Abstract
Background: Psychiatric disorders are one the leading causes of non-fatal disease in India. Among them, schizophrenia is one of the most common, distressing, and costly psychiatric disorders worldwide. There are large price differences between different brands of the same antipsychotics marketed and prescribed in India. Escalating drug costs are one of the causes of drug non-compliance, which can lead to adverse health outcome.

Aims and Objective: The purpose of the study was to analyze the cost variability of different brands of oral antipsychotics marketed in India.

Materials and Methods: The present study was an observational analytical one. The highest and lowest price of each antipsychotic drugs in the same strength, marketed by different pharmaceutical companies, were collected from the current index of medical specialties (CIMS), January to April 2023. Calculations were done in Indian Rupees per 10 tablets/capsules. For each antipsychotic drug, the cost ratio and percentage of price variation (PPV) were calculated.

Results: The costs of a total of 14 drugs (10 single and 4 combined preparations) available in 337 dissimilar strengths were analyzed. Among typical antipsychotics, chlorpromazine 50 mg had the highest cost ratio and PPV of 5.36% and 435.62%, while haloperidol in the strength of 20 mg had the lowest cost ratio and PPV of 1.09% and 9.41%, respectively. On the other hand, atypical antipsychotic risperidone 1 mg had highest cost ratio and PPV of 6.97% and 596.99%, clozapine in the strength of 50 mg had lowest cost ratio and PPV of 1.13% and 13.18%, respectively. Among fixed-dose combinations, risperidone + trihexyphenidyl (2+2) mg had highest cost ratio and PPV of 2.47% and 147.53%, while trifluoperazine + trihexyphenidyl (10+2) mg had lowest cost ratio and PPV of 1.05% and 4.53%, respectively.

Conclusion: This study showed large differences in cost ratio as well as PPV between various brands of the same antipsychotics. To reduce the financial burden and improve drug compliance, physicians must prescribe less expensive drugs. Furthermore, for the benefit of patients in general, MBBS students, future community prescribers, should also be trained in pharmacoeconomics to make them aware of the cost differences of the same drugs from different brands.

Key words: Pharmacoeconomics; Cost-analysis; Antipsychotic Drugs; DPCO; Schizophrenia