DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162950

Economic analysis of oral cephalosporins in the Indian market

Ashwini V. Karve, Kumardeep B. Paul

Abstract


Background: Bacterial infections require appropriate and affordable treatment. A number of antimicrobial formulations are available in the Indian scenario. Affordable prescriptions improve compliance rate of the patients. This study was planned to evaluate & analyse the variation in the cost of oral cephalosporins (single and combination) in the Indian market.

Methods: Cost per tablet or capsule of cephalosporins being manufactured by different companies, in the same strength and dosage forms was obtained from two drug compendia. The difference in the maximum and minimum price and percentage variation in price was calculated.

Results: There are a number of companies manufacturing a particular drug, eg. Tab Cefixime (200 mg) - 127 companies, Tab Cefpodoxime (200 mg) - 106 companies, Cap Cefalexin (500 mg) - 38 companies and amongst the combinations; Tab Cefixime (200 mg) + Tab Clavulanate (125 mg) - 51 companies, Tab Cefpodoxime (200 mg) + Tab Clavulanate (125 mg) - 32 companies. A wide variation was found amongst the drugs ranging from 1746% for Tab Cefpodoxime (200 mg) to just 8.4% for Tab Cefdinir (100 mg). A similar variation existed for the combination drugs 9900% for Tab Cefixime (250 mg) + Tab Ornidazole (500 mg) and 42.1% for Tab Cefpodoxime (200 mg) + Tab Ofloxacin (200 mg).

Conclusions: This study shows a wide price variation of the same drugs manufactured by different companies. The manufacturing companies must aim to reduce the price variation while maintaining the quality and therapeutic efficacy in order to benefit patients and practitioners.


Keywords


Pharmacoeconomics, Cephalosporins, Pricing strategy, DPCO 2013, Indian patent act 2005, WHO guide to good prescribing, Reasons for price variation

Full Text:

PDF

References


World Health Organisation. Factsheet: The 10 leading causes of death by country income group, 2012. Available at http://www.who.int/ mediacentre/ factsheets/ f310/ en/ index1.html. Accessed 12 July 2015.

Caldera A, Zarnic Z. Affordability of Pharmaceutical Drugs in Developing Countries. Advanced Studies in International Economic Policy Research, Kiel Institute for World Economics. Working Paper 419. 2015:7.

Pichholiya M, Basu A, Yadav AK, Kothari N, Tahashildar J. An observational comparative study of cost between branded medicines and generic medicines. Int J Basic Clin Pharmacol. 2015;4:269-72.

Antibacterial Drugs. In Rang HP, Ritter JM, Flower RJ, Hendersen G (Eds). Rang and Dale’s Pharmacology. Chapter 51. 8th Edition. Elsevier Ltd., 2014:631-2.

Penicillins, Cephalosporins, and Other β-Lactam Antibiotics. In: Brunton LB, Lazo JS, Parker KL, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. Chapter 53. 12th ed. New York, NY: McGraw-Hill. 2011:741-8.

Mendall LA, Wundrick RG. Chapter 153. Pneumonia. In Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL (Eds). Harrison’s Principles of Internal Medicine, 19th Edition. New York: McGraw Hill. 2012:803-13.

Date AP, Mahajan HM, Dashputra AV, Bhosale RR. Study of variation in price of various antidiabetic drugs available in Indian market. Int J Basic Clin Pharmacol. 2015;4(1):36-40.

Karve AV, Chattar KB. Cost analysis study of oral antihypertensive agents available in Indian Market. Int J Basic Clin Pharmacol. 2014;3(3):479-84.

Jadhav NB, Bhosale MS, Adhav CV. Cost analysis study of oral antidiabetic drugs available in Indian Market. Int J Med Res Health Sci. 2014;2(1):63-9.

Sarkar PK. A rational drug policy. Indian J Med Ethics. 2004;12:30-5.

Roy V, Rewari S. Ambiguous drug pricing: a physician’s dilemma. Indian J Pharmacol. 1998;30(6):404-7.

