Generic medicines utilizations and generic prescribing in Nepal: A reflection of current scenario and possible solutions

Ansari, Mukhtar; Humagain, Baburam

doi:10.1016/j.sapharm.2017.01.004

Cited by 5 publications

(9 citation statements)

References 4 publications

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“…A study by Vogler S et al, where the investigator surveyed the prices of cancer drugs in high-income countries (16 European countries, Australia, and New Zealand) found that the price of new cancer drugs varies widely from 28 to 388% [8]. The huge variation in the price of anticancer medicines in our study might be due to differences in the production cost, price control policy not covering some of the medicines, prescribing by brand name and pharmaceutical companies influencing the prescriber for writing their brand using different strategies [29,30]. The GoN has fixed the MRP of 117 commonly used medicines, including medicines for chronic diseases and 45 anticancer medicines (with different strengths and dosage forms) [31].…”

Section: Discussionmentioning

confidence: 71%

Price variation among different brands of anticancer medicines available in hospital pharmacies of Nepal

Shrestha

Poudel

et al. 2020

J of Pharm Policy and Pract

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Objective: To assess the variation in price among different brands of anticancer medicines available in hospital pharmacies at Nepalese cancer hospitals. Methods: The price of different brands of the same anticancer medicines available in the hospital pharmacies of two cancer hospitals was assessed. Prices of different dosage forms such as a single tablet, capsule and vial were calculated. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical industries was determined, and the percentage variation in price was calculated. The prices of medicines (brands) were also compared with the price determined by the government where available. Results: Price variation was assessed for 31 anticancer medicines belonging to six broad categories. Prices were found to vary maximally among the following medicines, each belonging to separate categories: among alkylating agents, the price of temozolomide 100 mg capsule varied 308%; among antimetabolite agents, the price of pemetrexed 500 mg injection varied 134%; among hormonal drugs, the price of letrozole 2.5 mg tablet varied 200%; among antibody class, the price of trastuzumab 440 mg injection varied 73%; among natural products, the price of irinotecan 100 mg injection varied 590%; and among miscellaneous agents, the price of bortezomib 2 mg injection varied 241%. There was a significant difference in the mean MRP of the alkylating agents with the antimetabolites (p-value 0.006) and the monoclonal antibody (p-value <.001). Antimetabolites, natural products, hormonal therapy all had significant mean differences in their MRPs with the monoclonal antibodies. (p-value <.001) and the monoclonal antibodies had a significant mean difference in the MRP with the miscellaneous agents. (p-value <.001).

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Section: Discussionmentioning

confidence: 71%

Price variation among different brands of anticancer medicines available in hospital pharmacies of Nepal

Shrestha

Poudel

et al. 2020

J of Pharm Policy and Pract

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“…Variation in prices of the same drug manufactured by different pharmaceutical industries plays a crucial role in its affordability by patients . In the present context, majority of prescribers tend to prescribe branded medicines, which is probably the influence of unethical promotional strategies of pharmaceutical manufacturers that still remain unregulated . Therefore, medicine affordability, availability and quality should be primarily considered by prescribers, dispensers and other stakeholders.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…[8] In the present context, majority of prescribers tend to prescribe branded medicines, which is probably the influence of unethical promotional strategies of pharmaceutical manufacturers that still remain unregulated. [9] Therefore, medicine affordability, availability and quality should be primarily considered by prescribers, dispensers and other stakeholders. Our study did not identify the variation in prices of medicines commonly used for the long-term cancer management and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is suggested that generic prescription (as GMP is mandatory for all manufacturers) should be institutionalized because they are cost effective and therefore, affordable for people with low economic status. [9] It is to be backed by conscientious and dynamic price regulation in a competitive market. Further, as observed, combination medicines, if found costlier than the individual drugs, should be avoided; unethical marketing practice should be avoided; and prices of medicines should be regulated without compromising the availability and the quality of the medicines.…”

Section: Discussionmentioning

confidence: 99%

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Variation in prices of medicines used for the long-term management of non-communicable diseases available in the pharmacy of a tertiary care hospital of Nepal

Poudel

Kumar

Shrestha

et al. 2018

J Pharm Health Serv Res

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Objectives Price variation of medicines affects their affordability. We aim to identify the variation in prices of medicines commonly used for the long‐term management of non‐communicable diseases available in the pharmacy of a tertiary care hospital of Nepal. Methods Price variation of medicines of different brands used for chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVDs) and diabetes manufactured by different Nepalese pharmaceutical industries were assessed from the pharmacy of a tertiary care hospital of Nepal. The prices of marketed medicines (brands) were compared with the government price where available. Key findings Of 46 medicines [including molecule(s) with different strengths and combinations], price variation was observed in 32 (69.56%) medicines. The price variation ranged from 0.48% to 60%. The prices of two medicines were not compatible with the prices fixed by the government. Conclusions There was variation in the prices of medicines used for the long‐term management of COPD, CVDs and diabetes.

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Determinants of national drug products acceptance across patients, pharmacists, and manufacturers: A mixed method study

Ahmed

Al‐Jumaili

Mutlak

et al. 2020

Journal of Generic Medicines

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Introduction The national pharmaceutical industry is pivotal for both the health sector and the national economy. This study aims to identify determinants of national drug products acceptance. The objectives of this study were to quantitatively measure the level of patient and community pharmacist acceptance of national drug products available in community pharmacies and to qualitatively explore the barriers facing national pharmaceutical companies and investigate the suggested solutions. Methods This cross-sectional study used an explanatory mixed method design. It was conducted in Baghdad, Iraq from July through October 2018. The study included two surveys (one for pharmacy customers and another for pharmacists) and thereafter semi-structured interviews of national pharmaceutical company owners/managers. The interview guide was developed based on preliminary quantitative results. Thematic analysis was used to analyze the interview findings. Results We received 123 patient surveys and 125 usable pharmacist surveys. We conducted seven interviews and stopped when we reached saturation. Integrated qualitative and quantitative findings showed that the main determinants of national drug product acceptance are product characteristics (namely price, packaging, brand, and availability), healthcare providers effect on product promotion and perceived effectiveness, and regulations enforced by authorities mainly the Ministry of Health. Conclusions Product price was the number one modulating factor in patient decision-making when purchasing a drug product. It appears that physicians and pharmacists are playing negative or at least neutral role in promoting national drug products and sustaining patients trust in national drug products. Current policies appeared to slow national drug industry growth and limit manufacturers’ ability to expand their share in the market. Manufacturer marketing efforts can help in gaining physicians and pharmacists support of the national drug product. Reforms to current drug policy and regulations were proposed by manufacturers.

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Generic medicines utilizations and generic prescribing in Nepal: A reflection of current scenario and possible solutions

Cited by 5 publications

References 4 publications

Price variation among different brands of anticancer medicines available in hospital pharmacies of Nepal

Price variation among different brands of anticancer medicines available in hospital pharmacies of Nepal

Variation in prices of medicines used for the long-term management of non-communicable diseases available in the pharmacy of a tertiary care hospital of Nepal

Determinants of national drug products acceptance across patients, pharmacists, and manufacturers: A mixed method study

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