DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20200717

A cost variation analysis study of various bisphosphonates preparations available in the Indian market

Sushma V. Naidu, Vibha Rani

Abstract


Background: Osteoporosis is a chronic disease leading to weakened and porous bones which increases the risk of fractures. It is a treatable condition using drugs like bisphosphonates. There is wide variation in the cost among various brands of bisphosphonates in the Indian market, so the objective of the study was to analyse cost of different brands of bisphosphonates.

Methods: Cost of both oral and injectable bisphosphonates in the same strength and dosage forms was obtained from CIMS India (January-April 2019). For oral form of the drug, price was calculated per 10 tablets, for injectable form the price per ampoule or vial was calculated and cost ratio, percentage of cost variation was calculated.

Results: 15 different formulations of bisphosphonates were analyzed and it was found that cost ratio is found to be highest with 60 mg of pamidronate injection and lowest with 10 mg alendronate tablet, also pamidronate 60 mg injection has highest percentage of cost variation (9632%) and lowest cost variation is seen with 10 mg alendronate (35%). Cost ratio of 11 formulations was found to be very high which was >2 while percentage of cost variation of 11 formulations was found to be more 100.

Conclusions: This study concludes that there is wide variation in cost of various brands of bisphosphonates in India. The huge price variation creates unnecessary burden leading on the patients resulting in noncompliance which increases the risk of morbidity and mortality. Therefore, there is an urgent need to regulate the cost of various formulations of bisphosphonates which will reduce the financial burden on the patients.


Keywords


Bisphosphonates, Cost ratio, Cost variation, Essential medicines, Pharmacoeconomics, Price variation

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References


Christodoulou C, Cooper C. What is osteoporosis?. Postgrad Med J. 2003;79(929):133-8.

World Health Organization: Risk factors-Osteoporosis. Available at: https://www.who.int/chp/topics/Osteoporosis.pdf. Assessed on 13 September 2019.

Kumar V, Kabbas A, Fausto N, Aster JC. Bones, Joints and Soft tissue tumours. In: Robins and Cotran Pathologic Basis of Diseases. 8th edition. Philadelphia: Elsevier Inc; 2010: 1205-1256.

Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Europ J Rheumatol. 2017;4(1):46-56.

Shaki O, Rai SK, Kashid M, Chakrabarty BK. Prevalence of osteoporosis in peri-and post-menopausal women in slum area of Mumbai, India. J Mid-Life Health. 2018;9(3):117-22.

Nallasivan S. Current treatment of osteoporosis. Indian J Rheumatol. 2019;14:57-60.

Bruton L, Chabner BA, Knollman BC. Agents Affecting Mineral Ion Homeostasis and Bone turnover. In: Goodman and Gilmans The Pharmacological Basis of Therapeutics. 12th edition. China: Mc Graw Hill Companies; 2011: 1275-1306.

Narula S. Current Drug Pricing Status in India. Pharmacoeconomics. 2015;1(1): e101.

Drug Price Control Order. Available at: http://www.arthapedia.in/index.php? Assessed on 15 September 2019.

Das SC. A critical study on availability and price variation between different brands: Impact on access to medicines. Ind J Pharmaceut Sci. 2007;69(1):160-3.

Selvaraj S, Farooqui HH, Karan A. Quantifying the financial burden of households’ out-of-pocket payments on medicines in India: a repeated cross-sectional analysis of National Sample Survey data, 1994–2014. BMJ Open. 2018;8(5):e018020.

Satoskar RS, Rege NN, Tripathi RK, Bhandarkar SD. General considerations and Pharmacokinetics. In: Pharmacology and Pharmacotherapeutics. 25th ed. India: RELX India Pvt Ltd. Popular Prakashan; 2017: 3-29.

Tripati KD. Introduction, Routes of Drug Administration. In: Essentials of Medical Pharmacology. 7th Edition. New Delhi: Jaypee Brothers Medical Publishers Ltd.; 2013: 4-5.

Maiti R, Bhatia V, Padhy BM, Hota D. Essential medicines: an Indian perspective. Ind J Commu Med: Offic Publicat Ind Assoc Prevent Soc Med. 2015;40(4):223-32.

Roy V, Rewari S. Ambiguous drug pricing: a physician’s dilemma. Ind J Pharmacol. 1998;30(6):404-7.

Galani VJ. Choice of better medicine in India: Branded vs Generic Medicine. Pharmacy Pharmacol Intl J. 2017;5:1-2.

Tiwari A, Reddy P, Goyal C. Cost analysis of antifungal drugs available in India: A pharmacoeconomic perspective. Indian J Pharm Pharm. 2016;3:192-6.

Sharmada Nerlekar AR, Karia S, Desousa A. Comparing prices of commonly used gastric acid suppressants available in India. Asian J Pharm Clin Res. 2016;9(4):378-80.

Chandra A, Kumar M, Kumar L, Dikshit H. Cost variation analysis of proton pump inhibitors available in Indian market. Int J Basic Clin Pharmacol. 2018;7(8):1626-29.

Shah NP, Chincholkar AS, Wagh RJ, Siddiqui WA. Cost variation analysis of antipsychotic drugs available in Indian market: An economic perspective. Int J Basic Clin Pharmacol. 2017;6:684-8.

Patel BS, Chavda FM, Mundhava SG. Cost variation analysis of single nonsteroidal anti-inflammatory agents available in Indian market: An economic perspective. Inter J Pharma Sci Res. 2016;7(5):2174-80.

Shet N, Qadiri GJ, Kalal BS, Sunita Saldanha. Impact of Out-Of-Pocket Health Care Financing and Health Insurance Utilization among the Population: A Systematic Review. Int J Health Sci Res. 2018;8(2):249-57.

Out-of-pocket payments, user fees and catastrophic expenditure. Available at: https://www.who.int/health_financing/topics/financial-protection/out-of-pocket-payments/en/. Accessed on 16 September 2019.

Kotwani A. Commentary: Will generic drug stores improve access to essential medicines for the poor in India?. J Public Health Policy. 2010;31(2):178-84.

Kumar S, Baldi A. Pharmacoeconomics: Principles, methods and economic evaluation of drug therapies. Ph Tech Med. 2013;2(5):362-9.