Abstract

Research Article

Cost Variation Analysis of Various Brands of Anti-Depressants Agents Currently Available in Indian Markets

Manpreet, Shamsher Singh, GD Gupta and Khadga Raj Aran*

Published: 21 June, 2023 | Volume 7 - Issue 1 | Pages: 017-021

Depression is a mental, psychiatric medical condition or disorder in which individuals manifest some clinical syndrome characterized by sadness, mood swings, societal withdrawal, lack of interest, family issues, and education problems which affect the daily student life in which the individual does not participate in daily activities. Sometimes individual commits suicide due to exam stress and that swings the mood upon the condition of the individual. The cost of brand-name medications prescribed in such circumstances exacerbates the disease burden and may even result in noncompliance with therapy. IDR (Indian Depository Receipt) was used to calculate the cost of various antidepressant drug brands. Using the percentage cost ratio, one can ascertain the price of each brand’s 10 tablets in INR (Indian Rupees), the cost ratio, and the percentage cost variance. The difference between the greatest and lowest prices of the same drug produced by Indian pharmaceutical industries was calculated. There is a greater price disparity between agents on the market. The greatest expense variance was found to be amitriptyline 25 mg (195%), fluoxetine 50 mg (95%), sertraline 50 mg (83%) and the lowest 
% cost variation was of fluvoxamine 20 mg (13.8 mg), duloxetine 20 mg (16%) and escitalopram 
10 mg (38%). On the Indian market, the average price disparity between antidepressant medications of various brands is quite high. If a pricey brand is prescribed, patients will incur additional costs.

Read Full Article HTML DOI: 10.29328/journal.jnnd.1001076 Cite this Article Read Full Article PDF

Keywords:

