pharmacoeconomic analysis of cephalosporins …
TRANSCRIPT
www.wjpps.com Vol 9, Issue 3, 2020.
1205
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
PHARMACOECONOMIC ANALYSIS OF CEPHALOSPORINS
AVAILABLE IN INDIAN PHARMACEUTICAL MARKET
Priyanka S.*, Sara Yeldhos, Sanoop J. and Shindya B.
Department of Pharmacy Practice, Karpagam College of Pharmacy, S. F. 762, Pollachi Main
Road, Othakkalmandapam, Coimbatore-641032, Tamil Nadu, India, (Affiliated to The
Tamil Nadu Dr. M. G. R. Medical University).
ABSTRACT
Background: Cephalosporins are antibiotics used to treat a wide
variety of bacterial infections, such as respiratory tract infections, skin
infections and urinary tract infections. Different brands of the same
medications are available in market leading to immense cost variation.
This can affect medication compliance by the patient.
Pharmacoeconomics research can take us toward the final aim of
making drugs affordable to all. The present study was undertaken to
evaluate the variation and minimization in costs of Cephalosporins
available in India. Materials and methods: The cost of the drugs were
obtained from CIMS, July to Oct, 2019, and cost range, mean cost,
cost ratio and percentage cost variation for individual drug brands was
calculated. The cost of 10 tablets or capsules and 1 vial/ampoule was
taken in case of oral and parenteral preparations respectively. Results:
There is a gross variation in the prices of branded drugs of
Cephalosporins in India. The highest cost range is for IV Cefuroxime 750mg (1,695) and
mean cost is for oral Cefaclor 750mg (772.34). The highest cost ratio and percentage price
variation is for oral Cefuroxime 500mg (19.29, 1829.825). Conclusions: Higher medication
costs are often being considered as an important factor for medication non-adherence,
dropouts/lost follow-ups and drug resistance. Hence, the practitioner must be sensitized about
the cost of therapy to make sure adequate patient compliance.
KEYWORDS: Cephalosporins, Cost range, Mean cost, Cost ratio, Percentage cost variation,
Compliance.
WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES
SJIF Impact Factor 7.632
Volume 9, Issue 3, 1205-1216 Research Article ISSN 2278 – 4357
Article Received on
30 Dec. 2019,
Revised on 20 Jan. 2020,
Accepted on 10 Feb. 2020
DOI: 10.20959/wjpps20203-15635
*Corresponding Author
Priyanka S.
Department of Pharmacy
Practice, Karpagam college
of Pharmacy, S. F. 762,
Pollachi Main Road,
Othakkalmandapam,
Coimbatore-641032, Tamil
Nadu, India, (Affiliated to
The Tamil Nadu Dr. M. G.
R. Medical University).
www.wjpps.com Vol 9, Issue 3, 2020.
1206
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
INTRODUCTION
In developing countries, the main source of dead weight loss are due to unreasonable or
uneconomic treatment costs making the healthcare system outworn. Total health expenditures
about 50-90% drugs are paid out-of – pocket payments. It is estimated that 20 million people
in India fall below the poverty line each year because of indebtedness due to healthcare needs
(Pricewaterhouse Coopers, 2007). This is indeed an alarming figure.[1]
Bacterial disease emerges as a major concern of risk factors for spread and exists as an high
burden to the developing countries. In low income countries bacterial infection such as lower
respiratory tract infections (LRTI) accounts for the main cause of death and for middle low
income countries it remains the 3rd
leading cause of death (91; 53/1lakh population
respectively).[2]
India faces the challenge of treating a range of infectious diseases like
tuberculosis, malaria, respiratory infection, dengue fever from acute to chronic with the
potential to cause morbidity and mortality. In every country, the obtainable life saving
antimicrobials is of supreme importance. There are various antibiotics available primarily
indicated for the prophylaxis, and treatment of bacterial infections caused by both Gram-
positive as well as Gram-negative organisms which include penicillins, cephalosporins,
fluoroquinolones, aminoglycosides,and tetracyclines.[3]
In a healthcare setup, the basic services that hospitals offer are primary care, serve as
referral institutes for higher-level care, and train health care workers but benefits are
expensive.[4]
Apart from clinical setup, the major non clinical factors leads to price variation
of drugs include professional decision making, the availability and distribution of resources,
physician incentives, financing and reimbursement models. The main policy challenge is thus
to find the root cause rather than eliminating the variation altogether.[5]
The Government of India regulates prices of essential drugs through Drug Price Control
Order (DPCO) implemented by National Pharmaceutical Pricing Policy (NPPA) but the
government regulated essential drug price list do not cover 80% of medications. This leads to
economic burden to common people.[6]
Pharmacoeconomics research can take us toward the final aim of making drugs affordable to
all. Though pharmacoeconomics is in its infancy in India, it is rapidly evolving and good
quality studies are being conducted across the nation. The first proposed Pharmacoeconomics
guidelines draft was recently prepared by experts in the field (Gupta et al., 2013).[7]
www.wjpps.com Vol 9, Issue 3, 2020.
