Disparity between cost variation of antibiotics in northern and western India: A cross-sectional study

Abstract

Background- About 58% of India’s health expenditure is out of pocket expenditure. There is a wide variation in the cost of different brands of the same generic drug. Prescription of expensive brands of antibiotics contributes to the development of antibiotic resistance. There is literature available on the cost variation and cost ratio of antibiotics but none on the regional disparity.

Materials and Methods- An observational cross-sectional study design was adopted. The study was conducted at the medical stores of Aligarh (Uttar Pradesh) and Mumbai (Maharashtra). The maximum and minimum cost/unit in Rupees (INR) of each antibiotic manufactured by multiple pharmaceutical companies was noted. Furthermore, Cost per daily defined dose (cost/DDD) was calculated for the most expensive and least expensive drug.

Results-

ALIGARH- The highest percent cost variation of 1897.14 and cost ratio of 19.97 was found for Piperacillin 4000mg + Tazobactam 500mg tablets. The least percent cost variation of 48.92 and cost ratio of 1.49 was found for ciprofloxacin 200mg vial.

MUMBAI- The highest cost variation of 3031.05 and cost ratio of 31.31 was found for cefixime 200 mg tablets. The least percent cost variation of 6.43 and cost ratio of 1.06 was found for ciprofloxacin 200 mg vial.

Conclusions- There is disparity in the cost variation and ratio between the two cities Aligarh and Mumbai in this study, which can be attributed to availability of different brands, under a generic group, in the different regions of the country.