A calm look at the cost of various brands of antiasthmatic drugs available in India
Keywords:Cost analysis, Antiasthmatic, Compliance, Adherence, Branded drugs, Asthma, Health economics
Background: Asthma is an inflammatory disorder of lungs that affects people of all ages and is a significant source of morbidity and mortality worldwide. Approximately 300 million people in the world currently have asthma and there has been a concerning increases in the prevalence of this condition in recent decades. The asthma epidemic experienced by high-income countries over the past 30 years is now an increasing problem in low- and middle-income countries. Because asthma is a chronic condition, it requires continuous medical care. Failure to use appropriate drugs and comply with treatment can lead to unnecessary deaths. Higher and unaffordable drug prices are among the major reasons for non-compliance and resultant treatment failure. In the global market, the cost of drugs is highly variable. The cost of drugs plays a crucial role in patient’s care especially in developing countries. It has been observed that there is a gross variation in the cost of different brands of same generic drug. If doctors are not aware that large differences can exist in the price of medications used for the same indication, they may prescribe costly brands, which ultimately lead to non-adherence. The present study was planned to get some idea about cost differences in various brands of antiasthmatic drugs.
Methods: The minimum and the maximum cost in Rupees (INR) of a particular antiasthmatic agent manufactured by various pharmaceutical companies in the same strength were noted. The cost ratio and percentage cost variation were noted for each brand.
Results: This study shows that there is a noticeable variation in the prices of different brands of same antiasthmatic drug in Indian market. The highest percent cost variation (663) was found for Deflazacort 6mg tablet, followed (404) for Doxophylline 400 mg tab. Other significant percent cost variations were for: Theophylline 600 mg tab (353), Combination of Formoterol and Budesonide (122), Budesonide (103), Monteleukast 10 mg tab (93) and Deflazacort 1mg (88).The lowest percent cost variations found were for: Monteleukast 4mg tab (10), Ipratropium bromide (14) and Monteleukast 5mg tab (20).
Conclusions: Since there is a significant cost variation in different brands of the same generic antiasthmatic drug, a conscientious doctor should always choose cheapest effective brand while prescribing. Asthma being a chronic illness requiring prolonged treatment, even a small cost variation can have significant economical implications.
Global Initiative for Asthma (GINA): Pocket guide for asthma management and prevention. Available at http://www.ginasthma.org/local/uploads/files/GINA_Pocket_2015.pdf. Accessed on 16.12.2015.
World Health Organization. Fact sheet (N0206): Bronchial asthma. Available at http://www.who.int/mediacentre/factsheets/fs206/en/Accessed on 16.12.2015.
Bahadori K, Doyle-Waters MM, Marra C, Lynd L, Alasaly K, Swiston J. Economic burden of asthma: a systematic review. BMC Pulm Med. 2009;19;9:24.
Global Asthma Network: The Global Asthma Report 2014.http://www.globalasthmareport.org/resources/Global_Asthma_Report_2014.pdf. Accessed on 16.12.2015.
World Health Organization. Trade, foreign policy, diplomacy and health: Access to medicine. Available at http://www.who.int/trade/glossary/story002/en/ Accessed on 16.12.2015.
Gupta RK, Reddy PS. A calm look on cost analysis of different brands of anti-epileptic drug. J MGIMS. 2011;16(i):64-6.
Bhushan B, Gaude G. Study to assess factors contributing to compliance of aerosol therapy in bronchial asthma. Internet J Pulm Med. 2009;12(1):1-6.
Kardas P, Bishai WR. Compliance in infective medicine. Adv Stud Med. 2006;6(7C):S652-8.
World Health Organization: Workshop on differential pricing and financing of Essential Drugs. https://www.wto.org/english/tratop_e/trips_e/hosbjor_presentations_e/35balasubramaniam_e.doc Accessed on 16.12.2015.
Drug Today. October-December. 2015;23(2):867-89.
CIMS. 2015(update 3):130-60.
Drug Brands: available at http://drugbrands.in/index.php?/. Accessed on 16.12.2015.
Akila L, Rani RJ. Cost analysis of different brands of antianginal drugs available in India. Int J Basic Clin Pharmacol. 2015;4:860-3.
Planning Commission Govt. of India 2014. Report of the expert group to review the methodology for measurement of poverty. Available at http://planningcommission.nic.in/reports/genrep/pov_rep0707.pdf. Accessed 12.12.2015.
Uppsala universitet. Economical access to antibiotics in an era of increasing resistance - a study from Lahore, Pakistan (CR). Available at http://www.farmfak.uu.se/farm/exjob/diplomawork/VT10BinaAzhar.pdf. 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.
Management Sciences for Health (MSH). Evaluating the cost of pharmaceuticals. 2007. Available at http://www.who.int/medicines/technical_briefing/tbs/06-TG_Evaluating-drug-costs_final-08.pdf. Accessed 12.12.2015.
SCOPE: Pharmacist's Guide to Judicious Usage of Antibiotics.https://cme.dannemiller.com/scope/articles/activity?id=428&p=12. Accessed 12.12.2015.
PR Newswire: Higher Out-of-Pocket Costs Cause Massive Non-Compliance in the Use of Prescription Drugs, and This Is Likely to Grow. Available at http://goo.gl/2ClISI. Accessed 16.12.2015.
Andayani TM, 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.
Allan GM, Lexchin J, Wiebe N. Physician awareness of drug cost: A systematic review. PLoS Med. 2007;4(9):e283.