Price analysis of antianginal drugs available in Indian market
Keywords:Antianginal drugs, Coronary artery disease, Price variation, Pharmaceutical companies
Background: Coronary artery disease (CAD) is one of the most common causes of cardiovascular mortality and morbidity in developing countries like India. Initial management includes use of many antianginal drugs. There is wide variation in market prices of these drugs. This study was planned to analyse the percentage variation in prices amongst monotherapy and combination therapy of antianginal drugs manufactured and sold under different brand names in Indian market.
Methods: Price of antianginal drugs manufactured by different pharmaceutical companies, in the same strength and dosage forms was obtained from “Current Index of Medical Specialties (CIMS)” January-April 2016 and “Indian Drug Review (IDR)” Vol. XXII, Issue No.1, 2016. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in price per 10 tablets was calculated.
Results: Percentage variation in price for antianginal drugs marketed in India was found to be amlodipine (5 mg) 1128.57% followed by amlodipine (10 mg) 1040% and amlodipine (2.5 mg) 780% as a monotherapy. Whereas atenolol (25 mg), atenolol (50 mg) and nicorandil (10 mg) also showed significant percentage variation in prices 525%, 426.66% and 350.84% respectively. For combination therapy, percentage variation in prices were seen with amlodipine + atenolol (5 + 50 mg) 700%, followed by atenolol + hydrochlorothiazide (50 + 12.5 mg) 362.5% and Isosorbide dinitrate + aspirin (5 + 75 mg) 300%.
Conclusions: There is a wide variation in the price of different brands of antianginal drugs available in India. The clinicians prescribing these drugs should be aware of these variations to reduce the financial burden of drug therapy.
Idrayan A. Forecasting vascular disease cases and associated mortality in India. Reports of the National Commission on Macroeconomics and Health, Ministry of Health and Family Welfare, India; 2005:197-215.
Murray CJL, Lopez AD. Alternative projection of mortality and morbidity by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349(9064):1498-504.
Deepa R, Arvind K, Mohan V. Diabetes and risk factors for coronary artery disease. Curr Sci. 2002;83:1497-505.
Gupta R, Sharma KK, Gupta A, Agrawal A, Mohan I, Gupta VP, et al. Persistent high prevalence of CV risk factors in the urban middle class in India: Jaipur Heart Watch-5. J Assoc Physicians India. 2012;60:11-6.
National Institute for Health and Clinical Excellence. Management of stable angina. (Clinical guideline 126) 2011. Available at http://guidance.nice.org.uk/CG126. Accessed on 14 April 2016.
Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012;60:e44-164.
Lofholm PW, Katzung BG. Rational prescribing and prescription writing. In: Katzung BG, Trevor AJ, Editors. Basic and Clinical Pharmacology, 13th Edition. New Delhi: Tata McGraw-Hill Education Private Limited; 2015:1108-1117.
Satoskar RS, Bhandarkar SD, Rege NN. Pharmacotherapy of angina pectoris, acute MI and peripheral vascular diseases. In: Satoskar RS, Bhandarkar SD, Rege NN, Editors. Pharmacology and Pharmacotherapeutics, 24th Edition. New Delhi: Elsevier Ltd; 2015:398-415.
Indian Brand Equity Foundation. Introduction: Indian Pharmaceutical Industry. Available at http://www.ibef.org/industry/pharmaceutical-india.aspx. Accessed on 14 April 2016.
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.
Frazier LM, Brown JT, Divine GW, Fleming GR, Philips NM, Siegal WC, et al. Can physician education lower the cost of prescription drugs? A prospective, controlled trial. Ann Intern Med. 1991;115(2):116-21.
Chawan VS, Gawand KV, Badwane SV. Cost analysis of oral hypolipidemic agents available in India. Int J Basic Clin Pharmacol. 2014;3:1-4.
Phatak AM, Hotwani JH, Deshmukh KR, Panchal SS, Naik MS. Cost analysis of long established and newer oral antiepileptic drugs available in the Indian market. Int J Med Res Health Sci. 2015;4(4);744-8.
Chawan VS, Gawand KV, Badwane SV. Fluoroquinolones in India-Are we prescribing it right: A cost variation study. Natl J Physiol Pharm Pharmacol. 2015;5:306-8.
Chawan VS, Badwane SV, Gawand KV, Chhaya MU. Analysis of price variation amongst different formulations of anxiolytic drugs available in Indian market. Int J Res Med Sci. 2016;4:2398-401.