Wertheimer AI, Grumer SK. Overview of international pharmacy pricing. Pharmacoeconomics. 1992;2(6):449-55.

Berki SE, Richards JW, Weeks HA. The mysteries of prescription pricing in retail pharmacies. Med Care. 1977;15(3):241-50.

Chapter 2 Introduction to P-drugs. In: De Vries M., Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing – A Practical Manual, World Health Organisation Action Programme on Essential Drugs Geneva. 1994:17-20.

Di Masi JA, Hansen RW, Grabowski HG. The Price of Innovation: New Estimates of Drug Development Costs. Journal of Health Economics. 2003;22(2):151-85.

Adams CP, Brantner VV. Estimating the Cost Of New Drug Development: Is It Really $802 Million? Health Affairs. 2006;25(2):420-8.

Mukherjee R. Prescribe generic drugs: MCI to doctors 2013. Available at articles. Times of india. indiatimes.com/ 2013-01-27/ india/ 36576717_1_generic-drugs-generic medicines generic-versions. Accessed 12 July 2015.

The Patents (Amendment) Act 2005. Controller General of Patents Designs and Trade Marks, Department of Industrial Policy and Promotion, Ministry of Commerce and Industry available at http://www.ipindia.nic.in/IPActs_Rules/IPActs_Rules.htm as accessed on 12 July 2015.

Compendium of Notified Ceiling Prices of Scheduled Drugs – 2015. National Phamaceutical Pricing Authority (Ministry of Chemicals and Fertilizers, Government of India) February 2015. Available at www.nppaindia.nic.in. Accessed on 12 July 2015.

NPPP (2011). National Pharmaceuticals Pricing Policy. Available at http://pharmaceuticals.gov.in/ mshT2810/FTY2.pdf. Accessed 12 July 2015.

Kumar V, Gupta NV, Kumar KA. A Comparison between old and latest systems in DPCO. Int J Pharmacy and Pharmaceutical Sciences 2014;6(2):19-20.

Thakkar KB, Billa G. Light at the end of the tunnel?: The Great Indian Pharmacoeconomics story. Front. Pharmacol. 2013;4:153. doi: 10.3389/ fphar.2013.00153.

Rajagopal D. (2013). Drug price control order may not achieve much. The Economic Times. Available at http://articles.economictimes.indiatimes.com/ 2012–2010-03/ne ws/34238918_1_drug-price-control-order-combination-drugs-drug-industry-executives. Accessed on 12 July 2015.

Manikandan S, Gitanjali B. National list of essential medicines of India: the way forward. J. Postgrad. Med. 2013;58:68-72.

Rashtriya Swasthya Bima Yojana. About RSBY: What is RSBY? 2008. Available at http://www.rsby.gov.in/about_rsby.aspx. Accessed 12 July 2015.

First Post–India (2013, October 3). SC Raises Ceiling Price Question on New Drug Price Control Order. First Post-India. New Delhi. Available at: http://www.firstpost.com/ india/ sc-raises-ceiling-price-question-on-new-drug-price-control-order-1150829.html?utm_source=ref_article. Accessed on 12 July 2015.

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.

Patel D, Thiyagu R, Surulivelrajan M, Patel H, Pandey S. Price variability among the oral antibiotics available in a South Indian Tertiary Care Hospital. J Clin Diagn Res. 2009;3(6):1871-5.

National List of Essential Medicines, 2011. Available from: http://www.mohfw.nic.in/ WriteReadData/ 1892s/ 7364497. Accessed 12 July 2015.

World Health Organisation. Essential drugs and medicines: Drug finance. Available at: http://www.whoindia.org/ EN/ Section2/ Section/ Section160_959.html. Accessed 12 July 2015.

Panchal SS, Pandit PR, Phatak AM, Lohi KM. Cost analysis of antiretroviral agents available in India. Int J Basic Clin Pharmacol. 2015;4(3):479-82.