Preprint / Version 1

Antiepileptic Drug Prices, Availability and Affordability in a Resource-Limited Setting

Authors

  • Karan Singh Department of Neurology, Dayanand Medical College and Hospital UG Boys Hostel, Ludhiana, Punjab, India
  • Shivani Kalra College of Nursing, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Jatinder Goraya Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Sarit Sharma Department of Community Medicine, College Campus Dayanand Medical College, Civil Lines Ludhiana, Punjab, India
  • Anurag Chaudhary Department of Community Medicine, College Campus Dayanand Medical College, Civil Lines Ludhiana, Punjab, India
  • Rajinder Bansal Department of Neurology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Namita Bansal Statistics, Research and Development Centre, Dayanand Medical College, Statistician, Ludhiana, Punjab, India
  • Suman Sharma Research and Development Centre, Dayanand Medical College, Research Fellow, Ludhiana, Punjab, India
  • Raj Setia Punjab Remote Sensing Centre, Dayanand Medical College, Research Fellow, Ludhiana, Punjab, India
  • Gagandeep Singh Department of Neurology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Keywords:

Affordability, antiepileptic drugs, availability, epilepsy

Abstract

The availability and affordability of antiepileptic drugs (AEDs) are critical to the success of public health initiatives enabling care for people with epilepsy in the community. Objective: To pilot survey the availability and affordability of AEDs in the community. Methods: Field workers used standard WHO–Health Action International approaches and collected data on the availability of, and maximum retail prices of originator brands and least price generics of AEDs in 46 randomly selected public (n = 29), private (n = 8), and charitable (n = 9) pharmacy outlets. Median price ratios were computed apropos international reference prices of corresponding medications and affordability gauged with reference to daily wage of lowest paid worker. Results: Only 10 outlets (7 – private, 3 – public, and none – charitable) stocked at least one essential AED. Median price ratios varied between 1.1 and 1.5 essentially reflecting the difference between the least price generics and originator brands. Of note, carbamazepine-retard, 200 mg put up the slightest difference in prices of originator and least price generic brands and also was the most affordable AED. Conclusions: The availability and affordability of most AEDs were poor and hence, this needs to be studied on a wider scale and thereafter efforts to improve both the availability and affordability are desirable in order to address the huge treatment gap for epilepsy in India. Keywords: Affordability, antiepileptic drugs, availability, epilepsy

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