Cost minimization analysis of antihypertensive drugs available in the pharmacy of tertiary care hospital

Apurv B. Patel; Komal M. Patel; Snehal S. Anturlikar; Nirav N. Patel; Sneh H. Dudhia; Haresh A. Desai

doi:10.18203/2319-2003.ijbcp20261110

Authors

Apurv B. Patel Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India
Komal M. Patel Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India
Snehal S. Anturlikar Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India
Nirav N. Patel Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India
Sneh H. Dudhia Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India
Haresh A. Desai Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20261110

Keywords:

Cost minimization, Pharmacoeconomics, Hypertension

Abstract

Background: Hypertension is a major preventable cause of cardiovascular morbidity and mortality and poses a significant public health burden in India. Its rising prevalence is linked to urbanization, lifestyle changes, and an aging population. As lifelong treatment is required, medication adherence is crucial, but high out-of-pocket costs can affect it. Despite similar therapeutic effects, antihypertensive drugs show significant inter-brand price variation, highlighting the need for cost-minimization to support rational prescribing.

Methods: A three-month cross-sectional cost-minimization study was conducted in a tertiary care hospital pharmacy to assess inter-brand price variation among oral, single-molecule antihypertensive drugs. Data from pharmacy stock records were analysed using cost difference, cost ratio, and percentage cost variation. Only drugs with multiple brands of the same strength were included.

Results: Enalapril and ramipril showed minimal inter-brand price variation (≤10%), indicating stable pricing. Among ARBs, telmisartan had low variability (≤16%) and remained close to NLEM prices, while losartan showed moderate variation (~56%). Atenolol also maintained stable NLEM-compliant pricing. Verapamil and diltiazem showed minimal variation, whereas amlodipine 5 mg had higher variability (~97%). Among diuretics, frusemide (~84%) and spironolactone (~68%) showed notable variation. Clonidine showed minimal variation at 100 µg but moderate variability at 150 µg (~23%).

Conclusions: This cost-minimization analysis shows significant inter-brand price variation among antihypertensive drugs despite therapeutic equivalence. Greater prescriber awareness, stricter price regulation, and cost-effective prescribing are needed to reduce patient burden and improve adherence.

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