Prescription-based cost analysis of medicines for cardiovascular risk factors at Indian Council of Medical Research-Rational Use of Medicine Centre Hospitals of India

Author:

Chugh Preeta Kaur1,Gupta Pooja2,Wasan Himika2,Tripathi C. D.3,Chandy Sujith J.4,Ranjalkar Jaya4,Bright Heber Rew4,Badyal Dinesh Kumar5,Samuel Madhulika Peter5,Jhaj Ratinder6,Banerjee Aditya6,Joshi Rupa7,Medhi Bikash7,Prakash Ajay7,Kamat Sandhya8,Tripathi Raakhi8,Shetty Yashashri8,Parmar Urwashi8,Dikshit Harihar9,Mishra Hitesh9,Roy Sukalyan Saha9,Kumar Rajiv9,Chatterjee Suparna10,Bhattacharya Manjari10,Samanta Kalyan10,Trivedi Niyati11,Shah Prashant11,Chauhan Janki11,Ramasamy Raveendran12,Mathaiyan Jayanthi12,Gauthaman Jeevitha12,Kaushal Sandeep13,Jain Samriti13,Arora Shalini13,Gupta Kanchan13,Cherian Jerin Jose14,Chatterjee Nabendu Sekhar14,Kshirsagar Nilima Arun14

Affiliation:

1. Department of Pharmacology, VMMC and Safdarjung Hospital, New Delhi, India

2. Department of Pharmacology, AIIMS, New Delhi, India

3. Department of Pharmacology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India

4. Department of Pharmacology and Clinical Pharmacology, CMC, Vellore, Tamil Nadu, India

5. Department of Pharmacology, CMC, Ludhiana, Punjab, India

6. Department of Pharmacology, AIIMS, Bhopal, Madhya Pradesh, India

7. Department of Pharmacology, PGIMER, Chandigarh, India

8. Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

9. Department of Pharmacology, IGIMS, Patna, Bihar, India

10. Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India

11. Department of Pharmacology, Medical College and SSG Hospital, Vadodara, Gujarat, India

12. Department of Pharmacology, JIPMER, Puducherry, India

13. Department of Pharmacology, DMCH, Ludhiana, Punjab, India

14. Department of Basic Medical Sciences, ICMR, New Delhi, India

Abstract

Abstract OBJECTIVES: India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs. MATERIALS AND METHODS: Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range). RESULTS: Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593–3104) and for non-NLEM was INR 5343 (2964–14364). It was INR 806 (243–2132) for generic and INR 3809 (1968–14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5–22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins (P < 0.0001). CONCLUSION: The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines.

Publisher

Medknow

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