1207
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
As health resources are limited, increased attention is being given to the assessment of
healthcare measures in terms of money. This is achieved by comparing costs and
consequences of alternative interventions. Different brands of the same mediations are
available in market leading to immense cost variation. This can affect medication compliance
by the patient. The present study was undertaken to evaluate the variation in costs of
Cephalosporins available in India.
MATERIALS AND METHODS
1. The cost of 8 oral and 8 parenteral preparations of cephalosporins available under
different brands in Indian pharmaceutical market was analyzed as of data available in
CIMS, July to Oct, 2019.
2. The cost of 10 tablets/capsules and 1 vial/ampoule was calculated for each strength in a
generic group.
3. Cost range and mean cost of the drugs are calculated and cost range is the range of the
drug from minimum to maximum cost and mean cost is calculated by adding the cost of
all brands of the same generic drug divided by number of brands available. Cost is
calculated in Indian National Rupees (INR).
4. Cost ratio gives the ratio of the cost of costliest to the cheapest brand of proton pump
inhibitors of the same strength available in the Indian market and it gives an idea about
how many times the costliest brand costs more than the cheapest brand available in each
generic group.
5. Percentage price variation for each strength of the same generic group was calculated
using the equation,
6. The drug Manufactured by or a definite strength of drug manufactured by a single
company is excluded.
7. The different brands of the drug whose price is not disclosed in CIMS, July to Oct 2019
are excluded.
8. Fixed dose combinations and other formulations are not analyzed.
9. The numbers of trades of Cephalosporins in the Indian pharmaceutical market are
analyzed.
www.wjpps.com Vol 9, Issue 3, 2020.
1208
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
RESULTS
The study shows that there are currently 769 brands of Cephalosporins are available in India
and Cefpodoxime holds the highest number of brands 194 (25.227%), Cefuroxime has 171
brands (22.236%), Cefixime has 154 brands (20.026%), Ceftriaxone has 131 brands
(17.035%), Cefalexin has 28 brands (3.641%), Ceftazidime has 21 brands (2.730%), Cefaclor
has 18 brands (2.340%), Cefadroxil has 16 brands (2.080%), Cefotaxime has 11 brands
(1.430%), Cefaperazone has 8 brands (1.040%), Cefdinir has 6 brands (0.780%), Cefpirome
has 5 brands (0.650%), Cefazolin has 3 brands (0.390%), Cefetamet has 2 brands (0.260%),
Ceftizoxime has 1 brand (0.130%)(Fig-1).
Fig-1: Total number of brands of each cephalosporins available in India.
Cefaclor is available at 125mg, 250mg, 375mg, 500mg and 750mg strengths as oral
formulation in 2,8,3,3 and 2 brands of each respectively. Cefadroxil is available at 125mg,
250mg and 500mg strengths as oral formulations in 5, 6 and 5 brands of each respectively.
