet (93.53%). Tadalafil (99.9%) was prescribed most frequently PDEI. The minimum cost ratio was for tablet Paroxetine 12.5 mg, that is, 1:1.50 and the percentage cost variation was 500. The maximum cost ratio was for tablet Bupropion 150 mg and has percentage cost variation of 490. In PDEIs sildenafil had maximum cost ratio (1:2.51) and cost variation percentage (151). Conclusions: Wide range of cost variations seen in medicines. This knowledge can help doctors to prescribe as per patient’s socio-economic status.

Cost Analysis of Different Antibiotic Brands Available in Indian Market with Reference to National List of Essential Medicines.

Background:About 60%–90% of healthcare spending in India is on medicine which is mainly out of pocket. Almost all the drugs including antibiotics are available as brands with variable cost. Indian government formulated National List of Essential Medicines (NLEM) to ensure availability of affordable medicines to the population. Prescribing drugs from NLEM and considering the cost of drug, especially antibiotics in practice, can reduce cost of treatment and patient's out-of-pocket expenditure.Objective:The objective of the study is to analyze cost variation of different antibiotic brands available in Indian market with reference to NLEM.Materials and Methods:List of antibiotics listed in the NLEM 2015, India, was prepared. Percentage cost variation and cost ratio of different brands of these antibiotics were calculated and compared.Results:We found 17 antibiotics listed in NLEM 2015. The number of brands varied from 2 to 102. We found wide cost variations among different brands of same antibiotics. Minimum cost variation was 7.34% (for ciprofloxacin 200 mg/100 ml vial) while maximum 1049.82% (for azithromycin 500 mg tablet).Conclusion:There is wide cost variation in different brands of same antibiotics listed in the NLEM. Prescribers should prescribe cheaper brands of antibiotics to ensure that patients complete the course of treatment and thus reduce development of resistance to antibiotics.

To analyze the variations in cost of Anti-glaucoma eye preparations available in Indian market

Aim: To analyze the percentage cost variations among different brands of the commonly prescribed anti–glaucoma drugs. Material and 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 5ml:263.63, Eye drop Dorzolamide (2%) of 5ml:9.77, Eye drop Pilocarpine (2%) of 5ml:160.40, Eye drop Betaxolol (0.5%) of 5ml:56.54, Eye drop Latanoprost(50mcg/ml) of 2.5ml:135.88, Eye drop Brimonidine tartarate (0.15%) of 5ml:183.9, Eye drop Levobunolol (5mg/ml) of 5ml:32.38, Conclusion: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. Keywords: Glaucoma, Percentage cost variation, Cost ratio.

Cost variation analysis among different antidepressant drugs used to treat major depressive disorder

The Indian pharmaceutical industry produces drugs on a large scale and standing on 3rd rank bases on the scale of production. Due to this huge scale of production they produce all of the drugs and there are many brands of the same drugs. These brands are having competition between them so cost variation could be seen. Aim:The aim of our study is to find out the cost variation among the antidepressant drugs used in the treatment of major depressive disorder (MDD) that are the tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), the serotonin–norepinephrine reuptake inhibitors (SNRIs). Materials and Method:The anti-depressant drugs that are manufactured by various Indian pharmaceutical industries are analyzed in that study. The data was collected by the authors from “Current Index of Medical Specialties” (CIMS) online edition, www.drugs.com and Mobile Application of National Pharma Pricing. Results:There are 15 anti-depressant drugs with 63 formulations are available in the marked of India with 1173 brands. Among all the antidepressant drugs, the highest cost ratio and percentage cost variation was found for the fluvoxamine 100 mg followed by amitriptyline 50 mg Nortriptyline 20 mg and clomipramine 75 mg. The highest numbers of brands are for escitalopram 10 mg followed by Sertraline 50 mg and Paroxetine 37.5 mg. Conclusion:It is concluded that there is very high cost variation among the marked preparations of antidepressant drugs used to treat Major depressive disorder (MDD). Keywords: Major Depressive Disorder (MDD), Tricyclic antidepressants (TCAs), Selective serotonin reuptake inhibitors (SSRIs), Monoamine oxidase inhibitors (MAOIs), The serotonin–norepinephrine reuptake inhibitors (SNRIs), Cost ratio, Percentage cost variation

Analysis for price variations in fluoroquinolones eye preparations manufactured by various pharmaceutical companies

Introduction: Fluoroquinolone eye drops are prescribing by Ophthalmologist in many ocular diseases as conjunctivitis, keratitis, bacterial corneal ulcers etc in more and more amount. There are many brands of fluoroquinolones drugs available in Indian market. Costly drugs can lead to economic burden on patients. Modifications in pharmaceutical policy are required, and prices of the drug should be controlled in effective way for all the drugs. Hence this study was done to assess the cost variation of fluoroquinolones ophthalmic solutions available in Indian market. Materials and Method: 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. Result:Percentage variation in cost for fluoroquinolones eye preparations marketed in India was found to be Eye drop Ciprofloxacin (0.3%) of 5ml:210.39, Eye drop Ciprofloxacin (0.3%) of 10 ml:162, Eye drop Gatifloxacin (0.3%) of 5ml:156, Eye drop Moxifloxacin (0.5%) of 5ml:196.95, Eye drop Ofloxacin (0.3%) of 5ml:245.16,Eye drop Ofloxacin(0.3%) of 10ml:62.5,Eye drop Norfloxacin(0.3%) of 5ml:120.68, Eye drop Sparfloxacin (0.3%):8.31,Eye drop Lomefloxacin (0.3%):16.17 Conclusion:There is a wide difference in the cost of different brands of fluoroquinolones eye preparations available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy. Keywords: Fluoroquinolones, Percentage cost variation, Keratitis, Bacterial corneal ulcer, Conjunctivitis

