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With the goal of improving the affordability of medicines, governments across the globe have instituted various forms of price controls. Since 2013, India has been regulating the prices of drugs included in its national list of essential medicines (NLEM). Here we evaluate the cost variations among available cardiovascular drugs and perform cost-analysis comparing essential and non-essential drugs. Data on listed prices of selected cardiovascular drugs - essential (NLEM) and non-essential (NNLEM) - were sourced from multiple drug information compendia. Price of medications was calculated in cost-per-defined-daily-dose (DDD)-units and NLEM vs. NNLEM drugs were compared. Regression analysis was used to explore the determinants of percentage cost variation (PCV) of drugs. The median-cost/DDD of essential medicines was lower as compared to non-essential ones for all therapeutic drug classes, with greatest difference observed for antianginals and least for heart failure medicines. There were substantial cost variations with values in excess of 1000% for six medicines, all being essential. The regression analysis failed to demonstrate a significant effect of essentiality on PCV (β = 0.19, P = 0.314). Our analyses demonstrate considerable cost variations for some essential cardiovascular medicines. Given the need for prolonged and often, lifelong-treatment, there is significant potential for cost savings based on chosen brand, highlighting the need for patient as well as prescriber education.


Simran Khanijo, Ashish Kumar Kakkar, Rohit Kumar, Amol Narayan Patil, Gomata Bhusal, Gopal Vishwas, Geetika Arora. Impact of pharmaceutical price controls on the cost of cardiovascular drugs: does essentiality matter? Expert review of clinical pharmacology. 2020 Jul;13(7):797-806

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PMID: 32552127

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