Pharmacoeconomic Analysis of Fixed-Dose Combinations of Proton Pump Inhibitors Available in India

Pradnya Deolekar; Kavita Vivek; Souvik Ghosh; Azra Naseem; Mayakalyani Srivathsan; Vivek S Rai; Sonal Signapurkar; Pramila Yadav

doi:10.7759/cureus.36112

Pharmacoeconomic Analysis of Fixed-Dose Combinations of Proton Pump Inhibitors Available in India

Cureus. 2023 Mar 14;15(3):e36112. doi: 10.7759/cureus.36112. eCollection 2023 Mar.

Authors

Pradnya Deolekar¹, Kavita Vivek¹, Souvik Ghosh², Azra Naseem¹, Mayakalyani Srivathsan¹, Vivek S Rai¹, Sonal Signapurkar¹, Pramila Yadav¹

Affiliations

¹ Pharmacology, D. Y. Patil Deemed to be University, Navi Mumbai, IND.
² Critical Care, D. Y. Patil Hospital, Navi Mumbai, IND.

Abstract

Introduction The global proton pump inhibitors (PPIs) market was valued at US$ 2.9 billion in 2020 and is expected to exhibit a compound aggregated growth rate of 4.30% during the forecast period (2020-2027), as they are regularly prescribed for many gastrointestinal disorders, and the treatment usually lasts for a longer period. PPIs are usually combined with antiemetics and prokinetic drugs. The price of PPIs for the same combination varies a lot, which can lead to a lot of financial burden on the patients. Objective To evaluate the cost ratio and percentage cost variation of commonly used PPIs in various combinations. Methodology The cost of different brands of commonly used PPIs in combination with other drugs was analyzed in our study. A total of 21 different combinations (10 capsules/tablets for oral use) were tabulated by referring to the "Monthly Index of Medical Specialities" October-December 2021, and 1mg online pharmacy. The cost ratio and percentage cost variation for various brands of a particular strength and dosage form were calculated and compared. Cost ratio > 2 and cost variation > 100% were considered significant. Results The results show a huge variation (1788.88%) in costs of different brands with the highest being rabeprazole 20 mg and domperidone 10 mg (cost ratio: 18.88, percentage cost variation: 1788.88%) in oral formulation, followed by pantoprazole 40 mg and itopride 150 mg. The minimum cost ratio (1.35) and percentage cost variation (1.35%) is for pantoprazole 40 mg and levosulpiride 75 mg. Logistic regression analysis between the number of brands and percentage cost variation gives an R² value of 0.0923. Conclusion There is a wide variation in the prices of PPIs available in the market, which can inadvertently increase the financial burden of therapy on patients. Physicians need to be made aware of these price differences so that they can choose the best available alternative for patients, which can help in increasing compliance with the prescribed drugs.

Keywords: health economics; pharmaceutical company; pharmacoeconomics; prescriptions; proton pump inhibitors.