title: Variation of Cost among Anti-cancer Drugs Available in Indian Market.
abstract: BACKGROUND
  Although cancer remains a major health problem all over the world, its treatment is limited by affordability of patients in a developing country like India. Information generated from cost analysis studies will be helpful for both the doctors in choosing the correct medicine for their patients and also for policy makers in successfully utilizing the meager resources that are available.
  
  
  OBJECTIVE
  The aim of the present observational study was to analyse the price variations of anti-cancer drugs available in India.
  
  
  METHODS
  The cost of a particular anti-cancer drug being manufactured by different companies, in the same dose and dosage form, was obtained from latest issue of "Current Index of Medical Specialties" (CIMS) January-April, 2016. The difference between the maximum and minimum prices of various brands of the same drug was analysed and percentage variation in the prices was calculated. The results of the study were expressed as absolute numbers and percentages.
  
  
  RESULTS
  Overall, the price of a total of 23 drugs belonging to 6 different categories available in 52 different formulations were analysed. Among alkylating agents, oxaliplatin (50mg; injection) showed the maximum price variation of 125.02%. In anti-metabolites, methotrexate (2.5mg; tablet) showed the maximum price variation of 75.30%. The maximum price variation among natural products was seen with paclitaxel (260 mg; injection) of 146.98%, among hormonal drugs, was seen with flutamide (250mg; tablet) of 714.24%, among targeted drugs was seen with imatinib mesylate (100mg; film coated tablet) of 5.56% and among supportive drugs, granisetron (1mg; tablet) showed the maximum price variation of 388.68%.
  
  
  CONCLUSIONS
  The average percentage variations of different brands of the same anti-cancer drug in same dose and dosage form manufactured in India is very wide. The government and drug manufacturing companies must direct their efforts in reducing the cost of anti-cancer drugs and minimizing the economic burden on the patients.
authors.affiliation: Associate Professor, Department of Pharmacology, Vinayaka Missions Medical College and Hospital , Karaikal, Puducherry, India .
authors.forename: Bhanu Prakash
authors.initials: BP
authors.lastname: Kolasani
authors.affiliation: Associate Professor, Department of Pharmacology, Vinayaka Missions Medical College and Hospital , Karaikal, Puducherry, India .
authors.forename: Divyashanthi Chellathambi
authors.initials: DC
authors.lastname: Malathi
authors.affiliation: Assistant Professor, Department of Pharmacology, Guntur Medical College , Guntur, Andhra Pradesh, India .
authors.forename: Raghunatha Rao
authors.initials: RR
authors.lastname: Ponnaluri
keywords: Alkylating agents; Antimetabolites; Cost analysis; Targeted drugs