Abstract
Background: Proton-pump inhibitors (PPIs) are among the most prescribed drugs for acid-related gastrointestinal disorders. Various guidelines are available for the clinical use of PPIs; however, their non-judicious use has been reported. PPIs combined with other agents as fixed-dose combinations (FDCs) are available but there is an acute lack of data about cost incurred on their use. This is important since health-care expenditure in India is borne primarily by patients.

Aim and Objective: This study aims to evaluate the cost of FDCs of PPIs of different brands and to analyze the price variation among those available in the Indian market.

Materials and Methods: An observational, analytical study was carried out in which price of FDCs of PPI in INR manufactured by different Indian pharmaceutical companies was obtained from CIMS (July–September 2020) and IDR (August 2020). Percentage variation and cost ratio were calculated.

Results: A total of 842 brands of six PPIs in various FDC were evaluated. Maximum percentage variation in cost and maximum cost ratio was found for rabeprazole + domperidone (20 mg + 30 mg), that is, 633.33% and 7.3, respectively, while minimum percentage variation in cost and minimum cost ratio was found for ilaprazole + domperidone (10 mg+30 mg), that is, 30.30% and 1.3, respectively.

Conclusion: This study showed wide variation in prices of FDCs of PPIs available in Indian market. There should be combined efforts from the government and pharmaceutical companies to reduce such a price variation so the prescribing physician can provide maximum benefits to patients.

Key words: Proton-Pump Inhibitor; Fixed-Dose Combinations; Cost Analysis; Percentage Variation; Cost Ratio