Impact of pharmaceutical price controls on the cost of cardiovascular drugs: does essentiality matter?

Khanijo, Simran; Kakkar, Ashish Kumar; Kumar, Rohit; Patil, Amol; Bhusal, Gomata; Vishwas, Gopal; Arora, Geetika

doi:10.1080/17512433.2020.1783248

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…They usually streamline the generic drug approval process and require generic prescribing and substitution where such policies are not yet in place ( 21 ). India has been regulating the prices of drugs included in its national list of essential medicines ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Wen

Yin

Cui

et al. 2021

Front. Public Health

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Objectives: To assess the effects of the National Centralized Drug Purchasing Pilot Program on nucleos(t)ide analogs (NAs) in Shenzhen city.Methods: Drugs procurement records in medical institutions were analyzed covering the period from January 2018 to December 2019. An interrupted time series (ITS) analysis was used to evaluate the impact of the “4+7” pilot policy on NAs in Shenzhen city. The outcome measures were usage volume, expenditures, daily cost, and distribution structure of NAs.Findings: After the introduction of the “4+7” pilot policy, the defined daily doses (DDDs) of NA drugs increased by 76.48%, the expenditures and defined daily dose cost (DDDc) of NAs decreased by 45.43 and 69.08%, respectively. The proportion of winning products in Entecavir and Tenofovir Fumarate DDDs was increased by 64.21 and 19.20%, respectively. The post-intervention period witnessed a significant increase in the regression level for NAs DDDs (level coefficient: β2 = 631.87, p < 0.05). The expenditures (trend coefficient: β3 = 392.24, p < 0.05) and DDDc (level coefficient: β2 = −6.17, p < 0.001; trend coefficient: β3 = −0.21, p < 0.05) of NAs showed decreasing trend in the post-intervention period. The expenditures of original products and generic products both showed a decreasing trend in the post-intervention period (trend coefficient: β3 = −372.78, p < 0.05, trend coefficient: β3 = −130.78, p < 0.05, respectively). The DDDc of original products in the policy-related varieties was a significant decrease in the regression slope and level (level coefficient: β2 = −2.18, p < 0.05; trend coefficient: β3 = −0.32, p < 0.01).Conclusion: After the implementation of the“4+7” policy, the DDDc of NAs decreased, the accessibility of policy-related drugs was improved, and the usage of generic medicine was promoted.

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Section: Introductionmentioning

confidence: 99%

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Wen

Yin

Cui

et al. 2021

Front. Public Health

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“…β= 0.316, p = 0.021, (significant as p < 0.05) proved that listing of drugs as essential medicines and ceiling their prices reduced cost variation among various number of brands available in the market. 25 Hence, we can conclude that association between number of brands and cost variation may be therapeutic class specific and larger pharmacoeconomic analyses are required to get a broader perspective. Furthermore, with drugs used in organ transplantation, switching brands can lead to over suppression or under suppression of immune function due to varying equivalence criteria to demonstrate bioequivalence between innovator and generic drugs.…”

Section: Resultsmentioning

confidence: 99%

“…Findings of one such study on CVS drugs revealed that inclusion of drugs in National List of Essential Medicine had no impact on their cost variation. 25 Another study conducted on neuropsychiatric drugs found that NLEM drugs were economical than NNLEM in case of antiepileptic, antidepressant, and drugs for bipolar disorder. However as per same study, antimigraine drugs and drugs for generalized anxiety disorders, NNLEM drugs were more economical.…”

Section: Discussionmentioning

confidence: 99%

Impact of National List of Essential Medicines (NLEM) on Cost Variation of Immunosuppressants available in Indian Market

Borkar¹,

Shinde²,

Bhandari³

et al. 2022

J Young Pharm

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Background: Immunosuppressants are used commonly in two conditions: to prevent graft versus host rejection in transplantation and autoimmune disorders. Autoimmune diseases are chronic in nature requiring lifelong treatment. Organ transplantation is also expensive. Therefore, affordability of these medicines is crucial. To address the problem of affordability, government caps the prices of drugs included in National List of Essential Medicines. However, even cost variation among various brands of the drugs included in essential medicine list is of concern as majority of prescriptions are written using brand names. Hence this study was undertaken to evaluate impact of essential medicine list on cost variation of these drugs. Materials and Methods: Immunosuppressant drugs were broadly classified into two categories -drugs listed under National List of Essential Medicines and drugs not included. Prices of the drugs belonging to both the groups were obtained from website "Pharma Sahi Dam" . Later, cost ratio, percentage cost variation was calculated. The multiple linear regression analysis was performed to investigate association between percentage cost variation and essentiality/number of brands. Results: Immunosuppressant drugs showed wide cost variation. Overall higher cost variation was seen among drugs not included in essential medicine list. This was further substantiated by multiple regression analysis (β = 0.316, p = 0.021). However, number of brands had no effect on cost variation. Conclusion: Hence, to improve affordability of these drugs which are mainstay in autoimmune disorders and organ transplantation, regulatory bodies should widen the inclusion criteria for essential medicine list. Also, efforts are needed to create awareness of cost variation among prescribers.

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“…These downsides have been shown to excessively affect the poor and rural consumers, the two most healthcare-deprived groups in these settings. Thus, despite aiming to improve affordability and access to medicines, price controls can ironically, negatively impact their availability [6,14,15].…”

Section: Pharmaceutical Price Regulation: the Unintended Consequencesmentioning

confidence: 99%

Impact of pharmaceutical price controls on the cost of cardiovascular drugs: does essentiality matter?

Cited by 4 publications

References 29 publications

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

The Effects of the National Centralized Drug Purchasing Pilot Program on Nucleos(t)ide Analogs in Shenzhen City: An Interrupted Time Series Analysis

Impact of National List of Essential Medicines (NLEM) on Cost Variation of Immunosuppressants available in Indian Market

Pharmaceutical price regulation and its impact on drug innovation: mitigating the trade-offs

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