Cost variation analysis of anti-epileptic drugs available in the Indian market

Abstract

Background: Epilepsy is a chronic, noncommunicable disease of the brain affecting 50 million people worldwide. Out-of-pocket expenditure (OOPE) remains a major burden for Indian households, leading to poor adherence in epilepsy treatment. Many patients discontinue therapy due to high costs, worsening disease outcomes. This study aimed to analyse price variations among different brands of anti-epileptic drugs (AEDs) available in India. Methods: The prices in Indian rupees for all AEDs of same strength manufactured by different pharmaceutical companies in the Indian market were obtained from Current Index of Medical Specialities (CIMS) 3rd update 2024, Indian drug review (IDR) 2024 issue and National Pharmaceutical Pricing Authority (NPPA)-Pharma Sahi Daam. The cost ratio was calculated by dividing the price of the costliest brand by the price of the least costly brand. The percentage cost variation was determined by subtracting the minimum cost from the maximum cost, dividing it by the minimum cost and multiplying by 100. Results: Analysis of 1708 brands of 23 single AEDs and 112 brands of fixed dose combinations (FDCs) in India revealed wide cost variations. Clonazepam showed highest percentage cost variation and cost ratio among single drugs, while Oxcarbazepine and Sodium valproate had the lowest percentage cost variation and cost ratio, respectively. Conclusions: The study highlights significant cost disparities among different brands of AEDs, affecting patients’ OOPEs. Clinicians should therefore consider these price variations to prescribe cost-effective treatments, improving patient compliance and disease outcomes. The findings also emphasize need for regulatory measures to promote equitable and affordable drug pricing