Wide Variation In Prices Research Articles

Assessing the true cost of cancer screening: Comparing hospital prices to claims remittance data for common cancer screening tests at top-ranked US hospitals.

11055 Background: Patients in the United States often lack information about the price of common cancer screening services across hospitals and payers. Recent legislation in the US, including the 2021 Hospital Price Transparency Final Rule and the No Surprises Act of 2022, require hospitals to post payer-specific negotiated prices for all services, creating a unique opportunity to understand variation in hospital pricing. While there has been much study regarding the wide variations in prices for healthcare screening services, little is known about the relationship between the prices for screening made publicly available by hospitals and the actual claims remittance recorded for those same services. Methods: We extracted payer-specific prices for four common cancer screening tests among 20 top-ranked US hospitals: colonoscopy, low-dose helical computed tomography (CT) scan, mammography, and prostate-specific antigen (PSA). Additionally, we extracted the cash prices published by these same hospitals and determined the median cash price for each screening service. To evaluate price variation for these screening tests, we determined the median and inter-quartile range (IQR) across all payers for these 20 hospitals. We compared this hospital pricing data to the 835 claims remittance data from December 1, 2021 to January 15, 2022. Results: Across 20 top US hospitals, the median hospital price for colonoscopy was $1597 (IQR $1780) and median claims price was $806 (IQR $788). The median hospital price for low-dose CT was $315 (IQR $472) and median claims price was $126 (IQR $83). The median hospital price for mammogram was $300 (IQR $351) and median claims price was $72 (IQR $83). The median hospital price for PSA was $85 (IQR $113) and median claims price was $29 (IQR $10). For all four screening tests, the median cash price was greater than the median negotiated price by an average of 27%. Conclusions: For common cancer screening tests, the distribution of hospital prices is wider than the actual prices reflected in claims data for the same screening services. Median cash prices published by hospitals were greater than the median negotiated rates for all cancer screening services, consistent with trends observed among large academic centers in metropolitan areas. Policies that improve precision in price estimates may help improve adherence in the United States for uninsured patients by providing more accurate information about prices for common cancer screening services. [Table: see text]

Most Major Hospitals Fail to Comply With Federal Price Transparency Regulations

PurposeThis study aims to present hospital compliance with federal price transparency regulations for sports medicine procedures. MethodsOnline price estimator and machine-readable files were recovered for U.S. News and World Report’s (USNWR) top 100 orthopedic hospitals. From June to November 2023, compliance and monetary values were recorded for each of Centers for Medicare and Medicaid Services (CMS) price transparency regulations. Price estimator data was assessed based on hospital placement in the bottom and top 50 of the 100 institutions under review, as well as by region (Northeast, South, Midwest, West). Statistical analyses included two-sample t-tests and Kruskal Wallis tests. Results95% of hospitals had a price estimator tool for both subacromial decompression (Current Procedural Terminology (CPT): 29826) and meniscectomy (CPT: 29881). Only 38% were compliant with all regulations for subacromial decompression and 39% for meniscectomy; the remaining did not list minimum or maximum procedure charges. Higher ranked hospitals were significantly more likely to charge a higher cash price for subacromial decompression and meniscectomy (p = 0.040 and p = 0.009 respectively). Compliance with machine-readable file reporting was poor with less than 20% meeting requirements for each CPT code. Reported prices varied greatly by hospital. ConclusionsThis study demonstrates that USNWR top 100 orthopedic hospitals exhibit poor overall compliance with federal price transparency regulations for sports medicine procedures. Most often they lack full compliance by not reporting minimum or maximum charges as part of their price estimator tool or do not report procedure prices in their machine-readable files. Hospitals also exhibit wide variation in prices reported for specific procedures. Clinical RelevanceConsumer price transparency continues to be an important goal in healthcare as it allows patients to make informed decisions when selecting appropriate treatment options and providers. To realize the full benefits of price transparency hospitals should address areas of improvement.

