Background: Depression is a disorder that disrupts the public health through factors such as its occurrence, distress, ill health, and economic burden. There is a wide variation in the prices of antidepressant drugs marketed in India. Aims and Objective: To find out the price variations in the oral antidepressant drugs available in India either as a single drug or in combination and to evaluate the differences in the cost of various brands of the same oral antidepressant drug by calculating the percentage variation in cost in Indian rupees. Materials and Methods: The cost of a particular drug being manufactured by different companies, in the same strength and dosage forms, was obtained from ''Current Index of Medical Specialties'' July-October, 2014, and ''Indian Drug Review, 2014;21(4)''. The difference between the maximum and minimum prices of the same drug and the percentage variation in the prices was calculated. Result: The prices of a total of 25 drugs (21 single and 4 combination preparations) available in 66 different formulations were analyzed. In single drug therapy, among tricyclic antidepressants, reboxetine (2 mg) showed the maximum price variation of 900%. In atypical antidepressants, bupropion hydrochloride (150 mg) showed the maximum price variation of 447.94%. In selective serotonin reuptake inhibitors (SSRIs), paroxetine (37.5 mg) showed the maximum price variation of 1116.66%. In serotonin norepinephrine reuptake inhibitors (SNRIs), Venlafaxine hydrochloride (37.5 mg) showed the maximum price variation of 246.15%. In monoamine oxidase (MAO)-A inhibitors, moclobemide (150 mg) showed the maximum price variation of 246.15%. In combination therapies, chlordiazepoxide with amitriptyline showed the maximum price variation of 227.23%. Conclusion: The average percentage variations of different brands of the same drug manufactured in India is very wide. The management of the marketing drugs should be directed toward maximizing the therapeutic benefits to the community and minimizing the economic burden.

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Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment.

Background: Coronary artery disease (CAD) is a major cause responsible for mortality more in younger age group than in elderly. Studies have reported underuse of four evidence based medicines namely aspirin, β-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB), and statins in patients with CAD, particularly in developing countries. Therefore, this study was planned to analyse the prescriptions of patients with CAD to determine the appropriateness of the prescriptions.Methods: After obtaining the Institutional ethics committee permission, a cross sectional observational study was conducted at a tertiary care hospital. Total 150 patients were enrolled from the outpatient department, wards and intensive care unit of medicine department. Total 150 patients’ prescriptions presenting with varied category of CAD were screened and analysed.Results: The most common categories of CAD encountered was ST segment elevated myocardial infarction (N=50, 33%) followed by chronic stable angina (N=29, 20%). Among the drugs prescribed, antiplatelet drugs were prescribed to 135 (90%), hypolipidemics to 134 (89%), nitrates to 114 (76%), beta blockers to 97 (65%), ACE inhibitors to 94 (64%), anticoagulants to 60 (40%) and miscellaneous drugs to 52 (35%), patients. Of 68 (45%) patients with type 2 diabetes mellitus, 15 (22%) were prescribed only metoprolol and others were given ACE-I or ARBs.Conclusions: Among four evidence based drugs, use of 3 drugs, antiplatelets, beta blockers and hypolipidemics was apparent in 90% of prescriptions. Use of ACE inhibitors and ARBs was observed in type 2 diabetic patients with CAD, reflecting rational prescribing behavior of clinicians.

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