COST ANALYSIS OF COMMONLY USED DRUGS UNDER PRICE CONTROL IN INDIA: ASSESSING THE EFFECT OF DRUG PRICE CONTROL ORDER ON BRAND PRICE VARIATION

Objective: Rising cost of medical therapy is a major concern for patients, and there is high variability in the prices of numerous branded medicines available in India. Drug Price Control Order (DPCO) 2013 was implemented by the government of India with the aim of bringing down the cost of essential medicines. This cost analysis study was carried out to assess the brand price variation in major classes of common drugs under price control; thus assessing the impact of DPCO and analyse issues related to it.Methods: Latest price list of available brands for cardiovascular drugs, antibacterial, analgesics, drugs for diabetes, asthma, arthritis, convulsions covered under the DPCO, was procured from a leading commercial drug directory. Unit prices of drug formulations available as different brands were compared. Maximum-minimum prices and average prices were found. Price variations between brands were calculated and expressed as percentage variations. Assessment of existing pricing policy and quality norms was done.Results: Significant inter-brand price variations were found for the majority of formulations. These variations ranged from more than 100 % from average to more than 500 % between maximum and minimum brand prices for drugs like amlodipine, atorvastatin, diclofenac, amoxicillin-clavulanic acid, clopidogrel. Out of 60 formulations observed, 40 showed price variations in excess of 50 % from average price and 23 showed variations greater than 200 % between the costliest and cheapest brands.Conclusion: Despite the implementation of price control, brand price variations still exist widely for commonly used drugs. Re-assessment of pricing policy and implementation of quality norms is needed.Keywords: Pharmacoeconomics, Price control, Brands, Price variation, Essential medicine

Cumulative effects in inflation with ultra-light entropy modes

In multi-field inflation one or more non-adiabatic modes may become light, potentially inducing large levels of isocurvature perturbations in the cosmic microwave background. If in addition these light modes are coupled to the adiabatic mode, they influence its evolution on super horizon scales. Here we consider the case in which a non-adiabatic mode becomes approximately massless ("ultralight") while still coupled to the adiabatic mode, a typical situation that arises with pseudo-Nambu-Goldstone bosons or moduli. This ultralight mode freezes on super-horizon scales and acts as a constant source for the curvature perturbation, making it grow linearly in time and effectively suppressing the isocurvature component. We identify a Stuckelberg-like emergent shift symmetry that underlies this behavior. As inflation lasts for many e-folds, the integrated effect of this source enhances the power spectrum of the adiabatic mode, while keeping the non-adiabatic spectrum approximately untouched. In this case, towards the end of inflation all the fluctuations, adiabatic and non-adiabatic, are dominated by a single degree of freedom.Comment: 27 pages, 1 figure; v2: improved discussions, version published in JCA

Heavy fields, reduced speeds of sound, and decoupling during inflation

121301Theoretical Physic

Detection of Bulbar Dysfunction in ALS Patients Based on Running Speech Test

This paper deals with detection of speech changes due to amyotrophic lateral sclerosis (ALS) – fatal neurological disease with no cure. The detection process is based on analysis of running speech test. However, in contrast to conventional frame-based classification (in which whole signal is analyzed) we proposed to use selected vowels extracted from the test signal. It is shown that similarity of spectral envelopes of different vowels and formant frequencies are crucial features for bulbar ALS detection. Applying the proposed features to classifier base on linear discriminant analysis (LDA) the detection accuracy of 84.8% is achieved

Intuitive control of rolling sound synthesis

International audienceThis paper presents a rolling sound synthesis model which can be intuitively controlled. To propose this model, different aspects of the rolling phenomenon are explored : physical modeling, perceptual attributes and signal morphology. A source-filter model for rolling sounds synthesis is presented with associated intuitive controls

DEVELOPMENT OF COMPOSITE BUBALINE CANCELLOUS BONE XENOGRAFTS BY SEEDING GUINEA PIG FETAL OSTEOBLASTS

Xenografts are considered as an alternative strategy to restore a critical-sized bone defect. The present study was conducted to standardize the technique for seeding and cryopreservation of decellularized bubaline cancellous bone with Guinea pig fetal osteoblast for the development of a composite bone xenograft. The composite bone grafts were prepared by seeding the expanded osteoblasts on the acellular bubaline cancellous bone matrix. The foetal osteoblast seeded scaffold, acellular bone scaffold, and native bovine bone were analyzed using scanning electron microscopy (SEM) and histological examination. Composite bone xenograft was cryopreserved in 10% glycerol at - 80°C for three months and evaluated for post-thaw viability. Findings from the in vitro study suggested that the seeding of acellular scaffold was adequate, and osteoblasts had good adhesion and proliferation inside pores of acellular bone matrix. Histologically the integrity of collagen matrix was best preserved in the acellular group as compared to the freshly seeded and cryopreserved scaffold. The osteoblast seeded decellularized bubaline cancellous bone xenografts can be preserved for three months with adequate cell viability in the post-thaw evaluation at – 80°C in sterile tubes containing 10% glycerol as the cryoprotectant

An Arthroscopic Device to Assess Articular Cartilage Defects and Treatment with a Hydrogel

The hydraulic resistance R across osteochondral tissue, especially articular cartilage, decreases with degeneration and erosion. Clinically useful measures to quantify and diagnose the extent of cartilage degeneration and efficacy of repair strategies, especially with regard to pressure maintenance, are still developing. The hypothesis of this study was that hydraulic resistance provides a quantitative measure of osteochondral tissue that could be used to evaluate the state of cartilage damage and repair. The aims were to (1) develop a device to measure R in an arthroscopic setting, (2) determine whether the device could detect differences in R for cartilage, an osteochondral defect, and cartilage treated using a hydrogel ex vivo, and (3) determine how quickly such differences could be discerned. The apparent hydraulic resistance of defect samples was ~35% less than intact cartilage controls, while the resistance of hydrogel-filled groups was not statistically different than controls, suggesting some restoration of fluid pressurization in the defect region by the hydrogel. Differences in hydraulic resistance between control and defect groups were apparent after 4 s. The results indicate that the measurement of R is feasible for rapid and quantitative functional assessment of the extent of osteochondral defects and repair. The arthroscopic compatibility of the device demonstrates the potential for this measurement to be made in a clinical setting