Cefetamet is available at 250mg and 500mg strengths as oral formulation in 1,1 brand of each
respectively. Cefdinir is available at 100mg, 300mg strengths as oral formulation in 1 and 5
brands of each respectively. Cefalexin is available at 125mg, 250mg, 375mg, 500mg, 750mg
strengths as oral formulation in 3, 12, 2, 9 and 2 brands of each respectively. Cefpodoxime is
available at 50mg, 100mg and 200mg strengths as oral formulation in 31, 75 and 88 brands of
each respectively. Cefixime is available at 50mg, 100mg, 200mg and 400mg strengths as oral
formulation in 25, 61, 67 and 1 brands of each respectively. Cefuroxime is available at
125mg, 250mg and 500mg strengths as oral formulation and 2.5mg, 250mg, 500mg, 750mg
www.wjpps.com Vol 9, Issue 3, 2020.
1209
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
and 1500mg strengths as parenteral formulation in 9, 54, 62 and 1, 6, 1, 19 and 19 brands of
each respectively. Ceftriaxone is available at 125mg, 250mg, 500mg, 1000mg and 2000mg
strength as parenteral formulation in 10, 35, 37, 47 and 2 brands of each respectively.
Ceftizoxime is available at 1000mg strength as parenteral formulation in 1 brand.
Ceftazidime is available at 125mg, 250mg, 500mg, 1000mg and 2000mg strengths as
parenteral formulation in 1, 5, 2, 11 and 2 brands of each respectively. Cefpirome is available
at 500mg and 1000mg strengths as parenteral formulation in 1 and 4 brands of each
respectively. Cefotaxime is available at 125mg, 250mg, 500mg, 1000mg and 1500mg
strengths as parenteral formulation in 2, 3, 3, 2 and 1 brands of each respectively.
Cefoperazone is available at 250mg, 1000mg and 2000mg strengths as parenteral formulation
in 2, 5 and 1 brands of each respectively. Cefazolin is available at 250mg, 500mg and
1000mg strengths as parenteral formulation in 1, 1 and 1 brand of each respectively.
The cost range of oral Cefaclor 125mg, 250mg, 375mg, 500mg and 750mg is in between
156.81 -216.66 INR, 169.86 – 446.66 INR, 376.66 – 457.00 INR, 465.00 – 620.00 INR and
686.35 – 858.33 INR respectively. Cost range of oral Cefadroxil 125mg, 250mg and 500mg
is in between 10.48 – 14.00 INR, 18.98 – 31.20 INR and 36.30 – 42.38 INR respectively.
Cost range of oral Cefdinir 300mg is in between 230.00 – 550.00 INR. Cost range of
Cefalexin 125mg, 250mg, 375mg, 500mg and 750mg is in between 30.00 – 68.50 INR, 51.22
– 145.70 INR, 102.50 – 181.00 INR, 99.90 – 162.00 INR and 184.50 – 315.00 INR
respectively. Cost range of Cefpodoxime 50mg, 100mg and 200mg is in between 52.10 –
90.00 INR, 71.50 – 245.70 INR and 90.00 – 290.00 INR respectively. Cost range of Cefixime
50mg, 100mg, 200mg and 400mg is in between 28.60 – 154.50 INR, 32.00 – 130.00 INR and
53.10 – 200.00 INR respectively. Cost range of Cefuroxime 125mg, 250mg and 500mg is in
between 74.00 – 250.65 INR, 59.00 – 660.00 INR, and 76.00 – 1466.667 INR respectively
(Table-1).
www.wjpps.com Vol 9, Issue 3, 2020.
1210
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
Table 1: Cephalosporins with their number of brands, minimum and maximum cost,
cost range and mean cost of each oral formulations in India.
