Cost variation analysis of various brands of anti-epileptic drugs currently available in Indian pharmaceutical market

Background: Epilepsy is a common neurological disorder affecting about 10 million persons in India. The compliance to a particular antiepileptic drug is highly dependent on the cost of the drug which directly translates into success or failure of therapy. Hence there is a need for all clinicians to keep themselves updated with the latest prices and price variation of the commonly prescribed drugs. This study aims to analyze cost variation of various brands of anti-epileptic drugs currently available in Indian pharmaceutical market.Methods: Current Index of Medical Specialities July-October 2016 edition was referred to know the maximum and minimum price in INR of various brands of anti- epileptic drugs in India. Further analysis was done by using Percentage Cost Variation.Results: There is wide variation in the prices of different brands of same antiepileptic agents in Indian market. The highest % cost variation was found for diazepam 5mg tablet (374.42), followed by lorazepam 2mg tablet (213.63), carbamazepine 100mg syrup/5ml-100ml (172.58), levetiracetam 1000mg FC-tablet (168.57), lamotrigine 25mg DIS- tablet (150), clobazam 10mg tablet (147.37), clonazepam 0.5mg tablet (145.90), oxcarbazepine 150mg tablet (89.46), gabapentin 300mg capsule (71.67), valproic acid 200mg FC-tablet (58.62), divalproex sodium 500mg ER-tablet (47.82), topiramate 50mg tablet (41.66) and lowest % cost variation was of phenytoin sodium 300mg tablet (0.23).Conclusions: The average percentage price variation of different brands of same oral anti-epileptic drug in Indian market is very wide. To counter act such cost variation, physicians should be encouraged to prescribe a medication brand with low cost. This in turn reduces the unnecessary economic burden to the patients.

MS Patients Report Excellent Compliance with Oral Prednisone for Acute Relapses

Background:Multiple Sclerosis is characterized by relapses separated by periods of relative quiescence. High dose intravenous corticosteroid pulses for three to five days is the current standard for the treatment of acute relapses, but recent evidence supports the use of equivalent doses of oral therapy as an alternative. The highest single dose preparation of oral prednisone is a 50mg tablet, requiring patients to take 25 tablets a day. Questions regarding compliance with this oral regimen have been raised.Objectives:To determine whether MS patients are complaint with 1250mg of oral prednisone daily for acute relapses.Methods:Between November 2008 and December 2009, all patients diagnosed with an acute relapse in the London (Ontario) MS clinic were prospectively identified. If treatment with oral prednisone was initiated, subjects were given a survey to be mailed anonymously to the clinic.Results:Sixtyeight MS relapses were diagnosed and treated with corticosteroids in 66 patients of which 60 (58 subjects) were treated with 1250mg prednisone. Fifty-three (91.4%) surveys were returned. The reported compliance rate was high at 94.3% (50/53) with only one patient reporting being unable to take all the required pills due to intolerance. Most subjects (43, 86.0%) encountered at least one side effect, most commonly insomnia, mood changes and increased appetite. Two thirds of subjects (69.8%) indicated a preference for oral medication for future relapses.Conclusion:High dose (1250mg) oral prednisone is an acceptable therapy to MS patients for the treatment of acute relapses with a high rate of compliance.