Cost analysis study of price variation among the various brands of proton pump inhibitors available in Benghazi-Libya

Authors

  • Khalid A. Mohamad Department of Pharmacy Practice, Faculty of Pharmacy, Libyan International Medical University, Benghazi, Libya
  • Osama S. Alhallouji Department of Pharmacy Practice, Faculty of Pharmacy, Libyan International Medical University, Benghazi, Libya
  • Izzaldien H. Alabbar Department of Pharmacy Practice, Faculty of Pharmacy, Libyan International Medical University, Benghazi, Libya
  • Abdallah M. Alfitori Department of Pharmacy Practice, Faculty of Pharmacy, Libyan International Medical University, Benghazi, Libya
  • Suleiman I. Sharif Department of Pharmacy Practice, Faculty of Pharmacy, Libyan International Medical University, Benghazi, Libya

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20241645

Keywords:

Cost analysis, Proton pump inhibitors, H2-receptor antagonists, Cost ratio, Percentage cost variation, Pharmacoeconomics

Abstract

Background: A large proportion of patients in developing countries have to pay out of pocket for their medications. The prices of different brands of the same medications vary considerably and may vary from one community pharmacy to another. This study was undertaken to evaluate the variation in costs of proton pump inhibitors (PPI) and histamine H2-receptor antagonists available in Libya.

Methods: Prices of various brands of PPI and various formulations were collected from four community pharmacies in the city of Benghazi. Both cost ratio and percentage variation were calculated and compared for various brands of the same strength and number of tablets, capsules, injections, or syrups.

Results: The highest cost ratio and percentage price variation were found with omeprazole 20 mg, followed by omeprazole 40 mg. Other significant cost variations (>100%) were seen with pantoprazole 40 mg, Downoprazol (omeprazole + sodium bicarbonate) 40 mg, and esomeprazole 40 mg. Ampoules of omeprazole, cimetidine, and ranitidine had cost ratios of 1:1.7, 1:1.7, and 1:1.8, and cost variation ratios of 71.4, 66.7, and 75, respectively. Variations in prices of PPI and histamine H2 antagonists from the same manufacturer between different community pharmacies were common. The highest percentage cost variation (100) was seen with omeprazole 20 mg.

Conclusions: Due to political instability, the prices of all drugs are controlled by importing private companies and the owners of community pharmacies instead of governmental authorities, that leads to cost variations. Therefore, the health authorities exert strict control on pricing of medications.

References

World Health Organization. Global spending on health: Weathering the storm. 2020. Available at: https://www.who.int/publications/i/item/9789240017788. Accessed on 01 November 2023.

Goldman DP, Joyce GF, Zheng Y. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. JAMA. 2007;298(1):61-9.

Kesselheim AS, Huybrechts KF, Choudhry NK, Fulchino LA, Isaman DL, Kowal MK, et al. Prescription drug insurance coverage and patient health outcomes: a systematic review. Am J Public Health. 2015;105(2):e17-30.

Gellad WF, Grenard J, McGlynn EA. A review of barriers to medication adherence: A framework for driving policy options. Santa Monica, California: RAND Corporation. 2009. Available at: https://www.rand.org/content/dam/rand/pubs/technical_reports/2009/RAND_TR765.pdf. Accessed on 01 November 2023.

Kennedy J, Tuleu I, Mackay K. Unfilled prescriptions of medicare beneficiaries: prevalence, reasons, and types of medicines prescribed. Journal of Managed Care Pharmacy. 2008;14(6):553-60.

Nekui F, Galbraith AA, Briesacher BA, Zhang F, Soumerai SB, Ross-Degnan D, et al. Cost-related medication nonadherence and its risk factors among Medicare beneficiaries. Medical Care. 2021;59(1):13-21.

Hong M, Shcherbakova N. Comparison of discounted and undiscounted cash prices for cardiovascular medications by type of US community pharmacy. J Gen Int Med. 2021;36:114-20.

Moshtaghi O, Haidar YM, Ghavami Y, Gu J, Moshtaghi A, Sahyouni R, et al. Price variation in the most commonly prescribed ear drops in Southern California. The Laryngoscope. 2017;127(8):1780-4.

National Consumer Agency. Prescription medicines price study. Available at: https://www.rte.ie/ documents/news/nca-medicines.pdf. Accessed 29 October 2023.

Siang TC, Hassali MA, Saleem F, Alrasheedy AA, Aljadhey H. Assessment of medicines price variation among community pharmacies in the state of Penang, Malaysia by using simulated client method. J Med Market. 2014;14(2-3):115-24.

Luo J, Kulldorff M, Sarpatwari A, Pawar A, Kesselheim AS. Variation in prescription drug prices by retail pharmacy type: a national cross-sectional study. Ann Int Med. 2019;171(9):605-11.

Kolasani BP, Divyashanthi CM. Pharmacoeconomic analysis of drugs used for peptic ulcer in India. Int J Basic Clin Pharmacol. 2016;5(4):1672-7.

Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):1500-11.

Cappell MS. Clinical presentation, diagnosis, and management of gastroesophageal reflux disease. Med Clin. 2005;89(2):243-91.

Gwee KA, Goh V, Lima G, Setia S. Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: risks versus benefits. J Pain Res. 2018;361-74.

Kowada A, Asaka M. Economic and health impacts of Helicobacter pylori eradication strategy for the treatment of peptic ulcer disease: A cost‐effectiveness analysis. Helicobacter. 2022;27(3):e12886.

Moshtaghi O, Haidar YM, Ghavami Y, Gu J, Moshtaghi A, Sahyouni R, et al. Price variation in the most commonly prescribed ear drops in Southern California. The Laryngoscope. 2017;127(8):1780-4.

Siang TC, Hassali MA, Saleem F, Alrasheedy AA, Aljadhey H. Assessment of medicines price variation among community pharmacies in the state of Penang, Malaysia by using simulated client method. J Med Market. 2014;14(2-3):115-24.

Irish Times. Consumer agency pulls drug price survey over errors. Available at: https://www.irish times. com/news/health/consumer-agency-pulls-drug-price-survey-over-errors-1.1343496. Accessed on 10 November 2023.

Gotadk R. Proton pump inhibitors market research report. Available at: https://www.marketresearch future.com/reports/proton-pump-inhibitors-market-19223 Accessed on 17 April 2024.

H2 receptor antagonist market size and share analysis. 2024. Available at: https://www.coherentmarket insights.com/industry-reports/h2-receptor-antagonist-market. Accessed on 17 April 2024.

Kolasani BP, Divyashanthi CM. Pharmacoeconomic analysis of drugs used for peptic ulcer in India. Int J Basic Clin Pharmacol. 2016;5(4):1672-7.

Puranik RU, Karandikar YS, Bhat SM, Patil VA. Pharmacoeconomic Evaluation of Pantoprazole and Pantoprazole Plus Domperidone in Treatment of Patients with GERD. J Clin Diagnost Res. 2018;12(11):IC01-IC05.

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Published

2024-06-25

How to Cite

Mohamad, K. A., Alhallouji, O. S., Alabbar, I. H., Alfitori, A. M., & Sharif, S. I. (2024). Cost analysis study of price variation among the various brands of proton pump inhibitors available in Benghazi-Libya. International Journal of Basic & Clinical Pharmacology, 13(4), 464–468. https://doi.org/10.18203/2319-2003.ijbcp20241645

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Original Research Articles