Cost analysis study of antihypertensive agents available in India

Hypertension is a global public health problem. To decrease its morbidity and mortality it needs lifelong 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.The cost of different brands of commonly used antihypertensive 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.Thepercentage variation in the cost was above 100% with most of single drug therapy for hypertension and is 42 out of 69. It’s found maximum in Atenolol (12.5mg) 880%, Amlodipine (5mg) 460%, Nifidipine (30mg) 456.29% and Diltiazem (90mg) 407.02%. Among the combination therapy percentage variation in the cost was above 100% in 16 out of 26. It’s found maximum in Lisinopril+Hydrochlorothiazide (5mg+12.5mg) 926%, Telmisartan+Hydrochlorothiazide (40mg+12.5mg) 254.75%, Amlodipine+Losartan (5mg+50mg) 246.96% and Amlodipine+Enalapril (5mg+5mg) 217.20%.The average percentage price 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 analysis of rabies prophylaxis in India

Background: Rabies, a viral zoonotic disease is the 10th biggest cause of death due to infectious disease worldwide. This study was conducted to analyse the cost of post exposure prophylaxis and to compare the cost of post exposure prophylaxis with assumed cost of pre exposure prophylaxis.Methods: Current index of medical stores (CIMS), and online literature were used to review the prices of anti-rabies vaccine (ARV) in market. Cost for different categories was compared for 60kg person. Percentage cost variation was calculated to find the cost variation among ARV brands.Results: The cost of post exposure vaccination as per Essen regimen was approximately Rs.2000 and including immunoglobulin for category 3, added up to Rs. 22,894 for a 60 kg person. This was compared with cost of pre exposure prophylaxis which was found to be Rs. 1050-1200. It was found that PrEP was 20 times lesser than the cost of PEP.Conclusions: We infer that pre exposure prophylaxis is a cost effective strategy which can aid in the control and elimination of rabies in endemic countries. Health education activities should be intensified towards pre exposure vaccination among pet owners, in areas with high population of dogs and also in vulnerable group.

Impact of pharmaceutical price controls on the cost of cardiovascular drugs: does essentiality matter?

ABSTRACT Background With the goal of improving the affordability of medicines, governments across the globe have instituted various forms of price controls. Since 2013, India has been regulating the prices of drugs included in its national list of essential medicines (NLEM). Here we evaluate the cost variations among available cardiovascular drugs and perform cost-analysis comparing essential and non-essential drugs. Methods Data on listed prices of selected cardiovascular drugs – essential (NLEM) and non-essential (NNLEM) – were sourced from multiple drug information compendia. Price of medications was calculated in cost-per-defined-daily-dose (DDD)-units and NLEM vs. NNLEM drugs were compared. Regression analysis was used to explore the determinants of percentage cost variation (PCV) of drugs. Results The median-cost/DDD of essential medicines was lower as compared to non-essential ones for all therapeutic drug classes, with greatest difference observed for antianginals and least for heart failure medicines. There were substantial cost variations with values in excess of 1000% for six medicines, all being essential. The regression analysis failed to demonstrate a significant effect of essentiality on PCV (β = 0.19, P = 0.314). Conclusions Our analyses demonstrate considerable cost variations for some essential cardiovascular medicines. Given the need for prolonged and often, lifelong-treatment, there is significant potential for cost savings based on chosen brand, highlighting the need for patient as well as prescriber education.

Computer-aided synthesis of cost-effective perovskite crystals: an emerging alternative to silicon solar cells

One of the ways that scientists and engineers have come up to harness solar power is by inventing photovoltaics. Perovskite, which is one of the most promising materials for solar cell fabrication, has gained much attention in recent years due to its exceptional increase in performance. However, the most challenging issue that has been prevalent is the stability of perovskite solar cells. Perovskite crystal has a general formula of ABX3, where A and B are cations, and X is an anion. The Goldschmidt’s tolerance factor and the octahedral tolerance factor are the stability criteria that have to be satisfied by a crystal, for it to be considered a perovskite. Also, there are different combinations of site-A cations, site-B cations, and site-X anions that can give rise to a perovskite crystal. There is, therefore, the need to synthesize perovskite crystals which satisfy these tolerance factors to guarantee stability at a minimum bearable cost. In this paper, we present an optimization problem, where we formulate an objective function to determine site-A cation, site-B cation, and site-X anion that minimize the cost of perovskite crystal synthesis subject to the octahedral and Goldschmidt’s tolerance factors to assure stability. We further present three case studies based on this optimization approach. The results indicate that the optimal perovskite crystal structure is ammonium–magnesium–formate with a cost of 0.1784 ($/g), while the percentage variation in cost from the first-best combination to the second-best is 19.24%. Optimal selection of ions using computational tools for computer-aided synthesis of perovskite solar cells