Oral Antidiabetic Drugs Available In Indian Market Economics Essay

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Oral Antidiabetic Drugs Available In Indian Market Economics Essay

There exists a broad scope of fluctuation in the monetary values of drugs marketed in India and other states of universe. Very few surveies have been conducted to uncover such monetary value fluctuations in the unfastened market.

Aim & A ; Aims: To measure the cost of unwritten anti-diabetics of different generic categories and different trade name names of one compound, To measure the difference in cost of different trade names for same active drug by ciphering per centum fluctuation of cost.

Methods: Cost of a peculiar drug being manufactured by different companies, in the same strength, figure and dose signifier was compared. The difference in the upper limit and minimal monetary value of the same drug manufactured by different pharmaceutical companies and the per centum fluctuation in monetary value was calculated.

Consequences: In Single drug therapy, among sulfonylurea group of drugs, Glimepiride ( 1 milligram ) shows maximal monetary value fluctuation of 655.38 % , while Glipizide ( 10mg ) shows fluctuation of 38.88 % . In Biguanides & A ; Thizolidinediones groups of drugs, Metformin ( 500 milligram ) & A ; Pioglitazone ( 15 milligram ) show maximal monetary value fluctuation of 308.33 % & A ; 542 % severally. In I±-glucosidases inhibitor group of drugs, Miglitol shows maximal monetary value fluctuation of 135.50 % . In combination therapies, Glipizide & A ; Metformin combination shows maximal fluctuation up to 399.04 %

Decision: The mean per centum monetary value fluctuation of different trade names of the same drug manufactured in India is really broad and the assessment and direction of marketed drugs should be directed toward maximising the benefits of therapy and minimising negative personal and economic effects.

Keywords: Cost analysis, anti-diabetic drugs, trade names, monetary value rating

Introduction:

In the development states the cost of drugs is a major concern to both physician and patient ; yet there are few informations on prescribing forms and expenditure1. Cost of drugs is an of import factor act uponing conformity with treatment.2 In the context of pharmaceutical and other wellness merchandises, differential pricing ( besides called tiered pricing ) is the version of merchandise monetary values to the buying power of consumers in different geographical or socio-economic sections. Differential pricing could potentially be a really effectual scheme to better entree to indispensable medical specialties in low and middle-income states where most patients pay for medical specialties out-of-pocket and hence can non afford monetary values comparable to high income markets.3 A

Diabetess is the most common non catching disease worldwide. The International Diabetes Federation ( IDF ) estimates the entire figure of diabetic topics to be around 40.9 million in India and this is farther set to lift to 69.9 million by the twelvemonth 2025.4,5 Diabetes is a chronic upset. It requires womb-to-tomb intervention. So the cost of antidiabetic drug is the major make up one’s minding factor for the patients ‘ conformity. Choice of unwritten antihyperglycaemic agents as first-line drug or combined therapy should be based on both the pharmacological belongingss of the compounds ( efficaciousness and safety profile ) and the clinical features of the patient ( phase of disease, bodyweight, etc. ) 6. There exists a broad scope of fluctuation in the monetary values of drugs marketed in India and other states of universe.

In the Indian market assorted antidiabetic drugs of assorted trade names are available. This creates a batch job to physician to make up one’s mind the drug of pick for single patient. Besides in the literature really less surveies are available which compare the cost of drugs of different trade names. Sing unwritten hypoglycaemic agents, with the best of our cognition no survey is available which compares the cost of drugs of different trade names.

So, we decided to transport out the survey which compares monetary values of different unwritten anti-diabetic drugs. This survey besides evaluates the cost of unwritten anti-diabetics of different trade name names of one compound and difference in cost of different trade names for same active drug by ciphering per centum fluctuation of cost.

Aim & A ; Aims: This Pharmacoeconomic survey is designed with the purposes & A ; aims of,

To happen different anti-diabetics available either singly or in combination and the No. of trade names available for each.

To measure the cost of unwritten anti-diabetics of different generic categories and different trade name names of one compound.

To measure the difference in cost of different trade names for same active drug by ciphering per centum fluctuation of cost.

Materials and Methods:

CIMS ( current index of medical shops ) & A ; IDR ( Indian drug reappraisal ) [ 2011 issues ] were reviewed for the monetary values of drugs used in the direction of diabetes mellitus.

The retail cost of a peculiar drug being manufactured by different companies, in the same strength, figure and dose signifier was compared.

The difference in the upper limit and minimal monetary value of the same drug manufactured by different pharmaceutical companies was calculated.

The per centum fluctuation in monetary value was calculated.

The drugs being manufactured by merely one company or being manufactured by different companies nevertheless, in different strengths were excluded.

The per centum fluctuation in monetary value was calculated utilizing the undermentioned formulaA 2

Percentage = Price of most expensive trade name – Monetary value of least expensive trade name X 100

A Price of least expensive trade name

The drugs were classified into five classs depending on the per centum ( % ) scope of monetary value fluctuation. These were as follows

1 ) 0-25 % 2 ) 25.1-50 % , 3 ) 50.1-75 % , 4 ) 75.1-100 % and 5 ) more than 100 %

Findingss of our experimental survey were expressed as absolute Numberss every bit good as per centum.