A STUDY OF COST VARIATION ANALYSIS OF ORAL HYPOGLYCEMIC DRUGS AVAILABLE IN INDIAN PHARMACEUTICAL MARKET

Objectives: A large number of oral hypoglycemic drugs as single or fixed dose combinations are available for the treatment of diabetes mellitus which has a wide range of price variation and becomes a constraint in the treatment for both physician and patient. However, very few studies have been done to reveal such price variations. The objective of this study was to find out the cost variation among the different brands of various classes of oral hypoglycemic drugs in similar strength and dosage forms of single therapy and fixed-dose combinations. Methods: Cost of a particular drug being manufactured by different companies in the same strength, number, and dosage form was compared from the Current Index of Medical Specialties (CIMS) (January 2022–April 2022) and Indian Drug review 2022. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and the percentage variation in price was calculated. Results: Among single drug therapy, Glimepiride (1 mg) shows a maximum percentage variation in price of 3450%. Among Sulfonylureas-glimepiride (1 mg) shows a maximum price variation of 3450%, in Biguanides–metformin (500 mg), in Thiazolidinediones – Pioglitazone (15 mg) shows a maximum price variation of 900%, and 300%, respectively, and among the glucosidase inhibitors, Voglibose (0.3 mg) shows maximum price variation of 571.2%. Among combination formulation, glimepiride (1 mg) + metformin SR (500 mg) shows a maximum percentage of price variation of 262.1%. Conclusion: It is observed from our results that there is a wide variation in prices of drugs manufactured by different pharmaceutical companies. Hence, it is very necessary for regulatory authorities to regulate the wide variation in drug prices to maximize the benefits of the treatment. It is recommended that the appraisal and management of marketing drugs should be well-regulated.

Pharmacoecomonic study of oral antidiabetic drugs available in Indian pharmaceutical market

Background: Diabetes mellitus is a metabolic disorder requiring lifelong medication which further adds to comorbidity. Cost of the drug pays an important role in adherence and compliance to the treatment. There is a wide variation in prices of oral hypoglycemic drugs available in Indian pharmaceutical market. Aims and objectives of the study was planned to evaluate cost of oral antidiabetic drugs of various brands currently available in Indian market either as single drug or in combination. Methods: Cost of antidiabetic medications manufactured by various pharmaceutical companies in the same strength and dosage form was obtained from the price list provided by various pharmaceutical companies in current index of medical specialties December 2022-March2023. The cost ratio and percentage price variation for each formulation was calculated and analyzed. Results: Among single antidiabetic drugs, Tab. Metformin 500 mg shows highest percentage price variation (809%) and highest cost ratio (9.09). Among fixed dose combinations, Tab. Glibenclamide 5 mg + Tab. Metformin 500 mg shows highest percentage price variation 300.8% and highest cost ratio 4. Conclusions: Our study shows that there is high price variation for oral anti diabetics. It is important to bring awareness about wide variation in prices so that drug cost can be reduced and made affordable to common man which plays major role in compliance of patient.

Cost analysis of oral hypoglycemic agents available in Indian pharmaceutical market

Background: Diabetes mellitus is “A metabolic disorder requiring lifelong medication which further adds to. Cost of the drug pays an important role in adherence and compliance to the treatment. There is a wide variation in prices of oral hypoglycemic drugs available in Indian pharmaceutical market. Aims and Objectives: The study was planned to evaluate cost of oral antidiabetic drugs of various brands currently available in Indian market either as single drug or in combination. Materials and Methods: Cost of antidiabetic medications manufactured by various pharmaceutical companies in the same strength and dosage form was obtained from the price list provided by various pharmaceutical companies in current index of medical specialties April–July 2022. The cost ratio and percentage price variation for each formulation was calculated and analyzed. Results: The highest percentage price variation is seen with Tab. Metformin 809% and lowest with Tab. Glibenclamide 5 mg 46.8% while the highest cost ratio is seen with Tab. Metformin 9.09 and and lowest cost ratio Tab. Glibenclamide 5 mg 1.46. Other oral anti diabetic drugs with percentage price variation and cost ratio are Tab. Gliclazide 30 mg–346.7% and 4.46, Tab. Pioglitazone 15 mg 299% and 3.99, Tab. Voglibose 0.2 mg 352% and 4.52. Conclusion: Our study shows that there is high price variation for oral anti diabetics. It is important to bring awareness about wide variation in prices so that drug cost can be reduced and made affordable to common man which plays major role in compliance of patient.

Pharmaceutical Care in Phytotherapy: quality of Passiflora spp. products purchased from pharmacies in São Luís, Maranhão, Brazil

The use of plants and their products as a therapeutic resource is expanding, reflecting the tendency to use natural products of plant origin in the recovery of health, a worrying situation, considering the risks associated with the use of poor-quality products for medicinal purposes. Thus, this study proposes to evaluate the quality samples of leaves of Passiflora spp., used for medicinal use by the Maranhão population, sold in São Luís, Maranhão, Brazil. Samples acquired in five pharmaceutical establishments were submitted to quality assessment using marketing parameters, authenticity, integrity, and purity. Most samples do not meet legal labeling parameters and there is wide price variation. All samples are within the limits of the specialized literature regarding water content, foam content, and total ash. In the quantification of flavonoids, two samples presented values lower than that required by the official monograph. The results show the need for greater supervision, surveillance, and quality control of medicinal plant material made available for commercialization.

