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Fluoroquinolones in India—Are we prescribing it right: A cost variation study

Vihang S Chawan, Kalpesh V Gawand, Sagar V Badwane.


Background: Quinolones are the fastest growing antibacterial agents worldwide as they are being used in both the hospitals and community practices to treat infections. Ciprofloxacin and levofloxacin dominate the market mostly, which together charge 65% ($3.3 billion) of global sales. Quinolones such as ciprofloxacin, levofloxacin, and moxifloxacin have been found to possess enormous market capacity and sales volume. Fluoroquinolones in India comprise 30% share of Global Pharmaceuticals Market counterparts.

Aims and Objective: To find out the cost of various oral fluoroquinolones available in India either as a single drug or in combination and to evaluate the difference in cost of various brands of same fluoroquinolone by calculating percentage variation in cost in Indian rupees.

Material and Methods: Cost of oral fluoroquinolones manufactured by different companies, in the same strength and dosage forms, was obtained from Current Index of Medical Specialties, July–October 2014, and Indian Drug Review, Vol. XXI, Issue No. 4, 2014. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in price was calculated.

Result: Percentage price variation for various fluoroquinolones was as follows: ofloxacin (200 mg) 869%; sparfloxacin (200 mg) 648%; gemifloxacin (320 mg) 477%; norfloxacin (400 mg) 291%; ciprofloxacin (500 mg) 290%; levofloxacin (250 mg) 264%; lomefloxacin (400 mg) 104%; and moxifloxacin (400 mg) 60%. Among the combination therapy, price variation was norfloxacin + tinidazole (400 + 600 mg) 983%; ofloxacin + cefixime (200 + 200 mg) 232%; levofloxacin + ornidazole (250 + 500 mg) 211%; ofloxacin + ornidazole (200 + 500 mg) 156.60%; and ciprofloxacin + tinidazole (500 + 600 mg) 150%.

Conclusion: The average percentage price variation of different brands of same oral fluoroquinolones manufactured in India is very wide. As India is a developing country, clinicians must prescribe fluoroquinolones keeping in mind the cost of therapy.

Key words: Fluoroquinolones; Cost Analysis; Price; Cost Variation

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