Prescription-based cost analysis of medicines for cardiovascular risk factors at Indian Council of Medical Research-Rational Use of Medicine Centre Hospitals of India.

OBJECTIVES: India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs. MATERIALS AND METHODS: Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range). RESULTS: Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593-3104) and for non-NLEM was INR 5343 (2964-14364). It was INR 806 (243-2132) for generic and INR 3809 (1968-14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5-22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins (P < 0.0001). CONCLUSION: The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines.

A cost analysis and availability scenario of drugs and oral care products prescribed for common oral conditions with reference to the current Indian market prices, Jan Aushadhi, and the state medical commissions.

Context: The prevalence of oral mucosal lesions across various countries varies from 4.9% to 64.7%. The cost barrier is an important factor that prevents people in low-middle income countries from seeking professional help for dental problems. Aims: The present study aims to analyze the costs of medicines and oral care products prescribed for common oral lesions and to find the most expensive and the most economic brands. Methods and Material: The list of medicines and oral care products prescribed for the management of four oral conditions namely, recurrent aphthous stomatitis, oral candidiasis, oral herpes, and gingivitis were taken and their median retail prices, cost variation percentages were calculated from the current Indian market brands. The median retail prices were compared with their corresponding Jan Aushadhi prices. Also, the availability of the drugs and oral care products were evaluated across the state drug procurement lists of Tamil Nadu, Rajasthan, Uttar Pradesh, Telangana, and Bihar. Results: Wide cost variations were seen in most of the drugs and oral care products. The Jan Aushadhi prices of included drugs were very economical compared to the median market prices. However, the availability of the drugs was less in the Jan Aushadhi list and also in the state medical commission lists. Conclusions: The availability of such commonly used drugs in oral conditions has to be ensured in state and central departments by the policy makers. Price regulations of drugs routinely prescribed by dentists will help reduce the overall treatment costs for dental care.

Wide Cost Variations Observed in Antibiotics and Analgesics Prescribed for Dental Care in India: A Price and Affordability Analysis.

Introduction With high prevalence rates across the population, dental pain is the most common symptom that drives a patient to visit the dentist. Dentists prescribe analgesics and antibiotic prophylaxis apart from routine dental treatments. The increasing costs of medications are a major factor that adds to the financial burden of patients seeking oral care. Methods A list of antibiotics and analgesics recommended by the American Dental Association for dental pain, swelling, and post-procedural pain management was analyzed for the cost variation and cost ratio. The affordability was calculated by the World Health Organization/Health Action International (WHO-HAI) methodology. The most expensive and the least expensive brands of all drug regimens were compared. Results Wide cost variations were observed between the different brands of antibiotics and analgesics. The highest cost variation was found in ampicillin 500 mg injection (13579.2%). In the affordability analysis; when the most expensive brands were analyzed, the lowest-paid unskilled worker had to lose 2.1 days of wages to afford the drug regimen. The price range was widest for injection ampicillin 500 mg (Rs. 4.24-580.0) and lowest for tablet ibuprofen 400 mg (Rs. 0.7-1.6).  Conclusion Dental surgeons need to be well aware of the pharmacoeconomics behind medications that directly decides the affordability of treatments. Careful selection of drugs by the dentists considering their quality, availability, and costs is of pivotal importance. Prescribing generic medications and increasing the availability of drugs in public health sectors can help provide cost-effective dental care for all.