Payer-Negotiated Prices for Cancer Services Across National Cancer Institute-Designated Cancer Centers

INTRODUCTION: To promote price transparency and encourage insurer competition, recently implemented federal regulations require hospitals to publish payer-specific negotiated prices for all services. We sought to understand availability of payer-negotiated prices as well as how they vary within and across centers performing cancer operation. METHODS: We reviewed National Cancer Institute (NCI)-Designated Cancer Center (n = 64) websites to extract payer-negotiated prices and discounted cash prices for 131 services related to diagnosis and management of melanoma, colon, lung, pancreas, prostate, and rectal cancer. For each condition, we compared the highest and lowest payer-negotiated price within each center. We also compared centers with the highest median and lowest median payer-negotiated price for each condition. RESULTS: Of the 64 NCI-designated Cancer Centers, 34 (53.1%) had publicly available price data. Among these, there was wide variation in prices within and across centers and services. For example, median price for a pneumonectomy at 1 center demonstrated little variability ($7,423 to $9,000, median ratio 1.21) while another center for superficial axillary lymph node dissection demonstrated wide variation ($377 to $18,427, median ratio 31.7). Price variation also differed widely across different conditions with transanal excision demonstrating limited variability in median price across centers ($2,500.02 to $4,969.00, median ratio 1.99), while MLH1 gene analysis demonstrated wide variability in median price across centers ($2.80 to $2,631, median ratio 939.8) (Figure).FigureCONCLUSION: Adherence to federal regulations mandating hospital price transparency continues to be low. Significant variation in payer-negotiated prices exists both within and across hospitals for services related to diagnosis and treatment of the most common cancers.

A study on cost analysis of oral antihypertensive drugs available in India

The major health care problem in developing world is shifting from communicable diseases to non-communicable disease which causes morbidities more than mortality affecting the personal efficiency. Hypertension is a major health care burden in developing countries like India causing both morbidity and mortality. Few studies shows that the hypertension prevalence has raised from 2% to 15% in rural population and 2% to 25% in urban population in last six decades in India. This research work aims to enumerate the price of commonly available oral antihypertensive drugs in India. It also aims to study the cost variation of oral antihypertensive drugs. The present study was carried out in the department of Pharmacology in a tertiary care medical college in south India. The cost analysis of individual drugs by different manufacturers were done. Percentage of cost variation was analysed. The variation in cost of most of the antihypertensive drugs is more than 100%. It’s found maximum in Amlodipine (5mg) with cost variation of 625%, Atenolol 100 mg with cost variation of 413%. In India there is a wide price variation among antihypertensive drugs. The major gap in the cost variation of antihypertensive drugs to be narrowed for the benefit of the patients. So the government and the prescribing doctors should think about the huge difference in cost and work in the direction of benefitting the patient.

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.

Abstract 8935: A Study of CMS-Mandated Online Tools for Comparing the Prices of Outpatient Cardiovascular Diagnostic Studies

Objectives: To assess the tools the US Centers for Medicare & Medicaid Services (CMS) price transparency mandate provides to patients to compare prices of cardiovascular (CV) diagnostic studies in US hospitals. Background: In January 2019, CMS mandated that hospitals make prices of CV diagnostic and treatment services available to patients to enable cost comparison. These prices are published in price lists called hospital chargemasters. Methods: We searched hospital chargemasters for the top 20 hospitals listed on the 2020-21 US News Best Hospitals Honor Roll. We collected published price data for six common CV diagnostic studies. Endpoints included listed prices, the format and uniformity of price listings, and accompanying disclaimers or guides for use. Results: Of the 20 studied hospitals, 19 (95%) published a chargemaster on their website, of which 16 were in Microsoft Excel format (84%) and 3 included standardized CPT codes (16%). Disclaimers that prices may not reflect real billing were included with 17 (85%). From available hospital chargemasters (n=19), the following price data were collected. Conclusions: The hospital chargemasters available to compare pricing of CV diagnostic studies show wide variation in price and scope, differ by format, and include technical terms and initialisms. Most include disclaimers that prices may not reflect actual out-of-pocket or insurance billing. These findings suggest that these CMS-mandated price transparency tools may be inadequate for patients to estimate or compare prices for CV diagnostic studies.

