Background: Malaria has been a problem in India for centuries. There are innumerable brands of antimalarial present in the market. Malaria can be extremely fatal if not treated promptly. Costly drugs can lead to economic burden which results in decreased compliance or even non-compliance. Non-compliance leads to incomplete treatment which tends to increase morbidity. Increase in the patient medication cost was found to be associated with decreased adherence to prescription medication. Hence this study was done to assess the cost variation of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2017 edition and Drug Today January to March 2017, Vol 2. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of 10 tablets was calculated in case of oral drug and the cost of 1 ampoule or vial was noted in case of injectable drug. At last the cost ratio and % cost variation of various brands was compared.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Artemether injection showed the highest cost ratio and cost variation (cost ratio = 16.96 and % cost variation = 1596). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents. Chloroquine which is one of the most used antimalarial showed very low values for cost variation and cost ratio.Conclusions: The analysis showed that there is not much significant price variation among oral antimalarial drugs. The maximum variation shown by oral antimalarial was found to be for fixed dose combination of Artemether and Lumefantrine [cost ratio>2 (2.03) and % price variation >100 (103.7)]. But there was significant price variation among injectable antimalarial. Injectable antimalarials are often the choice of drug when dealing with critically ill malaria patients specially when suffering from complicated malaria. So, such significant price variation creates burden on poor patients economically which leads to non-compliance and hence increased morbidity and mortality due to incomplete treatment.
INTRODUCTIONPharmacology, the study of drugs, is mainly taught to 3 rd , 4 th and 5 th semester medical students in India. The traditional pharmacology teaching mainly takes place through didactic lectures, in which passive transfer and memorizing of information of drug class and individual compounds occurs. Whereas practical curriculum mainly includes pharmacy practical, animal experimentations, prescription writing and problem based learning (PBL) which has been criticized. So, there is a need to evaluate practical curriculum. [1][2][3] Rational use of drugs (RUD) entails that patients should receive medications appropriate to their specific clinical needs, proper dose and duration, with the lowest cost to them and their community. Safe and effective prescribing is based on a sound knowledge of the disciplines of pharmacology which is a major challenge encountered by students. 4 The above requirements will be fulfilled by the WHO Guide to Good Prescribing which gives medical students a normative model for therapeutic reasoning and prescribing and provides a six-step guide to the process of rational prescribing. 5 ABSTRACTBackground: This study was developed to know the students' views regarding personal drug (P-drug) concept in rational prescription of drugs and also giving them training of creating and using personal drug concept. Methods: 40 medical students (5 th semester) divided in four groups were involved voluntarily in a three phase, questionnaire based and prospective study. In first and second phase students were taught and asked to derive P-drug using different standard text books and Current Index of Medical Specialties (CIMS) by analyzing efficacy, safety, cost and convenience of drugs used for type II diabetes mellitus. Third phase was designed to know the students' perception regarding the exercise and difficulties faced in the process of P-drug selection. It contained demographic and 12 questions with answer using Likert scale. Results: Students selected biguanide (metformin) as a P-drug in terms of efficacy, safety, cost and convenience. 95% (36 out of 40) responded in the questionnaire, out of which 92% (33 out of 36) had given answer with mean score ≥4. Overall median score was 4 and Interquartile Range was 4-5. 89% (32) strongly agreed that P-dug selection teaching helped them to understand pharmacology better. Majority (83% or 30) were in favour of introducing P-drug selection exercises in undergraduate pharmacology curriculum. Conclusions: P-drug selection exercise helped students to understand the differences among various drugs used for the treatment of type II diabetes mellitus and given them a strong foundation for developing rational use of the medicine in their future career as a doctor.
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