Cost analysis of registered brands of oral antidepressant drugs in Pakistan: a descriptive analysis

ABSTRACT

Background and objective: Depression is a global public health threat, and its treatment constitutes drugs in psychopharmacology, a domain that is rapidly growing with the addition of newer agents in market that are of high cost. Therefore, the present study aims to investigate the number of registered brands and price variation of oral antidepressants in Pakistan.

Methods: A descriptive observational study was carried out to analyze the cost of oral antidepressants in Pakistan. Pharma guide 2019 was used to derive the cost of antidepressants marketed in Pakistan. The details about the number of registered brands and maximum and minimum prices of antidepressant drugs were calculated.

Results: Sixteen drugs in 38 formulations were registered in 607 brands in Pakistan. Variations among 38 different formulations range from 0% to 746.39%. Out of these 38 formulations, 31 had variations below 200%, while 7 formulations had price variation above 200%. The highest price (746.39%) variation was observed for citalopram 20 mg (price per tablet PKR 6.79 to PKR 57.47) and no (0%) price variation was for bupropion 75 mg (price per tablet PKR 10).

Conclusion: The study revealed wide variations in the number of registered brands and prices of oral tablets of antidepressants in Pakistan. The government needs to devise effective strategies to implement established policies to ensure uniformity in price, quality, and effectiveness with the ultimate goal to reduce treatment cost. Also, measures should be taken to inform prescribers about cost variation of drugs as prerequisite for cost-effective treatments to ultimately reduce treatment cost and financial burden and improve patient’s adherence to therapy.

KEYWORDS:

• Antidepressant drugs
• SSRIs
• availability of drugs
• price variation

Article highlights

• Depression is a major global public health threat, in terms of its prevalence, morbidity, poor quality of life, and economic crisis.

• There is a wide variation in the brands and prices of antidepressants.

• South Asia represents approximately 23% of the global population and one-fifth of the world’s mental health case.

• In low–middle-income nations, this dilemma resulted in serious consequence as depression leads to 3% disability-adjusted life years (DALYs).

• Among several barriers in accessibility to mental health care at two centers in Karachi, the price of care was attributed to 76% cases.

• Limited knowledge of prescribers about the cost of available drugs may lead to hindrances in prescribing cost-effective therapies to patients.

Acknowledgments

The authors would like to extend heartfelt graciousness to faculty members at Department of Pharmacy, Quaid-i-Azam University, Islamabad who provided support at every step of the research.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

The manuscript idea, concept, writing, and layout was done by SK and MS. ZK provided critical help in writing, statistical and layout designing. SM and HA provided critical input regarding data analysis at every step of the manuscript writing process. NA and KS proof read the manuscript and provided input in formulating the draft.

Availability of data and material

The data and materials are available with the corresponding author and can be obtained upon a request.

Additional information

Funding

This paper was not funded.