S.no Drug
(Tab/Cap)
Dose
(mg)
No. of
brands
Minimum
Cost(INR)
Maximum
Cost(INR)
Cost
Range
Mean
Cost
1. Cefaclor
125
250
375
500
750
2
8
3
3
2
156.81
169.86
376.66
465.00
686.35
216.66
446.66
457.00
620.00
858.33
59.85
276.8
80.34
155
171.98
186.735
315.368
414.831
544.88
772.34
2. Cefadroxil
125
250
500
5
6
5
10.48
18.98
36.30
14.00
31.20
42.38
3.52
12.22
6.08
12.052
27.73
39.988
3. Cefdinir 100*
300
1
5
-
230
-
550
-
320
-
366
4. Cefetamet 250*
500*
1
1
-
-
-
-
-
-
-
-
5. cefalexin
125
250
375
500
750
3
12
2
9
2
30.00
51.22
102.50
99.90
184.50
68.50
145.70
181.00
162.00
315.00
38.50
94.48
78.5
62.1
130.5
50.833
79.91
141.75
127.463
249.75
6. cefpodoxime
50
100
200
31
75
88
52.10
71.50
90
90
245.70
290
37.9
174.2
200
70.832
115.582
187.310
7. cefixime
50
100
200
400*
25
61
67
1
28.60
32.00
53.10
-
154.50
130.00
200.00
-
125.9
98
146.9
-
57.390
80.139
120.838
-
8. Cefuroxime
125
250
500
9
54
62
74
59
76
250.65
660.00
1466.667
176.65
601.00
1390.667
140.572
274.169
500.336
*prices are not available: hence cost range and mean cost cannot be calculated
Whereas in case of parenteral preparations, the cost range of injectable Cefoperazone 250mg
and 1000mg is in between 56.00 – 75.00 INR and 156.00 – 295.00 INR respectively. cost of
injectable Cefotaxime 125mg, 250mg, 500mg and 1000mg is in between 13.35 – 27.71 INR,
12.92 – 24.60 INR, 17.31 – 45.80 INR and 28.50 – 64.25 INR respectively. Cost of injectable
Cefpirome 1000mg is in between 351.00 – 744.00 INR. Cost of injectable Ceftazidime
250mg, 500mg, 1000mg and 2000mg is in between 66.00 – 132.10 INR, 171.00 – 202.20
INR, 193.75 –340.00 INR and 495.90 – 505.00 INR respectively. Cost of injectable
Ceftriaxone 125mg, 250mg, 500mg, 1000mg and 2000mg is in between 18.00 – 64.14 INR,
24.00 – 35.00 INR, 33.57 – 60.00 INR, 50.00 – 500.34 INR and 113.75 – 126.80 INR
www.wjpps.com Vol 9, Issue 3, 2020.
1211
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
respectively. Cost of injectable Cefuroxime 250mg, 750mg and 1500mg is in between 32.00
– 66.50 INR, 95.00 – 1790.00 INR and 175.00 – 325.00 INR respectively (Table-2).
Table 2: Cephalosporins with their number of brands, minimum and maximum cost,
cost range and mean cost of each parenteral formulations in India.
S.no Drug
(1 Vial)
Dose
(mg)
No. of
brands
Minimum
Cost(INR)
Maximum
Cost(INR)
Cost
Range
Mean
Cost
1. cefuroxime
2.5*
250
500*
750
1500
1
6
1
19
19
-
32
-
95
175
-
66.50
-
1790
325
-
34.5
-
1695
150
-
54.15
-
208.91
224.48
2. ceftriaxone
125
250
500
1000
2000
10
35
37
47
2
18
24
33.57
50
113.75
64.14
35
60
500.34
126.80
46.14
11
26.43
450.34
13.05
27.501
29.25
47.29
72.13
120.27
3. Ceftizoxime 1000* 1 - - - -
4. ceftazidime
125*
250
500
1000
2000
1
5
2
11
2
-
66.00
171.00
193.75
495.90
-
132.10
202.20
340.00
505.00
-
66.1
31.2
146.25
9.1
-
85.932
186.6
239.86
500.45
5. cefpirome 500*
1000
1
4
-
351.00
-
744.00
-
393.00
-
495.97
6. cefotaxime
125
250
500
1000
1500*
2
3
3
2
1
13.35
12.92
17.31
28.50
-
27.71
24.60
45.80
64.25
-
14.36
11.68
28.49
35.75
-
20.53
17.79
27.98
46.37
-
7. cefoperazone
250
1000
2000*
2
5
1
56.00
156.60
-
75.00
295.00
-
19
138.4
-
65.5
248.52
-
8. cefazolin
250*
500*
1000*
1
1
1
-
-
-
-
-
-
-
-
-
-
-
-
*Prices are not available: hence cost range and mean cost cannot be calculated.
