Cost analysis study of neuropsychiatric drugs: Role of National List of Essential Medicines, India

Context: This study investigated the cost variation among neuropsychiatric drugs prevalent in the Indian market with reference to the National List of Essential Medicines (NLEM, 2015). Aims: To promote the rational use of medicines through cost variation analysis among drugs for neuropsychiatric disorders enlisted in NLEM and those not included in NLEM (NNLEM). Study Design: This study included drugs used for epilepsy, migraine, psychosis, depression, generalized anxiety disorder (GAD), bipolar disorder, and obsessive-compulsive disorder (OCD). Materials and Methods: The unit drug cost for the selected strengths of different manufacturers mentioned in the Current Index of Medical Specialities 2016 was used for calculating cost/defined daily dose (DDD). Statistical Analysis: Comparison was done among individual drugs and groups (NLEM and NNLEM) by cost/DDD in terms of interquartile range, percentage cost variation, and cost ratio. Results: The cost variation is wide for neuropsychiatric drugs (maximum, 1724.3% for risperidone in NLEM, and 1780% for olanzapine in NNLEM). The drug-to-cost ratio is the highest (168.8 times) for bipolar disorder and the lowest (9.7 times) for GAD. The NLEM drugs were found to be more economical than the NNLEM drugs among antiepileptic drugs, antidepressants, and drugs for bipolar disorder; however, the reverse was noted for antimigraine drugs and drugs for GAD. Antipsychotic medications and drugs for OCD in the NLEM group have a wider range than in the NNLEM group. Conclusions: The NLEM group has economical drugs in some disease categories; there is a need to consider the cost effectiveness of all drug categories while revising the NLEM next time and attention should focus on drug price regulation policies to accomplish the goal of rational use of medicines.