Cost analysis of different brands of antimicrobial agents available in India

Shakeel Ahmad Mir


Background: A major reason why patients go-off regimen is the cost of drugs. In the global market, the cost of drugs is highly variable. In India, there are more than five hundred pharmaceutical manufacturers and most of the drugs are available in brands. Infectious and parasitic diseases are among the major causes of death worldwide. The greatest burden of infectious disease is found in developing countries. Many of these people could be cured if they receive appropriate treatment such as antimicrobials. People usually purchase the amount of drug they can afford and not what they need for total cure. If a clinician prescribes a cheaper effective brand, it could result in reduction of drug cost as well as total health-care costs. Clinicians cannot be expected to know the exact cost of each drug available in the market, but it would be helpful if they had some impression of the cost variation between different effective brands of the same generic drug. The objective of this study was to analyse the cost (acquisition cost) variation in different brands of commonly used antimicrobials in India.

Methods: The minimum and the maximum cost in Rupees (INR) of a particular antimicrobial agent manufactured by various pharmaceutical companies in the same strength were noted. The cost of 10 tablets, 10 capsules or 1 injection was calculated. The cost ratio and Percentage cost variation were calculated for each brand.

Results: A great variation was found in the cost of different brands of same antibiotic. Percent cost variation of (2000) was found for Ciprofloxacin 500 mg tablet, followed by (1830) for Imipenem one Gram vial. The lowest percent cost variations found were: Tigecycline 50 mg vial (9), Teicoplanin 400 mg vial (25), Acyclovir 800 mg tab (32), Vancomycin 1 G vial (40), and Lomefloxacin 400 mg tablet (72).

Conclusions: Since there is a significant cost variation in different brands of same generic antimicrobial agent, clinicians need to consider drug cost while prescribing. If the clinician prescribes the cheapest of the effective brands available, it will help keep costs down and improve patient compliance.


Cost analysis, Antimicrobials, Compliance, Adherence, Branded Drugs, Pharmaceuticals

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Allan GM, Lexchin J, Wiebe N. Physician awareness of drug cost: A systematic review. PLoS Med. 2007;4(9):e283.

Gupta RK, Reddy PS. A calm look on cost analysis of different brands of anti-epileptic drug. J MGIMS. 2011;16(i):64-6.

OECD Health Division (2006) OECD Health Data 2006, October 06. Available: Accessed 3March 2007)

Management Sciences for Health (MSH). Evaluating the Cost of Pharmaceuticals. 2007. Available at Accessed 12.12.2015.

India in business. Ministry of External affairs, Govt. of India. Investment and Technology Promotion Division. Available at Accessed 12.12.2015.

Piette JD, Beard A, Rosland AM, McHorney CA. Beliefs that influence cost-related medication non-adherence among the “haves” and “have nots” with chronic diseases. Patient Prefer Adherence. 2011;5:389-96.

Kardas P, Bishai WR. Compliance in infective medicine. Adv Stud Med.2006;6(7C):S652-58

Drug Today. October-December. 2015;23(2):359-548.

Akila L, Rani RJ. Cost analysis of different brands of antianginal drugs available in India. Int J Basic Clin Pharmacol. 2015;4:860-3.

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487-97.

SCOPE: Pharmacist's Guide to Judicious Usage of Antibiotics. Accessed 12.12.2015.

Planning Commission Govt. of India 2014. Report of the expert group to review the methodology for measurement of poverty. Available at Accessed 12.12.2015.

Andayani T M, Imaningsih I. Cost analysis of antidiabetic drugs for diabetes mellitus out patient in Kodya Yogyakarta hospital. Malay J pharm Sci. 2007;5(1):19-23.

Lal A, Sharma ML. A calm look at the cost of drugs in psychiatric practice. Indian J. PsychiaL 1992;34(1):18-20

World Health organization (WHO). Report of the Workshop on Differential Pricing & Financing of Essential Drugs. Available at Accessed 12.12.2015.

Uppsala universitet. Economical access to antibiotics in an era of increasing resistance - a study from Lahore, Pakistan(CR). Available at Accessed 12.12.2015.