The current study reveals that there is a wide variation in the cost of different brands of
cephalosporins available in the Indian pharmaceutical market. The highest cost ratio and
percentage cost variation among orally available cephalosporins was found for the drug oral
Cefuroxime 500mg [19.29,1829.825] and least cost ratio and least percentage price variation
is for the drug Cefadroxil 500mg[1.167,16.749] and for other Cephalosporins are described in
Table-3.
www.wjpps.com Vol 9, Issue 3, 2020.
1212
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
Table 3: Drug costs, cost ratio and percentage cost variation of oral cephalosporins
available in India.
S.no Drug
(Tab/Cap)
Dose
(mg)
No.of
brands
Minimum
Cost(INR)
Maximum
Cost(INR)
Cost
Ratio
Percentage
price
variation
1. Cefaclor
125
250
375
500
750
2
8
3
3
2
156.81
169.86
376.66
465.00
686.35
216.66
446.66
457.00
620.00
858.33
1.386
2.629
1.213
1.333
1.250
101.938
162.957
21.329
33.333
25.057
2. Cefadroxil
125
250
500
5
6
5
10.48
18.98
36.30
14.00
31.20
42.38
1.335
1.643
1.167
33.587
64.38
16.749
3. Cefdinir 100*
300
1
5
-
230
-
550
-
2.391
-
139.130
4. Cefetamet 250*
500*
1
1
-
-
-
-
-
-
-
-
5. cefalexin
125
250
375
500
750
3
12
2
9
2
30.00
51.22
102.50
99.90
184.50
68.50
145.70
181.00
162.00
315.00
2.283
2.844
1.765
1.621
1.707
128.333
184.459
76.585
62.162
70.73
6. cefpodoxime
50
100
200
31
75
88
52.10
71.50
90
90
245.70
290
1.727
3.436
3.222
72.744
243.636
222.222
7. cefixime
50
100
200
400*
25
61
67
1
28.60
32.00
53.10
-
154.50
130.00
200.00
-
5.402
4.062
3.766
-
440.209
306.25
276.647
-
8. Cefuroxime
125
250
500
9
54
62
74
59
76
250.65
660.00
1466.667
3.3871
11.18
19.298
238.716
1018.64
1829.825
Among the parenteral preparations of the Cephalosporins, the highest cost ratio and
percentage cost variation was seen with Cefuroxime 750 mg [18.84, 1784.210] and the least
with the drug Ceftazidime 2000mg [1.018, 1.835] and for others are depicted in Table -4.
www.wjpps.com Vol 9, Issue 3, 2020.
1213
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
Table 4: Drug costs, cost ratio and percentage cost variation of parenteral
cephalosporins available in India.
S.no Drug
(1 Vial)
Dose
(mg)
No. of
brands
Minimum
Cost(INR)
Maximum
Cost(INR)
Cost
Ratio
Percentage
price
variation
1. cefuroxime
2.5*
250
500*
750
1500
1
6
1
19
19
-
32
-
95
175
-
66.50
-
1790
325
-
2.07
-
18.84
1.85
-
107.81
-
1784.21
85.714
2. ceftriaxone
125
250
500
1000
2000
10
35
37
47
2
18
24
33.57
50
113.75
64.14
35
60
500.34
126.80
3.56
1.45
1.787
10.00
1.114
256.33
45.833
78.73
900.68
11.472
3. Ceftizoxime 1000* 1 - - - -
4. ceftazidime
125*
250
500
1000
2000
1
5
2
11
2
-
66.00
171.00
193.75
495.90
-
132.10
202.20
340.00
505.00
-
2.001
1.182
1.754
1.018
-
100.1515
18.245
75.58
1.835
5. cefpirome 500*
1000
1
4
-
351.00
-
744.00
-
2.119
-
111.965
6. cefotaxime
125
250
500
1000
1500*
2
3
3
2
1
13.35
12.92
17.31
28.50
-
27.71
24.60
45.80
64.25
-
2.075
1.904
2.645
2.25
-
107.565
90.402
164.586
125.438
-
7. cefoperazone
250
1000
2000*
2
5
1
56.00
156.60
-
75.00
295.00
-
1.339
1.887
-
33.928
88.378
-
8. cefazolin
250*
500*
1000*
1
1
1
-
-
-
-
-
-
-
-
-
-
-
-
*Prices are not available: hence cost ratio and percentage cost variation cannot be calculated.