Price differentials of tobacco products: A cross-sectional analysis of 79 countries from the six WHO regions.

INTRODUCTIONIncreased taxation is one of the most effective tobacco control measures. Price differentials across tobacco product types may undermine the effectiveness of taxation policies by providing the option to switch to cheaper products rather than to quit. The aim of this study was to use commercial data to compare prices and price differentials of both cigarette and non-cigarette products across countries from all geographical regions.METHODSWe analyzed 6920 price data points (i.e. product brands) from Euromonitor Passport 2016 for 12 types of tobacco products across 79 countries from the six WHO regions: Africa (n=5), Eastern Mediterranean (n=6), Europe (n=39), the Americas (n=15), South-East Asia (n=3), and Western Pacific (n=12). For each product and country, a price differential was computed as the percentage of minimum price to the median.RESULTSMedian cigarette prices (US$) were highest in Western Pacific countries (4.00; range: 0.80–16.20) and European countries (3.80; range: 0.80–14.00), but lowest in African countries (2.00; range: 0.80–2.20). The medians of cigarette price differentials were largest in the Eastern Mediterranean (48.33%) and African regions (50.00%), but smallest in Europe (82.35%). Pipe tobacco and fine-cut tobacco were generally less expensive than cigarettes while cigars were the most expensive. However, there were wide variations in prices and price differentials across regions and tobacco products.CONCLUSIONSWe found substantial variations in prices and price differentials between countries and world regions across tobacco products, likely reflecting differences in taxation policies and structures. Findings identify types of tobacco products in specific geographical regions where price differentials are highest, thereby highlighting areas where taxation policies need improvement, for example through implementing specific excise taxes.

Socioeconomics of coronary artery calcium: Is it scored or ignored?

ImportanceChicago is one of the most racially segregated cities in the US, with the largest mortality gap between neighborhoods. Computed tomographic coronary artery calcium scoring (CACS) is an excellent risk stratification tool, but costs about $200 out-of-pocket, making it inaccessible to some. ObjectiveTo determine whether this ACC/AHA guideline-recommended screening tool is accessible to all populations and neighborhoods, we evaluated the price and availability of CACS in Chicago area hospitals. DesignWe used the Illinois Department of Public Health list of area hospitals to inquire about CACS availability and price. We compared these results to US Census Bureau data for each hospital's service area's demographic, ethnic and socioeconomic population characteristics. ResultsOut of the 40 hospitals in Chicagoland, 30 offered CACS. The 10 hospitals without CACS were smaller hospitals in zip codes with a higher population density (p ​< ​0.01), higher poverty rates (22% vs. 13%, p ​< ​0.01), lower percentage of white population (p ​< ​0.02), lower frequency of higher education (35% vs. 51%, p ​< ​0.05), and a trend toward more black residents (p ​< ​0.10). Life expectancy was greater in areas with CACS available (78 vs. 75 years, p ​< ​0.05).Even in areas with CACS, there was wide price variation, with higher prices in poorer areas (r ​= ​0.57, p ​< ​0.01). The highest vs. lowest quintile of income had higher education, larger white population (80% vs. 14%, p ​< ​0.0001), and longer life expectancy (81 vs. 72 years, p ​< ​0.0002), but tended to have a lower price of CACS ($86 vs. $487, p ​< ​0.08). Conclusions and relevanceCACS is a powerful, evidenced-based clinical tool, but the availability and price vary widely in Chicagoland, and directly correlate with the socioeconomic and health care disparities that are known to exist. Removing these barriers to coronary artery disease screening may be one method to improve the poor cardiovascular outcomes in these areas.

Analysis of Hospital Quality Measures and Web-Based Chargemasters, 2019: Cross-sectional Study.

