Cost of treating bacterial infections in India: A cost minimization analysis to assess price variations

Abstract

Cost of drug therapy is a major concern for patients in developing countries. Indian government has launched a generic drug ('Jan Aushadhi') scheme to provide cheaper medicines. This cost minimization analysis was carried out to assess cost of treatment regimens for common bacterial infections, and variations in costs arising due to generic or branded prescribing. Various regimens recommended for common bacterial infections were noted from the national guidelines for antimicrobial use in India. The unit prices of antibacterial formulations available under the generic drug scheme were noted, and the median, maximum - minimum unit prices of branded formulations were calculated from a recognised commercial drug directory. Total cost of therapy for each regimen, and the variations in cost with generic and branded therapy were then calculated. Out of 68 regimens analysed for 24 bacterial infections, the cheapest regimen was for treating cholera (INR 3.48 - generic, INR 8.7 - median branded prescription) whereas the costliest was for infective endocarditis (INR 3912 - generic, INR 11823.84 - median branded prescription). Treatment costs varied significantly with prescription of maximum and minimum priced brands, ranging from 69.81% to 14900%. Branded therapy was more than 3 times costlier than generic therapy in 36 (52.9 %) regimens. In 51 (75 %) regimens, the variation in cost of treatment between maximum and minimum priced branded therapy was more than 100%, while in 21 (30.9 %) regimens it was more than 1000 %. Significant variations in cost of therapy due to differences in prescribing place a direct burden on the patients' pockets, and should be considered by physicians.