Consequences:

The monetary values of a sum of 20 drugs ( 11 individual and 9 combination readyings ) , available in 54 different preparations were analysed. These 54 preparations are manufactured by different pharmaceutical companies.

Single drug therapy:

In individual drug therapy, Table I shows the monetary value fluctuation between sulfonylurea group of drugs. In this group, Glimepiride ( 1 milligram ) shows maximal monetary value fluctuation of 655.38 % , while Glipizide ( 10mg ) shows fluctuation of 38.88 % .

Table II shows monetary value fluctuation in Biguanides ( Metformin ) & A ; Thizolidinediones ( Pioglitazones ) groups of drugs. In these groups, Metformin ( 500 milligram ) & A ; Pioglitazone ( 15 milligram ) show maximal monetary value fluctuation of 308.33 % & A ; 542 % severally.

Table III shows monetary value fluctuation between I±-glucosidases inhibitor group of drugs. In this group, Miglitol shows maximal monetary value fluctuation of 135.50 % .

Table IV shows monetary value fluctuation between Meglitinides group of drugs. In this group, Rapaglinide ( 0.5 milligram ) shows maximal monetary value fluctuation of 90.95 %

Combination therapy:

In Combination therapy, entire 7 combination therapies were analysed. In this, Glipizide & A ; Metformin combination shows maximal fluctuation up to 399.04 % . Table V shows monetary value fluctuation in combination drug therapy

Relationship between per centum monetary value fluctuation & A ; no. of Manufacturing Companies:

When we draw a graph demoing relationship between fabricating companies and % monetary value fluctuation, it was noted that there is additive relationship in between these two variables. As the no. of fabricating companies increases, the per centum monetary value fluctuation besides increases. ( As shown in figure no.1 )

Discussion:

The Indian market has over 100,000 preparations and there is no system of enrollment of medicines2. The drugs are chiefly sold under trade name names7.

A survey in the United States found drug monetary values to be high and that monetary value favoritism occurred across the industry7. But really less surveies are available in our scenarios which compare the cost of drugs of different trade names. Therefore we decided to transport out the survey which compares the cost of different trade names of drug of common upset.

The drug monetary values available in CIIMS & A ; IDR were compared, as they are readily available beginning of drug information and are updated on a regular basis. Drugs used in the direction of diabetes mellitus were selected as it is one of the major cause of morbidity and mortality & A ; the intervention requires uninterrupted prescription drug usage.

It is observed from our consequences that there is a broad ( up to 836.20 % ) fluctuation in monetary values of drugs manufactured by different pharmaceutical companies. The grounds for this monetary value fluctuation could be as follows8-14:

The bing market construction of the pharmaceutical industry

Asymmetry of information or progressive information

Industry costs

Government ordinances and pricing policies

From our survey it is besides clear that, monetary value fluctuation was straight related to the figure of companies fabricating a peculiar drug. So it can be concluded that monetary value fluctuation increases because of addition in competition among the fabrication companies.

Pharmacists do non distribute the same trade name as prescribed by the physician and seek to replace it with other options, citing the ground of nonavailability. This is frequently done with vested involvement for economic additions as some trade names have a higher net income border.

It is felt that doctors could supply better services and cut down costs of drugs if information about drug monetary values was readily available. Surveies have shown that supplying a manual of comparative drug monetary values annotated with ordering advice to doctors reduced their patients ‘ drug expense15.

Due to long term intervention continuance, diabetes patients normally have higher than mean monthly out-of-pocket disbursals and high out-of-pocket disbursals can be a barrier to adherence to prescription drug regimen. Many inveterate ill grownups cut back on medicines due to high prescription cost. Inadequate prescription coverage and out of pocket disbursals are one of the strong forecasters of their medicine attachment jobs.

Market construction and subsequent market cleavage provide footing for prescription agent pricing policies taking to broad fluctuation in monetary values of drugs. In the absence of information on comparative drug monetary values and quality, it is hard for physicians to order the most economical prescription.

Decision:

The mean per centum monetary value fluctuation of different trade names of the same drug manufactured in India is really broad. So it is recommended that the assessment and direction of marketed drugs should be directed toward maximising the benefits of therapy and minimising negative personal and economic effects.

Recommendations:

There is a demand for conjunct action from regulative governments, physicians, druggists and general populace at big to turn to this issue of unwritten antidiabetic drugs monetary value fluctuation.

At the infirmary degree governments and concerned commissions have to border policies on these facets.

The state of affairs can be improved by integrating analysis of prescription costs in medical course of study and by supplying updated and complete information sing bioequivalence, quality and cost of the pharmaceutical readying to the physicians.

Wherever possible a cheapest trade name should be prescribed because the high quality of any peculiar trade name over the others has ne’er been proved scientifically.

Presently, really few medical specialties are under drug monetary values control order16.A Hence it is desired that the Government should convey all lifesaving and indispensable medical specialties under monetary value control