BackgroundThe federal health care price transparency regulation from 2019 is aimed at bending the health care cost curve by increasing the availability of hospital pricing information for the public.ObjectiveThis study aims to examine the associations between publicly reported diagnosis-related group chargemaster prices on the internet and quality measures, process indicators, and patient-reported experience measures.MethodsIn this cross-sectional study, we collected and analyzed a random 5.02% (212/4221) stratified sample of US hospital prices in 2019 using descriptive statistics and multivariate analysis.ResultsWe found extreme price variation in shoppable services and significantly greater price variation for medical versus surgical services (P=.006). In addition, we found that quality indicators were positively associated with standard charges, such as mortality (β=.929; P<.001) and readmissions (β=.514; P<.001). Other quality indicators, such as the effectiveness of care (β=−.919; P<.001), efficient use of medical imaging (β=−.458; P=.001), and patient recommendation scores (β=−.414; P<.001), were negatively associated with standard charges.ConclusionsWe found that hospital chargemasters display wide variations in prices for medical services and procedures and match variations in quality measures. Further work is required to investigate 100% of US hospital prices posted publicly on the internet and their relationship with quality measures.

DEMAND, SUPPLY AND REASONS FOR PRICE HIKE OF POTATO IN BANGLADESH

The objective of the study is to find out the factors behind the supply, demand and thereby prices of potato and explore the existence of syndicate in the market. The study is mainly based on secondary data. Additionally, some qualitative data were collected through FGD and KII from Bogura, Rangpur and Munshiganj areas. The area, production and yield of potato grew by 4.58%, 6.61% and 1.95%, respectively per annum since independence. The production of HYV potato rose sharply, while local one rose at a slower pace. Potato production exhibits high fluctuation with roughly three years’ cycle, which sharply decreased in the recent past. The nominal prices of potato witnessed upward trend, while real prices experienced downward trend since independence. There exists wide seasonal price variation of potato with the lowest price in March and the highest in December. Potato market seemingly integrated as prices at all levels move together. The rising trend of potato prices seems to be halted after re-fixing prices by DAM. Real prices displayed wide price variation as volatility index stands at 73.16%. The total surplus of potatoes in 2020 stands at 3.40 lakh MT which is much lower than the previous years. The profit earned by the potato growers was estimated at around Tk. 1.1 million /ha. The estimated DRC implies that Bangladesh had comparative advantage in potato production for export promotion. In 2020, 73% capacity of 392 cold storages in operation is utilized. It is concluded that main cause of the price hike was the artificial crisis created by some profit seeking traders rather than the low production and higher consumption of potato in the country. Fixation of price, regular market monitoring and taking legal action to the artificial crisis creators may be the way of avoiding unexpected price hike of potato in the country.

Availability of prices for shoppable services on hospital internet sites.

A regulation from CMS required that, starting January 1, 2021, all US hospitals publicly display the cash price and minimum and minimum negotiated charge for 300 "shoppable services." We evaluated compliance with CMS requirements among highly respected US hospitals. We conducted a cross-sectional study of hospital websites. We evaluated the public websites of the 20 hospitals listed in the 2020-2021 US News & World Report honor roll between February 1 and February 14, 2021. We selected 2 imaging studies (brain MRI and abdominal ultrasound) and 3 hospital services (cardiac valve surgery, total joint replacement, and vaginal childbirth). For each service and hospital, we determined whether the discounted cash price and minimum negotiated charge were displayed and, if displayed, what the prices were. Among our 20 hospitals, 13 (65%) displayed the cash prices for the MRI and ultrasound, 8 (40%) for valve surgery, 10 (50%) for joint replacement, and 10 (50%) for childbirth. Only 1 (5%) displayed the minimum negotiated price for the 2 imaging studies and none for any of the hospital services. The mean (range) cash price for MRI was $3793 ($464-$6215) and for ultrasound was $767 ($136-$1391). The mean (range) cash price for cardiac surgery was $236,125 ($72,250-$349,782); for joint replacement, $46,008 ($22,170-$71,985); and for childbirth, $19,568 ($7314-$29,068). In an early assessment, a significant percentage of US hospitals were not in compliance with new price transparency legislation. Moreover, there is wide variation in prices among hospitals for identical services. These price differences suggest the potential for significant cost savings for patients.

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.

