Cost variation analysis of statins available in India

Ashika Arka Gopalakrishna, Noah M. Bose, Sharon M. Stanly


Background: The current study aimed to find out the percentage cost variation among the various brands of statins marketed in India. Statins are HMG-CoA reductase inhibitors which are widely prescribed as blood cholesterol lowering agents and hence reduce illness and mortality in those who are at high risk of cardiovascular disease. There are numerous brands of statins are marketed in India.

Methods: Cost of a particular drug manufactured by different companies in the same strength and the dosage form was obtained from the price list provided by the pharmaceutical companies in current index of medical specialities (CIMS) (42nd year January to April 2021). The difference in the maximum and the minimum price of the same drug manufactured by different pharmaceutical companies, cost ratio and the percentage variation in price were analysed.

Results: The percentage cost variation of statins was seen highest with tablet atorvastatin 20 mg (564.06%), followed by combination of capsule atorvastatin 10 mg+aspirin 75 mg (325%) which was followed by combination of film coated tablet atorvastatin 10 mg+fenofibrate 160 mg (267.4%), tablet rosuvastatin 20 mg (171.1%), tablet lovastatin 10 mg (108.9%), combination of tablet rosuvastatin 10 mg+fenofibrate 160 mg (87.34%) and lowest was seen with tablet simvastatin 20 mg (6.0%).

Conclusions: There is a very wide cost variation among different brands of statins marketed in India. The percentage cost variation was found to be the highest among the moderate intensity statins.



Brands, Cost variation, Cost ratio, Statins

Full Text:



Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J. Harrison’s principles of internal medicine. 18th ed. New York: McGraw Hill Education; 2012: 3158-9.

Table 1, statin dosing and ACC/AHA Classification of intensity-NCBI-NIH. Available at: http:/www.ncbi. Accessed on 3 June 2021.

Vutukuru P, Tekulapally K. Analysis of cost variation among various statin preparation available in India. Indian J Pharm Pharmacol. 2019;6(1):14-7.

Shrank WH, Young H, Ettner SL, Glassman P, Asch SM, Kravitz RL. Do the incentives in three-ties, incentive-based pharmaceutical benefit plans operate as intended? Results from a physician leadership survey. Am J Manag Care. 2005;11(1):16-22.

Alexander GC, Casalino LP, Meltzer DO. Patient-physician communication about out-of-pocket costs. JAMA. 2003;290(7):953-8.

Jadhav NB, Bhosale MS, Adhav CB. Cost analysis of study of oral anti diabetic drugs available in Indian market. Int J Med Health Sci. 2013;2(1):63-9.

Lexchin J, Grootendors P. Effects of prescription drug user fees on drug and health services use and on health stature in vulnerable populations: a systematic review of the evidence. Int J Health Serve. 2004;34(1):101-22.

Morgan SG, Lee A. Cost related non-adherence to prescribed medicines among older adults: a cross-sectional analysis of a serve in 11 developed countries BMT Open. 2017;7(1):014287.

Kashyap A, Balaji MN, Chhabra M, Rashid M, Muragerndi PM. Cost analysis of various branded verses generic chemotherapeutic agents used for the treatment of early breast cancer-a deep insight from India. Expert Rev Pharmacoecon Outcomes Res. 2020;20(4):355-61.

Saranghi SC, Kaur N, Tripathi M, Gupta YK. Cost analysis study of neuropsychiatric drugs: role of National list of essential medicines, India. Neurol India. 2018;66(5):1427-33.

Tangutari VK, Kennedy KF, Virani SS, Maddox TM, Armstrong K, Wasfy JH. Association between poverty and appropriate statin prescription for the treatment of hyperlipidaemia in the United State. An analysis from the ACC Ncdr Pinnalle registry. Cardiovasc Revasc Med. 2020;21(8):1016-21.

Piette JD, Heisler M, Krein S, Akerr E. The role of patient-physician in modulating medication non adherence due to cost pressure. Arch Intern Med. 2005;165(15):1749-55.

Piette JD, Heisler M, Horne R, Alexander GC. A conceptually based approach to understanding chronically ill patient’s response to medication cost pressure. Soc Sci Med. 2006;62(4):846-57.

Wysowski DK, Governale LA, Swann J. Trends in outpatient prescription drug cure and related costs in the United States: 1998-2003. Pharmacoeconomic. 2006;24(3):233-6.

Catlin A, Lowan C, Hartman M, Heffler S. For the national Health Expenditure Accounts Team. National health spending in 2006: A year of change for prescription drugs (published correction appearance in Health Aff (Millwood). Health Aff. 2008;27(1):14-29.

Devis S, Delfino SF, Feinberg CE, Johnson MF, Nappi VL, Olinger JT, et al. Current and emerging uses of statins in clinical therapeutics: a review. Lipid Insight. 2016;9:13-29.

Hajar R. Statins: past and present. heart view: the official. J Gulf Heart Assoc. 2011;12(3):121-7.

Zeber JE, Grazier KL, Valenstein M, Blow FC, Lantz PM. Effect of medication co-payment increase in veterans with schizophrenia. Am J Manag Care. 2007;13:335-46.

Hayner RB, Ackloo E, Sahoka N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;2:000011.

Soumerai SB, Pierr JN, Zhang N, et al. Cost related medication non-adherence among elderly and disabled Medicare beneficiaries: a national survey one year before the Medicare benefit. Arch Intern Med. 2006;166(17):1829-35.

Briesacher BA, Gurwitz JH, Soumerai SB. Patient at risk for cost related medication non adherence: a review of the literature. J Gen Intern Med. 2007;22(6):864-71.

Singh A, Kumar H. Cost analysis study of second generation antihistamines used in the treatment of allergic rhinitis in India. Int J Basic Clin Pharmacol. 2016;5(4):1228-33.

Shukla AK, Sharma P. Cost variation analysis of antidyslipidemic drugs. Int J Basic Clin Pharmacol. 2016;5(5):1850-5.

Das SC, Mandal M, Mandal SC. A critical study on availability and price variation between different brands: impact on access to medicines. Indian J Pharm Sci. 2007;69(1):160-3.

National Pharmaceutical Pricing Authority. Fact sheet: COVID-19 dashboard. Available at: Accessed on 23 June 2021.

WHO. Fact sheet: Guide to good prescribing-practical manual. Available at: Accessed on 23 June 2021.

Reichert S, Simon T, Halm EA. Physicians’ attitude about prescribing and knowledge of the cost of common medications. Arch Intern Med. 2000;160(18):2799-803.

Korn LM, Reichert S, Simon T, Halm EA. Improving physicians’ knowledge of the costs of common medications and willingness to consider cost when prescribing. J Gen Inter Med. 2002;18(1):31-7.

Shrank WH, Young T, Ettner SL. The implications of choice: prescribing generic or preferred pharmaceuticals improver medication adherence for chronic conditions. Arch Intern Med. 2006;166(3):332-7.

Kennedy J, Morgan S. Cost-related prescription non adherence in the United States and Canada: a systematic-level comparison using the 2007 International Health Policy Survey on seven countries. Clinic. 2009;31:213-9.

Mehani R, Sharma P. Cost variation analysis of oral anti-diabetic drugs. Int J Basic Clin Pharmacol. 2018;5(4):1709-14.

Chawan VS, Gawan KV, Badwane SV. Fluroquinolones in India-are we prescribing it right. A cost variation study. Natl J Physiol Pharmacol. 2015;5(4):306-8.