Pharmacoeconomic analysis of price disparities among anti-alzheimer drug brands in the Indian market
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20263780Keywords:
Alzheimer’s disease, Pharmacoeconomics, Cost variation, Branded drugs, IndiaAbstract
Background: Alzheimer’s disease (AD) is a leading cause of dementia, with a rapidly increasing burden in India. Although pharmacotherapy can halt disease development, treatment is mostly out-of-pocket, making drug affordability a key concern. Wide pricing disparities between branded generics may further impede access and adherence. The study objective of this study was to evaluate inter-brand cost variation among anti-Alzheimer drugs available in the Indian pharmaceutical market.
Methods: A cross-sectional pharmacoeconomic analysis was conducted by using the data obtained from the Current Index of Medical Specialties (CIMS) and MIMS website. Commonly prescribed drugs such as donepezil, rivastigmine, memantine, and their combinations were analyzed. Cost ratio and percentage of cost variation were calculated for each formulation.
Results: Prices varied significantly across all medicines. Rivastigmine displayed the most fluctuation, especially in 1.5 mg capsules (1634.13%; price ratio 17.34). Memantine 10 mg pills varied by 364.72%, whilst donepezil exhibited a lower but still considerable variance, with a maximum of 120.44%. Fixed-dose combinations showed moderate variability, with the largest being donepezil 5 mg plus memantine 5 mg (117.44%). Substantial discrepancies between the top and lowest expensive brands emphasize the possibility of cost savings.
Conclusion: Significant inter-brand price disparities exist among anti-Alzheimer medications in India, with rivastigmine showing the highest variability, followed by memantine and donepezil. Promoting cost-conscious prescribing and the use of lower-priced, bioequivalent alternatives could reduce economic burden and improve treatment continuity in patients with AD.
References
Wang R. Global burden of Alzheimer’s disease and other dementias during 1990–2021: a Global Burden of Disease and Risk Factors Study 2021-based study. Neuroepidemiology. 2026;60(1):16–27.
Kumar CT, Varghese M, Duddu V, Vaitheswaran S, Srivastava S, Shaji KS, et al. Indian Psychiatric Society multicentre study: diagnostic patterns, comorbidity and prescription practices for patients with dementia. Indian J Psychiatry. 2023;65(1):52–60.
Miculas DC, Negru PA, Bungau SG, Behl T, Hassan SS ul, Tit DM. Pharmacotherapy evolution in Alzheimer’s disease: current framework and relevant directions. Cells. 2023;12(1):131.
Mahadkar PU, Mane MS, Vichare SS. Evaluation of brand, ceiling and generic price differences in anti-epileptic drugs marketed in India: a novel cost variation analysis. Int J Basic Clin Pharmacol. 2025;14(4):556–64.
Ray S. Advances in pharmacology and clinical trials utilization pattern of anti dementia drugs and cost-effective analysis: Indian scenario. Adv Pharmacol Clin Trials. 2016;1(2):1–7. [Exact article details not independently verified; check the original journal issue or article PDF.]
Kaur M, Dhami M, Singh S, Gupta GD, Raj K. Cost variation analysis of variance brands of anti-Alzheimer’s agents currently available in Indian pharmaceutical market. Int J Biochem Physiol. 2020;5(3):1–5.
Suh GH, Wimo A, Gauthier S, O’Connor D, Ikeda M, Homma A, et al. International price comparisons of Alzheimer’s drugs: a way to close the affordability gap. Int Psychogeriatr. 2009;21(6):1116–26.
Jang S, McCoy RG, Chen J. Prescription drug costs among people with Alzheimer disease and related dementias. JAMA Netw Open. 2024;7(9):e2433026.
CIMS. CIMS (Current Index of Medical Specialities). January–April 2025. 1st ed. CIMS Medical India Pvt Ltd; 2025.
CIMS. CIMS India. 2025. Available at: https://www.mims.com/india. Accessed on 13 August 2026.
Hsu J, Price M, Huang J, Brand R, Fung V, Hui R, et al. Unintended consequences of caps on Medicare drug benefits. N Engl J Med. 2006;354(22):2349–59.
Eaddy MT, Cook CL, O’Day K, Burch SP, Cantrell CR. How patient cost-sharing trends affect adherence and outcomes: a literature review. P T. 2012;37(1):45–55.
Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C, et al. Chronic diseases and injuries in India. Lancet. 2011;377(9763):413–28.
Dunne S, Shannon B, Dunne C, Cullen W. Patient perceptions of generic medicines: a mixed-methods study. Patient. 2014;7(2):177–85.
Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet. 2009;373(9659):240–9.
World Health Organization. WHO guideline on country pharmaceutical pricing policies. Geneva: World Health Organization; 2020. Available at: https://www.who.int/publications/i/item/9789240011878 Accessed on 13 August 2026.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Pankaj U. Mahadkar, Pratik S. Rane, Samruddhi S. Vichare

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.