Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 1;56(2):97-104.
doi: 10.4103/ijp.ijp_61_23. Epub 2024 Apr 30.

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

Preeta Kaur Chugh  1 , Pooja Gupta  2 , Himika Wasan  2 , C D Tripathi  3 , Sujith J Chandy  4 , Jaya Ranjalkar  4 , Heber Rew Bright  4 , Dinesh Kumar Badyal  5 , Madhulika Peter Samuel  5 , Ratinder Jhaj  6 , Aditya Banerjee  6 , Rupa Joshi  7 , Bikash Medhi  7 , Ajay Prakash  7 , Sandhya Kamat  8 , Raakhi Tripathi  8 , Yashashri Shetty  8 , Urwashi Parmar  8 , Harihar Dikshit  9 , Hitesh Mishra  9 , Sukalyan Saha Roy  9 , Rajiv Kumar  9 , Suparna Chatterjee  10 , Manjari Bhattacharya  10 , Kalyan Samanta  10 , Niyati Trivedi  11 , Prashant Shah  11 , Janki Chauhan  11 , Raveendran Ramasamy  12 , Jayanthi Mathaiyan  12 , Jeevitha Gauthaman  12 , Sandeep Kaushal  13 , Samriti Jain  13 , Shalini Arora  13 , Kanchan Gupta  13 , Jerin Jose Cherian  14 , Nabendu Sekhar Chatterjee  14 , Nilima Arun Kshirsagar  14
Affiliations

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

Preeta Kaur Chugh et al. Indian J Pharmacol. .

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.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Average price per medicine per year presented in Indian rupee (INR) when prescribed as National List of Essential Medicines (NLEM) versus non-NLEM on the left and generic versus branded on the right. The box and whiskers represent median (minimum–maximum value). NLEM = National List of Essential Medicines, N-NLEM = Non-NLEM
See this image and copyright information in PMC

References

    1. Global Burden of Disease Health Financing Collaborator Network. Past, present, and future of global health financing: A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. Lancet. 2019;393:2233–60. - PMC - PubMed
    1. National Health Accounts-2017-18.pdf –Google Search. [Last accessed on 2022 Feb 12]. Available from:https://www.google.com/search?q=National+Health+Accounts-+2017-18.pdf&rl... .
    1. Motkuri V, Mishra RN. Pharmaceutical market and drug price policy in India. Rev Dev Chang. 2020;25:30–53.
    1. Barik D, Arokiasamy P. Rising health expenditure due to non-communicable diseases in India: An outlook. Front Public Health. 2016;4:268. - PMC - PubMed
    1. Report on Medical Certification of Cause of Death. Office of the Registrar General, India Government of India. 2013. [Last accessed on 2022 Feb 28]. Available from:https://www.censusindia.gov.in/2011-Documents/mccd_Report1/Mccd_2013.pdf .

Publication types

MeSH terms