title: Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital.
abstract: OBJECTIVE
  To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN) in the nephrology department of a tertiary care hospital.
  
  
  METHODS
  A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February-July 2015). Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost.
  
  
  RESULTS
  Of 100 patients, 50 were above 60 years and 75 were male. Ninety-seven patients had hypertension, which was the most common comorbidity. The majority (60 patients) belonged to Stage 5 DN and 59 patients were on dialysis. The mean number of drugs per patient was 7.60 ± 2.44. The total monthly cost per patient amounted to INR 24,203.27 with total direct cost of INR 21,013.90 (87%) and indirect cost of INR 3189.30 (13%). The monthly cost of dialysis and pharmacotherapy per patient were INR 9060.00 (37%) and INR 2535.98 (11%), respectively. Stage of DN (unstandardized coefficient, B = 7553.96, 95% confidence interval [CI] [6175.09-8932.82], P < 0.001) was a significant determinant of total cost. Number of drugs (B = 636.694, 95% CI [335.670-937.718], P < 0.001) and stage of DN (B = 852.986, 95% CI [297.043-1408.928], P = 0.003) were predictors of cost of pharmacotherapy.
  
  
  CONCLUSIONS
  Stage of DN and number of drugs prescribed were major determinants of cost of pharmacotherapy.
authors.affiliation: Department of Pharmacology, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
authors.forename: J V
authors.initials: JV
authors.lastname: Jose
authors.affiliation: Department of Pharmacology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
authors.forename: M
authors.initials: M
authors.lastname: Jose
authors.affiliation: Department of Pharmacology, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
authors.forename: P
authors.initials: P
authors.lastname: Devi
authors.affiliation: Department of Nephrology, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
authors.forename: R
authors.initials: R
authors.lastname: Satish
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D003956:Dialysis / Q000191:economics* / Q000706:statistics & numerical data; D017850:Economics, Pharmaceutical; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000191:economics*; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D055553:Prescription Drugs