Main Article Content
Abstract
Background
Diabetes mellitus, a chronic condition, requiring lifelong care, affects multiple organs on long term. In India, 8.8% adults suffer from diabetes in 2019 and prevalence is likely to rise up to 11.1% by 2045. Total expenditure behind diabetes varies around 12.6 to 34% in different income groups among rural and urban families. Out of these expenses major portion is spent behind cost of medication. Cost of medicines varies among various company brands and generic products, and hence expenditure on cost of medication can be decreased by proper drug selection. Present study aims at determining cost variability and cost analysis of various antidiabetic formulations available in Indian market.
Materials and methods
Metformin and its combinations with sulfonylureas, pioglitazone and vogliboze were selected for cost analysis in present study. Among sulfonylureas, glibenclamide, gliclazide, glimepiride and glipizide were selected. Cheapest, costliest and median priced formulations were searched for individual drugs and were compared to the price of their generic counterparts.
Results
Innovator formulations for metformin 500mg, 500mg SR, 1000mg SR and combination of metformin 500mg with glipizide 5mg were available at cheaper rate than their generic counterparts. Price of other combinations’ cheaper formulations were at least 119.17% to 257.5% higher than generic formulations. Considerable cost variation was observed among different brands, price of costliest preparations are 2.11 to 7.89 times higher than cheapest innovator formulation price.
Conclusion
Innovator formulations of metformin were available at cheaper cost than generic formulations. For combinations of metformin with other antidiabetic drugs, generic were the cheapest one. By prescribing generic antidiabetic formulations or lower cost innovator formulations, one can reduce treatment expenditure by many folds.
Keywords
Article Details
References
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References
[1]. IDF Diabetes Atlas 9th edition Available from: https://www.diabetesatlas.org/en/. 2019.
[2]. Diabetes [Internet] 2010. Available from: https://www.who.int/westernpacific/health-topics/diabetes
[3]. Insulin Resistance & Prediabetes | NIDDK [Internet]. National Institute of Diabetes and Digestive and
Kidney Diseases. 2019. Available from:
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin- resistance
[4]. Kahn BB. Type 2 diabetes: when insulin secretion fails to compensate for insulin resistance. Cell. 92(5),
1998, 593–6.
[5]. Ahren B. Type 2 Diabetes, Insulin Secretion and β-Cell Mass [Internet]. 2005. Available from:
https://www.ingentaconnect.com/content/ben/cmm/2005/00000005/00000003/art00003
[6]. Aronson D. Hyperglycemia and the pathobiology of diabetic complications. Adv Cardiol. 45, 2008, 1–16.
[7]. J V, Chavan VR, Arshad M, M R, Fayazuddin M. Non-adherence to anti- diabetic therapy and its consequences among type-2 diabetic patients in a tertiary care hospital. International Journal of Basic & Clinical Pharmacology. 6(6), 2017, 1348–51.
[8]. Sajith M, Pankaj M, Pawar A, Modi A, Sumariya R. Medication adherence to antidiabetic therapy in patients with type 2 diabetes mellitus. In 2014.
[9]. Ramachandran A, Ramachandran S, Snehalatha C, Augustine C, Murugesan N, Viswanathan V, et al.
Increasing Expenditure on Health Care Incurred by Diabetic Subjects in a Developing Country: A study from
India. Diabetes Care. 30(2), 2007, 252–6.
[10]. Abidi A, Rizvi DA, Ahmad a. Pharmacoeconomic and drug utilization study of antidiabetic therapy in a tertiary care teaching hospital of northern india. 9(3), 2016, 6.
[11]. IDR Triple I Compendium. In: Bengaluru: CIMS Medica India Pvt Ltd; 2019, 217–25.
[12]. CIMS Medica. In:Bangaluru: CIMS Medica India Pvt Ltd; 146, 366–80.