Anti-depressant; Cost variation; Amitriptyline; Fluoxetine; Sertraline

References

  1. Goldman LS, Nielsen NH, Champion HC. Awareness, diagnosis, and treatment of depression. J Gen Intern Med. 1999 Sep;14(9):569-80. doi: 10.1046/j.1525-1497.1999.03478.x. PMID: 10491249; PMCID: PMC1496741.
  2. Lewinsohn PM, Rohde P, Seeley JR, Fischer SA. Age-cohort changes in the lifetime occurrence of depression and other mental disorders. J Abnorm Psychol. 1993 Feb;102(1):110-20. doi: 10.1037//0021-843x.102.1.110. PMID: 8436687.
  3. Rottenberg J, Kasch KL, Gross JJ, Gotlib IH. Sadness and amusement reactivity differentially predict concurrent and prospective functioning in major depressive disorder. Emotion. 2002 Jun;2(2):135-46. doi: 10.1037/1528-3542.2.2.135. PMID: 12899187.
  4. Der-Avakian A, Mazei-Robison MS, Kesby JP, Nestler EJ, Markou A. Enduring deficits in brain reward function after chronic social defeat in rats: susceptibility, resilience, and antidepressant response. Biol Psychiatry. 2014 Oct 1;76(7):542-9. doi: 10.1016/j.biopsych.2014.01.013. Epub 2014 Jan 31. PMID: 24576687; PMCID: PMC4117827.
  5. Uher R, Payne JL, Pavlova B, Perlis RH. Major depressive disorder in DSM-5: implications for clinical practice and research of changes from DSM-IV. Depress Anxiety. 2014 Jun;31(6):459-71. doi: 10.1002/da.22217. Epub 2013 Nov 22. PMID: 24272961.
  6. Pfennig A, Ritter PS, Höfler M, Lieb R, Bauer M, Wittchen HU, Beesdo-Baum K. Symptom characteristics of depressive episodes prior to the onset of mania or hypomania. Acta Psychiatr Scand. 2016 Mar;133(3):196-204. doi: 10.1111/acps.12469. Epub 2015 Aug 7. PMID: 26252885.
  7. Černis E, Freeman D, Ehlers A. Describing the indescribable: A qualitative study of dissociative experiences in psychosis. PLoS One. 2020 Feb 19;15(2):e0229091. doi: 10.1371/journal.pone.0229091. PMID: 32074139; PMCID: PMC7029850.
  8. Aung SK, Fay H, Hobbs RF 3rd. Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases. Med Acupunct. 2013 Dec 1;25(6):398-406. doi: 10.1089/acu.2013.1007. PMID: 24761185; PMCID: PMC3870484.
  9. Kaiser BN, Haroz EE, Kohrt BA, Bolton PA, Bass JK, Hinton DE. "Thinking too much": A systematic review of a common idiom of distress. Soc Sci Med. 2015 Dec;147:170-83. doi: 10.1016/j.socscimed.2015.10.044. Epub 2015 Oct 21. PMID: 26584235; PMCID: PMC4689615.
  10. Siddiqui RA, Shende TR. Prescription pattern of antidepressant drugs in a tertiary care centre of central India. J Cont Med A Dent. 2014; 2(2):14-6.
  11. Gilani AH, Rahman AU. Trends in ethnopharmocology. J Ethnopharmacol. 2005 Aug 22;100(1-2):43-49. doi: 10.1016/j.jep.2005.06.001. PMID: 16127805.
  12. Avasthi A, Grover S, Aggarwal M. Research on antidepressants in India. Indian J Psychiatry. 2010 Jan;52(Suppl 1):S341-54. doi: 10.4103/0019-5545.69263. PMID: 21836704; PMCID: PMC3146188.
  13. Grover S, Dutt A, Avasthi A. An overview of Indian research in depression. Indian J Psychiatry. 2010 Jan;52(Suppl 1):S178-88. doi: 10.4103/0019-5545.69231. PMID: 21836676; PMCID: PMC3146226.
  14. Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, Archer SM, Blakley BW, Carter JM, Granieri EC, Henry JA, Hollingsworth D, Khan FA, Mitchell S, Monfared A, Newman CW, Omole FS, Phillips CD, Robinson SK, Taw MB, Tyler RS, Waguespack R, Whamond EJ. Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg. 2014 Oct;151(2 Suppl):S1-S40. doi: 10.1177/0194599814545325. PMID: 25273878.
  15. Pant P, Dhamija P, Ahmad Y, Srivastava P. Off-label use of antipsychotics and antidepressants-a double edged sword–obliges a close monitoring. Authorea Preprints. 2020 May 26.
  16. Tripathi A, Avasthi A, Desousa A, Bhagabati D, Shah N, Kallivayalil RA, Grover S, Trivedi JK, Shinfuku N. Prescription pattern of antidepressants in five tertiary care psychiatric centres of India. Indian J Med Res. 2016 Apr;143(4):507-13. doi: 10.4103/0971-5916.184289. PMID: 27377509; PMCID: PMC4928559.
  17. Baldessarini RJ, Leahy L, Arcona S, Gause D, Zhang W, Hennen J. Patterns of psychotropic drug prescription for U.S. patients with diagnoses of bipolar disorders. Psychiatr Serv. 2007 Jan;58(1):85-91. doi: 10.1176/ps.2007.58.1.85. PMID: 17215417.
  18. Hidaka BH. Depression as a disease of modernity: explanations for increasing prevalence. J Affect Disord. 2012 Nov;140(3):205-14. doi: 10.1016/j.jad.2011.12.036. Epub 2012 Jan 12. PMID: 22244375; PMCID: PMC3330161.
  19. Ghaemi SN, Hsu DJ, Thase ME, Wisniewski SR, Nierenberg AA, Miyahara S, Sachs G. Pharmacological Treatment Patterns at Study Entry for the First 500 STEP-BD Participants. Psychiatr Serv. 2006 May;57(5):660-5. doi: 10.1176/ps.2006.57.5.660. PMID: 16675760.
  20. Lam MK, Lam LT, Butler-Henderson K, King J, Clark T, Slocombe P, Dimarco K, Cockshaw W. Prescribing behavior of antidepressants for depressive disorders: A systematic review. Front Psychiatry. 2022 Sep 9;13:918040. doi: 10.3389/fpsyt.2022.918040. PMID: 36159914; PMCID: PMC9501861.
  21. Chen L, Chung SW, Hoy KE, Fitzgerald PB. Is theta burst stimulation ready as a clinical treatment for depression? Expert Rev Neurother. 2019 Nov;19(11):1089-1102. doi: 10.1080/14737175.2019.1641084. Epub 2019 Jul 11. PMID: 31282224.
  22. Blackburn TP. Depressive disorders: Treatment failures and poor prognosis over the last 50 years. Pharmacol Res Perspect. 2019 May 3;7(3):e00472. doi: 10.1002/prp2.472. PMID: 31065377; PMCID: PMC6498411.
