Cost minimization analysis of generic and innovator formulations of antihypertensive drugs

Vishalkumar K. Vadgama; Vishal L. Gaekwad

doi:10.18203/2319-2003.ijbcp20195268

Authors

Vishalkumar K. Vadgama Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, India
Vishal L. Gaekwad Department of Pharmacology, Medical College, Baroda, Gujarat, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20195268

Keywords:

Cost minimization, Antihypertensive, Generic, Innovator, Hypertension

Abstract

Background: Hypertension, a chronic condition requiring lifelong care, affects approximately 25.3% Indian population. Average annual hypertension management cost which also includes medication cost varies from Rs. 4042 to 7621, amounting up to 40% of total household income of few families. Selection of a different brand or generic formulation may have an immense impact on total expenditure for treatment of hypertension. Present study aims at determining cost variability and cost analysis of various single drug antihypertensive formulations available in Indian market.

Methods: One most prescribed drug, each from Joint National Committee recommended antihypertensive- thiazide diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin-receptor blockers and β blockers were selected for cost analysis. Cheapest, costliest and median priced formulations were searched for individual drugs and were compared to the price of their generic counterparts.

Results: Generic formulations of hydrochlorothiazide, amlodipine, enalapril, losartan and atenolol were cheaper even than their respective cheapest innovator formulations. Costliest innovator formulation of amlodipine was 1750% expensive than generic one. Costliest counterparts of generic formulations were many folds overpriced. Similarly, innovator formulation of losartan was up to 953.89% costly than generic one. Innovator formulations of hydrochlorothiazide were the least costly than its generic counterpart, yet being at least 150% more expensive. Also, there exists considerable broad range of price among similar innovator formulations.

Conclusions: By prescribing generic antihypertensive drug, we can reduce treatment expenditure by many folds. Same feat can be marginally achieved by using lower cost innovator formulations.

Metrics

Metrics Loading ...

References

Hypertension. Available at: https://www.who.int/ news-room/fact-sheets/detail/hypertension. Accessed on 1 October 2019.

Oparil S, Zaman M, Calhoun D. Pathogenesis of Hypertension. Ann Intern Med. 2003;139:761-76.

Puar T, Mok Y, Debajyoti R, Khoo J, How C, Ng A. Secondary hypertension in adults. Singapore Med J. 2016;57:228–32.

Kearney P, Whelton M, Reynolds K, Muntner P, Whelton P, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–23.

Gupta R, Gaur K, Ram C. Emerging trends in hypertension epidemiology in India. J Hum Hypertens. 2019;33:575–87.

Gheorghe A, Griffiths U, Murphy A, Legido-Quigley H, Lamptey P, Perel P. The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review. BMC Public Health. 2018;18:975.

Thakare B, Adhav A, Kadam S. Economic burden of hypertension care on households of Malwani slum of Mumbai: a cross-sectional study. Int J Res Med Sci. 2015;6:2376–81.

Generic Drugs: Questions and Answers. Available at: http://www.fda.gov/drugs/questions-answers/generic-drugs-questions-answers. Accessed on 1 October 2019.

Baumgärtel C. Myths, questions, facts about generic drugs in the EU. Generics Biosimilars Initiative J. 2012;1:34–8.

CIMS Medica. In: 146th ed. Bengaluru: CIMS Medica India Pvt Ltd; 121–147.

IDR Triple I Compendium. Bengaluru: CIMS Medica India Pvt Ltd; 2018: 37–53.

James P, Oparil S, Carter B, Cushman W, Dennison-Himmelfarb C, Handler J, et al. Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.

Solanki K, Mistry R, Singh A, Jadav S, Patel N, Trivedi H. Drug utilization study of anti-hypertensive drugs and their adverse effects in patients of a tertiary care hospital. J Clin Exp Res. 2013;1:58-67.

Rachana P, Anuradha H, Shivamurthy M. Anti-hypertensive prescribing patterns and cost analysis for primary hypertension: a retrospective study. JCDR. 2014;8(9):19–22.

Gupta R, Yusuf S. Towards better hypertension management in India. Indian J Med Res. 2014;139:657–60.

Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011;26:155–9.