PHARMACOECONOMIC EVALUATION OF MAJOR ORAL ANTIDIABETIC MEDICATIONS AVAILABLE IN INDIA: AN OBSERVATION STUDY

Abstract

Background: Pharmacoeconomics which evaluates the cost-effectiveness of various drug therapies, is an essential tool for optimizing healthcare resource allocation. It allows policymakers and healthcare providers to assess the value of a drug based on its clinical effectiveness, cost, and impact on quality of life. In countries like India, where out-of-pocket expenditure accounts for more than 60% of total healthcare spending, pharmacoeconomic evaluations are crucial for making rational therapeutic decisions.² 

Material & Methods: The cost data for each selected antidiabetic drug and its various branded versions were obtained from the Current Index of Medical Specialties (CIMS) database. Prices were recorded for a standard pack size of 10 tablets per brand. The key cost-related metrics analyzed were: Cost Ratio which  indicates how many times the most expensive brand is costlier than the least expensive brand for the same drug and Percentage Price Variation which  measures reflects the extent of price disparity among brands for the same drug.

Results: The Metformin + Glimepiride combination had the highest price variation among FDCs (372%). The Metformin + Sitagliptin combination showed a relatively lower variation (187%) but remained expensive overall. Boxplot analysis showing cost variation across different antidiabetic drug classes clearly indicates greater cost dispersion in newer drug classes like DPP-4 inhibitors and SGLT-2 inhibitors compared to older drugs like metformin and sulfonylureas.

Conclusion: Among the evaluated oral antidiabetic agents, metformin and glimepiride emerged as the most cost-effective choices, offering significant glycemic control at minimal cost.