  23. Watt DF, Panksepp J. Depression: An evolutionarily conserved mechanism to terminate separation distress? A review of aminergic, peptidergic, and neural network perspectives. Neuropsychoanalysis. 2009 Jan 1;11(1):7-51.
  24. Jesulola E, Micalos P, Baguley IJ. Understanding the pathophysiology of depression: From monoamines to the neurogenesis hypothesis model - are we there yet? Behav Brain Res. 2018 Apr 2;341:79-90. doi: 10.1016/j.bbr.2017.12.025. Epub 2017 Dec 25. PMID: 29284108.
  25. Bogdan R, Nikolova YS, Pizzagalli DA. Neurogenetics of depression: a focus on reward processing and stress sensitivity. Neurobiol Dis. 2013 Apr;52:12-23. doi: 10.1016/j.nbd.2012.05.007. Epub 2012 Jun 1. PMID: 22659304; PMCID: PMC3570616.
  26. Huberty TJ. Anxiety and depression in children and adolescents: Assessment, intervention, and prevention. Springer Science & Business Media; 2012 Apr 24.
  27. Miller WR. Motivational interviewing with problem drinkers. Behavioural and Cognitive Psychotherapy. 1983 Apr; 11(2):147-72.
  28. Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Dan Med Bull. 2007 Nov;54(4):306-69. PMID: 18208680.
  29. Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. J Rheumatol Suppl. 2005 Aug;75:6-21. Erratum in: J Rheumatol Suppl. 2005 Oct;32(10):2063. PMID: 16078356.
  30. Evans MD, Hollon SD, DeRubeis RJ, Piasecki JM, Grove WM, Garvey MJ, Tuason VB. Differential relapse following cognitive therapy and pharmacotherapy for depression. Arch Gen Psychiatry. 1992 Oct;49(10):802-8. doi: 10.1001/archpsyc.1992.01820100046009. PMID: 1417433.
  31. Grimwood S, Hartig PR. Target site occupancy: emerging generalizations from clinical and preclinical studies. Pharmacol Ther. 2009 Jun;122(3):281-301. doi: 10.1016/j.pharmthera.2009.03.002. Epub 2009 Mar 21. PMID: 19306894.
  32. Seligman L, Reichenberg LW. Selecting effective treatments: A comprehensive, systematic guide to treating mental disorders. John Wiley & Sons; 2011 Oct 19.
  33. Rathod S, Pinninti N, Irfan M, Gorczynski P, Rathod P, Gega L, Naeem F. Mental Health Service Provision in Low- and Middle-Income Countries. Health Serv Insights. 2017 Mar 28;10:1178632917694350. doi: 10.1177/1178632917694350. PMID: 28469456; PMCID: PMC5398308.
  34. Ofori-Asenso R, Agyeman AA. Irrational Use of Medicines-A Summary of Key Concepts. Pharmacy (Basel). 2016 Oct 28;4(4):35. doi: 10.3390/pharmacy4040035. PMID: 28970408; PMCID: PMC5419375.
  35. Rudrapal M, Khairnar SJ, Jadhav AG. Drug repurposing (DR): an emerging approach in drug discovery. Drug Repurposing-Hypothesis, Molecular Aspects and Therapeutic Applications. 2020 Jul 13; 10.
  36. Reich M, Lesur A, Perdrizet-Chevallier C. Depression, quality of life and breast cancer: a review of the literature. Breast Cancer Res Treat. 2008 Jul;110(1):9-17. doi: 10.1007/s10549-007-9706-5. Epub 2007 Aug 3. PMID: 17674188.
  37. Kuyken W, Byford S, Byng R, Dalgleish T, Lewis G, Taylor R, Watkins ER, Hayes R, Lanham P, Kessler D, Morant N, Evans A. Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: the PREVENT trial. Trials. 2010 Oct 20;11:99. doi: 10.1186/1745-6215-11-99. PMID: 20961444; PMCID: PMC2972263.
  38. Fullagar S, O'Brien W. Problematizing the neurochemical subject of anti-depressant treatment: the limits of biomedical responses to women's emotional distress. Health (London). 2013 Jan;17(1):57-74. doi: 10.1177/1363459312447255. Epub 2012 Jun 6. PMID: 22674747.
  39. Yin N. Pharmaceuticals, incremental innovation and market exclusivity. Toulouse School. 2012 Dec 17.
  40. Kumar N, Abbas A, Ahmad A, Choudhary R, Ganguly A, Dixit RK. Cost comparison of commonly used antidepressant drugs with drug price control order in India.
  41. Ray A, Najmi A, Khandelwal G, Sadasivam B. A Cost Variation Analysis of Drugs Available in the Indian Market for the Management of Thromboembolic Disorders. Cureus. 2020 May 5;12(5):e7964. doi: 10.7759/cureus.7964. PMID: 32523821; PMCID: PMC7273361.
  42. Kumar R, Joshi MM, Palod RJ, Dharmagadda S. Does India need a new pharmaceutical policy? Examining the implications of the drug price control order. Int J Health Plann Manage. 2022 Nov;37(6):3028-3038. doi: 10.1002/hpm.3554. Epub 2022 Aug 18. PMID: 35983617.
  43. Wetherell JL, Petkus AJ, White KS, Nguyen H, Kornblith S, Andreescu C, Zisook S, Lenze EJ. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults. Am J Psychiatry. 2013 Jul;170(7):782-9. doi: 10.1176/appi.ajp.2013.12081104. PMID: 23680817; PMCID: PMC4090227.
  44. Kamran S, Saqlain M, Khan Z, Mahmood S, Ali H, Ahmad N, Shah KU. Cost analysis of registered brands of oral antidepressant drugs in Pakistan: a descriptive analysis. Expert Rev Pharmacoecon Outcomes Res. 2020 Oct;20(5):473-479. doi: 10.1080/14737167.2019.1666001. Epub 2019 Sep 13. PMID: 31498710.
  45. McDonnell A, Pisani E, Singhvi S, Chalkidou K, Yadav P. A path to resiliency: mitigating the impacts of COVID-19 on essential medicines supply chains. CGD Policy Paper. 2021 Jun 4; 213.
  46. Tripathi RK, Singh S. Cost variation analysis among different antidepressant drugs used to treat major depressive disorder. Journal of Pharmaceutical and Biological Sciences. 2019 Apr 1; 6(2):51.

Figures:

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?