Cost minimization analysis of generic and innovator formulations of antihypertensive drugs

Background: Hypertension, a chronic condition requiring lifelong care, affects approximately 25.3% Indian population. Average annual hypertension management cost which also includes medication cost varies from Rs. 4042 to 7621, amounting up to 40% of total household income of few families. Selection of a different brand or generic formulation may have an immense impact on total expenditure for treatment of hypertension. Present study aims at determining cost variability and cost analysis of various single drug antihypertensive formulations available in Indian market.Methods: One most prescribed drug, each from Joint National Committee recommended antihypertensive- thiazide diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin-receptor blockers and β blockers were selected for cost analysis. Cheapest, costliest and median priced formulations were searched for individual drugs and were compared to the price of their generic counterparts.Results: Generic formulations of hydrochlorothiazide, amlodipine, enalapril, losartan and atenolol were cheaper even than their respective cheapest innovator formulations. Costliest innovator formulation of amlodipine was 1750% expensive than generic one. Costliest counterparts of generic formulations were many folds overpriced. Similarly, innovator formulation of losartan was up to 953.89% costly than generic one. Innovator formulations of hydrochlorothiazide were the least costly than its generic counterpart, yet being at least 150% more expensive. Also, there exists considerable broad range of price among similar innovator formulations.Conclusions: By prescribing generic antihypertensive drug, we can reduce treatment expenditure by many folds. Same feat can be marginally achieved by using lower cost innovator formulations

Bronchodilatory effect of Zingiber officinale Roscoe (ginger) in guinea pigs

Purpose: To determine the bronchodilatory effect of ginger on histamine-induced bronchospasm in guinea pigs. Methods: Thirty-six guinea pigs weighing 400 - 700 g were randomly divided into six groups. Group 1 received distilled water, while group 2 was given formoterol (1.55 μg/kg) + budesonide (0.02 mg/kg). Guinea pigs in groups 3 and 4 were given ginger (350 and 700 mg/kg, respectively), while those in groups 5 and 6 received ginger (350 and 700 mg/kg, respectively) in addition to formoterol (1.55 μg/kg) and budesonide (0.02 mg/kg). Pre-convulsion time and percent protection in each group was calculated. Results: There was statistically significant improvement in pre-convulsion times, with values of 156.64 ± 32.93, 299.33 ± 44.20, and 235.99 ± 34.55 s for groups 2, 5 and 6, respectively (p < 0.01). Moreover, statistically significant protection values of 73 and 68 % were obtained for groups 5 and 6, respectively, relative to normal control (p < 0.01). Conclusion: These results indicate that ginger has promising potential for use as an add-on treatment for bronchospasm. Keywords: Zingiber officinale, Histamine, Asthma, Pre-convulsion tim