A Comprehensive Cost Variation Analysis of Drugs Used in the Management of Type-2 Diabetes Mellitus Across India
Abstract
Background: This study aims to examine the cost variations of oral antidiabetic agents in India, highlighting the financial barriers that may impact patient adherence and treatment efficacy. Methods: This analytical study was performed by analysing the prices of 18 oral antidiabetic drugs with 42 formulations. Data was collected from the National Pharmaceutical Pricing Authority (NPPA) platform, focusing on single-drug tablet formulations. Price variations were assessed using cost ratios and percentage cost variations. Compliance with the Drug Price Control Order (DPCO) ceiling prices were also analysed. Results: The study revealed significant price variations among different brands of the same drug, with voglibose 0.3 mg exhibiting the highest cost ratio (1:139.92) and percentage variation (13892.30%). Additionally, a notable proportion of brands exceeded the DPCO ceiling prices, particularly metformin 1000 mg, where 9 out of 15 brands were non-compliant to the ceiling price. Conclusion: Despite the presence of a regulatory authority, substantial price variability among oral antidiabetic agents persists in India, potentially affecting patient adherence and health outcomes. The violations of DPCO pricing regulations indicate a need for stricter enforcement and expansion of price controls to ensure the affordability of essential medications and improve overall patient care.
[1] Sapra A, Bhandari P. Diabetes. [Updated 2023 Jun 21]. [Accessed on 2024 Sep 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551501
[2] Mekala KC, Bertoni AG. Epidemiology of diabetes mellitus. InTransplantation, bioengineering, and regeneration of the endocrine pancreas 2020 Jan 1 (pp. 49-58). Academic Press. https://doi.org/10.1016/B978-0-12-814833-4.00004-6
[3] Bommer C, Sagalova V, Heesemann E, Manne-Goehler J, Atun R, Bärnighausen T, Davies J, Vollmer S. Global economic burden of diabetes in adults: projections from 2015 to 2030. Diabetes care. 2018 May 1;41(5):963-70. https://doi.org/10.2337/dc17-1962
[4] Lorber D. Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2014 May 23:169-83. https://doi.org/10.2147/DMSO.S61438
[5] Rubin RR. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med. 2005 May 1;118(5):27-34. https://doi.org/10.1016/j.amjmed.2005.04.012
[6] Thomas M. Rational drug use and essential drug concept. In: Parthasarthi G, Nyfort-Hasen K, eds. A Textbook of Clinical Pharmacy Practice. 1st ed. Himayatnagar, Hyderabad: Orient Longman; 2004. p. 72-3.
[7] Thacker Ks, Mistry Vr, Kanani Nj. Oral Antidiabetics Agents Available In Indian Pharmaceutical Market: A Price Variation Analysis. Asian J Pharm Clin Res. 2020;13(3):143-7.
[8] Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy. 2014 Feb 20:35-44. https://doi.org/10.2147/RMHP.S19801
[9] Karymsakov A, Foster F, Toleubekova L, Yegembayeva N, Gaipov A, Aljofan M. The nonadherence to prescriptions among type 2 diabetes patients, and its determining factors. Electron J Gen Med. 2024 Feb 1;21(1).
[10] Muralidharan S. Diabetes and current Indian scenario: A narrative review. Journal of Diabetology. 2024 Jan 1;15(1):12-7. https://doi.org/10.4103/jod.jod_93_23
[11] Zhou X, Shrestha SS, Shao H, Zhang P. Factors contributing to the rising national cost of glucose-lowering medicines for diabetes during 2005–2007 and 2015–2017. Diabetes Care. 2020 Oct 1;43(10):2396-402. https://doi.org/10.1016/j.healthpol.2014.03.010
[12] Mehani R, Sharma P. Cost variation analysis of oral anti-diabetic drugs. Int J Basic Clin Pharmacol. 2018 Sep;7(9):1709-4. https://doi.org/10.18203/2319-2003.ijbcp201
[2] Mekala KC, Bertoni AG. Epidemiology of diabetes mellitus. InTransplantation, bioengineering, and regeneration of the endocrine pancreas 2020 Jan 1 (pp. 49-58). Academic Press. https://doi.org/10.1016/B978-0-12-814833-4.00004-6
[3] Bommer C, Sagalova V, Heesemann E, Manne-Goehler J, Atun R, Bärnighausen T, Davies J, Vollmer S. Global economic burden of diabetes in adults: projections from 2015 to 2030. Diabetes care. 2018 May 1;41(5):963-70. https://doi.org/10.2337/dc17-1962
[4] Lorber D. Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2014 May 23:169-83. https://doi.org/10.2147/DMSO.S61438
[5] Rubin RR. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med. 2005 May 1;118(5):27-34. https://doi.org/10.1016/j.amjmed.2005.04.012
[6] Thomas M. Rational drug use and essential drug concept. In: Parthasarthi G, Nyfort-Hasen K, eds. A Textbook of Clinical Pharmacy Practice. 1st ed. Himayatnagar, Hyderabad: Orient Longman; 2004. p. 72-3.
[7] Thacker Ks, Mistry Vr, Kanani Nj. Oral Antidiabetics Agents Available In Indian Pharmaceutical Market: A Price Variation Analysis. Asian J Pharm Clin Res. 2020;13(3):143-7.
[8] Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy. 2014 Feb 20:35-44. https://doi.org/10.2147/RMHP.S19801
[9] Karymsakov A, Foster F, Toleubekova L, Yegembayeva N, Gaipov A, Aljofan M. The nonadherence to prescriptions among type 2 diabetes patients, and its determining factors. Electron J Gen Med. 2024 Feb 1;21(1).
[10] Muralidharan S. Diabetes and current Indian scenario: A narrative review. Journal of Diabetology. 2024 Jan 1;15(1):12-7. https://doi.org/10.4103/jod.jod_93_23
[11] Zhou X, Shrestha SS, Shao H, Zhang P. Factors contributing to the rising national cost of glucose-lowering medicines for diabetes during 2005–2007 and 2015–2017. Diabetes Care. 2020 Oct 1;43(10):2396-402. https://doi.org/10.1016/j.healthpol.2014.03.010
[12] Mehani R, Sharma P. Cost variation analysis of oral anti-diabetic drugs. Int J Basic Clin Pharmacol. 2018 Sep;7(9):1709-4. https://doi.org/10.18203/2319-2003.ijbcp201
| Files | ||
| Issue | Vol 10 No 3 (2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Cost variation analysis Antidiabetic agents Drug Price Control Order Diabetes Mellitus | ||
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How to Cite
1.
D.G A. A Comprehensive Cost Variation Analysis of Drugs Used in the Management of Type-2 Diabetes Mellitus Across India. JPPM. 2025;10(3).