A cost variation analysis of various brands of oral anti-diabetic drugs currently available in Indian pharmaceutical market

Background: Diabetes mellitus is a metabolic disorder requiring lifelong treatment. There are a large number of anti-diabetic drugs available in the Indian market. The cost of drugs plays an important role in patient’s care, warranting the need for all physicians to keep themselves updated with the latest prices and price variation of various brands of anti-diabetic drugs. The objective of this study is to evaluate the cost of oral anti-diabetic drugs of different brands currently available in the Indian market.Methods: Cost of oral anti-diabetic drugs manufactured by different pharmaceutical companies in the same strength and dosage forms was obtained. The percentage price variation and cost ratio for each formulation was calculated.Results: In sulfonylurea group of drugs, maximum price variation was seen in glimepiride 1mg 1366% and minimum was seen in glipizide 2.5 mg 17%. In non-sulfonylurea group of drugs, a maximum variation was seen in metformin 500 mg 809% and a minimum variation was seen in acarbose 100 mg 10%. Among the fixed dose combination therapy, glimepiride 2 mg and metformin 500 mg showed the highest price variation 555% and pioglitazone 7.5 mg and metformin 500 mg showed the least price variation 8%.Conclusions: Our study showed that there is a very high price variation for oral anti-diabetic drugs by different brands. Since diabetes mellitus is a chronic illness, cost of the drug plays an important role in compliance to the treatment regimen. It is necessary to bring awareness regarding this wide variation in prices, such that the drug costs can be reduced and made more affordable to the common man.

ORAL ANTIDIABETICS AGENTS AVAILABLE IN INDIAN PHARMACEUTICAL MARKET: A PRICE VARIATION ANALYSIS

Objective: There are hundreds of brands in Indian markets for a single drug which is manufactured by various companies and thus leads to wide variation in prices for the same drug. Hence, we decide to evaluate the variation in price of different brands of the same drug available in Indian market.&#x0D; Methods: An analysis was done for comparing price variations among various drugs prescribed in diabetes mellitus. Indian Drug Review (IDR) (2019 Volume XXV Issue 4) and Current Index of Medical Specialties (CIMS) (July 2019–October 2019) were referred to know the maximum and minimum price in INR of drugs in all available strength and dosage forms being manufactured by different companies in India and percentage price variation was calculated.&#x0D; Results: Wide variation in the price of several brands of oral antidiabetics is found in Indian market. In single drug, highest price variation is found for glimepiride 1 mg tablet (1365.5%). In fixed-dose combinations (FDCs), highest price variation is found for glimepiride + metformin (2 mg + 500 mg) sustain release tablet (689.2%). Lowest price variation for FDCs was found for glimepiride + metformin (3 mg + 500 mg) tablet (4.8%). Furthermore, only few oral antidiabetic agents were included in the drug pricing control order 2013. Wide variation is seen in prices of brand and generic medicines.&#x0D; Conclusion: All the stakeholders should collectively make efforts to reduce price variation among the various brands so as to make them affordable and aim to improve the health status of the community.

Analysis of price variation of some commonly used antibacterial agents

Background: Antimicrobial resistance is a serious problem. Resistance may develop due to irrational use including poor patient compliance due to prescription of expensive drugs. In present study, the variation in the price of commonly used antibacterial was analysed.Methods: The price of commonly used antibacterial agents listed in recent issues of CIMS and MIMS was analysed in respect of number of brands available, price range (10 tablets or capsules) and 1 ampoule or vial (parenteral preparation) i.e. minimum, maximum and average price and price ratio (maximum/minimum). FDCs and formulation with only 1-2 brands were excluded.Results: The number of brands of oral antibacterial agents varied from 3 (faropenem 200 mg) to 90 (azithromycin 500 mg). The maximum price variation amongst different brands was 21.64 for levofloxacin 500 mg followed by 14.28 and 11.26 for linezolid 600 mg and moxifloxacin 400 mg respectively. For parenteral preparations, the number of brands varied from 2 (gentamicin 80 mg) to 57 (ceftriaxone 1 g). The maximum price variation was 5.05 for meropenem 1 g followed by 3.69 and 2.63 for meropenem 500 mg and ceftriaxone 1 g respectively.Conclusions: A very wide price variation was observed amongst different brands of both oral and parenteral formulations of antibacterial agents. Prescribing expensive brands may lead to resistance due to poor patient compliance.

Private Practice Pricing in the Birmingham Region.

This study was carried out to evaluate the difference in prices for dental treatments carried out privately in general dental practice within the Birmingham area. Ten different practices were chosen at random, which were spread across Birmingham, in order to get a better insight into the differences across the districts. Their prices for pre-determined dental procedures were procured off the practices' respective websites or through telephoning. The findings of this study have shown a wide variation in prices for each dental procedure, with the greatest variation in prices between practices being ?850 for dental implants. The procedures with the lowest average cost were fissure sealants at ?23.14. The procedure with the highest average cost was dental implants at ?2,261.11. This study also showed that as more dental treatment was required, the mean cost for the dental intervention increased, regardless of the tooth being treated.