DISCUSSION
A number of cephalosporins have been widely trial led and are becoming available in the
world. From the analysis, Cefpodoxime holds the highest number of 194 brands in India and
Ceftizoxime has the least number of marketed brands with only 1 brand. Cefuroxime is
available in both oral and parenteral forms and remaining drugs are available in either in oral
or parenteral forms. Among the oral formulations, cefadroxil 500mg is the cheapest
preparation available in the market whereas, Ceftazidime 2000mg is the cheapest parenteral
www.wjpps.com Vol 9, Issue 3, 2020.
1214
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
preparation available in which whose prices are made available in the CIMS, July to Oct
2019.
The mean cost has been calculated for all Cephalosporins available except some preparations
whose price is not mentioned in the CIMS, July to Oct, 2019 and the mean cost for oral
Cefaclor 125mg, 250mg, 375mg, 500mg and 750mg strengths is 186.735 INR, 315.368 INR,
414.831 INR, 544.88 INR and 772.34 INR respectively. For Cefadroxil 125mg, 250mg and
500mg strengths is 12.052 INR, 27.73 INR and 39.988 INR respectively. For Cefdinir 300mg
strength is 366 INR. For Cefalexin 125mg, 250mg, 375mg, 500mg and 750mg strengths is
50.833 INR, 79.91 INR, 141.75 INR, 127.4633 INR and 249.75 INR respectively. For
Cefpodoxime 50mg, 100mg and 200mg strengths is 70.833 INR, 115.582 INR and 187.310
INR respectively. For Cefixime 50mg, 100mg and 200mg strength is 57.3904 INR, 80.139
INR and 120.838 INR respectively. For Cefuroxime available at 125mg, 250mg and 500mg
strengths as oral formulation and 250mg, 750mg and 1500mg strengths as parenteral
formulation is 140.5722 INR, 274.1694 INR, 500.336 INR and 54.15 INR 208.911 INR and
224.484 INR respectively. For Ceftriaxone available at 125mg, 250mg, 500mg, 1000mg and
2000Mg strengths as parenteral formulation is 27.501 INR, 29.2517 INR, 47.29 INR,
72.1373 INR and 120.27 INR respectively. For Ceftazidime 250mg, 500mg, 1000mg and
2000Mg strengths as parenteral formulation is 85.932 INR, 186.6 INR, 239.866 INR and
500.45 INR respectively. For Cefpirome 1000mg parenteral formulation is 495.975 INR. For
Cefotaxime available at 125mg, 250mg, 500mg and 1000mg strengths as parenteral
formulation is 20.53 INR, 17.79 INR, 27.986 INR and 46.375 INR respectively. For
Cefoperazone is available at 250mg and 1000mg is 65.5 INR and 248.52 INR respectively.
The highest cost range among the oral preparation of Cephalosporin is for the drug
Cefuroxime 500mg and the least for the drug Cefadroxil 125mg whereas among parenteral
preparations, the highest cost range is for the drug Cefuroxime 750mg and the least for
Ceftazidime 2000mg.
