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

Comparative Study of Seismic Analysis of Pier Supported on Pile as per IRC:6-2017 and IRC SP:114-2018

This paper depicts the study of seismic analysis of reinforced concrete bridge piers as per provisions of Indian Road Congress (IRC) guidelines. Bridges are designed having two main structural elements named – “Superstructure” and “Substructure”. Superstructure consists of deck and supporting girder/truss system below deck. Substructure includes Abutments, Piers, Portals and Foundations. Amongst these, Abutments/Piers are crucial part of bridge. Therefore, as per the seismic design philosophy, it is necessary to study the seismic behaviour of bridge piers. With the advancements in technology and subsequent researches in Infrastructure fields, IRC guidelines are updated and revised time-to-time. Introduction of IRC SP:114-2018 guideline for earthquake forces in bridges is an example of such developments. In this research, seismic analysis of Reinforced Cement Concrete (RCC) bridge pier is carried out as per provisions of prevailing guideline IRC:6-2017. Base shear value of IRC:6-2017 is compared with IRC SP:114-2018 which now supersedes seismic provisions of IRC:6-2017. For analysis, different span lengths of 25 m, 30 m and 36 m are used. To assess the impact of height of piers in earthquake analysis, various pier heights such as 10 m, 20 m and 30 m are assumed. The analysis is carried out as per Elastic Seismic Acceleration Method with consideration of different zones and importance of the bridge as per IRC guidelines. Effect of vertical ground motion is also considered in analysis. From analysis, it is observed that base shear and vertical forces have been increased remarkably as per IRC SP:114-2018 compared to IRC:6-2017