This study discloses that there is a major dissimilarity in costs of cephalosporins available in
India. There were 9696 adult National Health Interview Survey (NHIS) participants who
reported chronic illness; Approximately 1 in 3 chronically ill NHIS participants are unable to
afford food, medications, or both. WIC and public health insurance participation are
associated with less food insecurity and cost-related medication underuse.[8]
Many
chronically ill patients frequently cut back on medication use owing to cost. Patients are
www.wjpps.com Vol 9, Issue 3, 2020.
1215
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
selective about the treatments they forgo. Out-of-pocket costs and inadequate prescription
coverage may lead to adherence problems for many important medication types.[9]
The above
analysis shows that the highest cost ratio and percentage cost variation among orally
available cephalosporins was found for the drug Cefuroxime 750mg [19.298,1829.825] and
least for the drug Cefadroxil 500mg [1.167,16.749] and among the parenteral preparations,
the highest cost ratio and percentage cost variation was seen with Cefuroxime 500 mg
[18.84,1784.210] and the least with the drug Ceftazidime 2000mg [1.018,1.835].
Cephalosporins are the class of agents which are very commonly prescribed for the treatment
and prophylaxis of various infectious diseases. The complete resolution of the disease
depends a lot on the patient compliance. Higher medication costs are often being considered
as an important factor for medication non-adherence, dropouts/lost follow-ups and drug
resistance. Hence, the practitioner must be sensitized about the cost of therapy to make sure
adequate patient compliance.[10]
CONCLUSION
Ebullient pricing leads to increasing economic burden on the general public. Practitioners
should consider the socio-economic background of the patients, while prescribing the drugs.
To control the expense, generic medicines must be preferentially prescribed. Thus the need of
the hour is a joint cooperation from practitioners, pharmacists and general public at large to
take some action to reduce this price variation without compromising therapeutic efficacy.
ACKNOWLEDGEMENTS
Primarily, I would thank God for being able to complete this work with success. We would
like to express our sincere gratitude to Department of pharmacy practice, Karpagam College
of pharmacy for providing us all the facilities and guidance throughout the study. Then I
would like to thank our parents and friends who have helped me with their valuable
suggestions and guidance which has been helpful in various phases of completion of their
work. Last but not the least we thank all our friends for their moral support and
encouragement.
REFERENCES
1. Thakkar K. B, 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.
www.wjpps.com Vol 9, Issue 3, 2020.
1216
Priyanka et al. World Journal of Pharmacy and Pharmaceutical Sciences
2. KARVE, Ashwini V.; PAUL, Kumardeep B. Economic analysis of oral cephalosporins in
the Indian market. International Journal of Research in Medical Sciences, 2016;
4143-4149.
3. BHANDARI, Prasan R.; BHANDARY, Apeksha. Cost variation analysis of parenteral
antibiotics in Indian pharmaceutical market. International Journal of Basic & Clinical
Pharmacology, 2019; 8(11): 2535-2540.
4. National List of Essential Medicines of India. Available at., 2014; 4.
http://www.mohfw.nic.in/WriteReadData/ l892s/7364497513National%20List%20of%20
Essential%20Medicine,%202011.pdf.
5. Anne Karin Lindahl, The 2018 establishment of a national expert panel for patients with
serious life-threatening disease in Norway Health Policy, 2019; 123(5): 468-471.
6. 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.
7. Chatterjee S, Levin C, Laxminarayan R. Unit cost of medical services at different
hospitals in India. PLoS One., 2013; 8(7).
8. Treat or Eat: Food Insecurity, Cost-related Medication Underuse, and Unmet Needs,
Author links open overlay panel Seth A. Berkowitz MD ab Niteesh K. Choudhry MD, Ph
Dbd, 2014; 01: 002. https://doi.org/10.1016/j.amjmed.
9. Cost-related medication underuse among chronically III adults: the treatments people
forgo, how often, and who is at risk, John D Piette, Michele Heisler, Todd H Wagner,
American Journal of Public Health, 2004; 94(10): 1782-1787.
10. Shukla AK, Sharma P. Cost variation analysis of antidyslipidemic drugs. Int J Basic Clin
Pharmacol, 2016; 5: 1850-5.