OBJECTIVES: To perform the cost-minimization analysis (CMA) and prescription auditing of antibiotics used in respiratory tract infections (RTI)

METHODS: A prospective observational study was carried out in the Pulmonology department for six months. Patients who were diagnosed with an RTI and prescribed at least one antibiotic were included in the study. All the necessary patient information was collected and well documented for analysis. Prescription auditing was carried out and medications were categorized according to the WHO -ATC system. Cost minimization analysis of antibiotics was carried out by calculating the percentage cost difference using the formula: Cost of the branded drug- Cost of generic drug / Cost of generic drug * 100. Branded medication prices were obtained from the hospital pharmacy whereas generic prices from Jan Aushadhi scheme of Govt. of India.

RESULTS: A total of 50 patients’ prescriptions were included in this study with an average age of 47.86 ± 9.7 years among them [n=29, 58%] were female. The majority of them were diagnosed with lower respiratory tract infection with the most common class of antibiotics prescribed was cephalosporin antibiotics [n=25, 43.1%] followed by macrolide antibiotics [n=15, 25.8%]. The oral route of administration was most preferred[n=40,68.9%] over injectables. A huge cost variation was evident between the cost of generic and branded antibiotics of which the highest cost variation was observed with Linezolid infusion 600mg/300ml (541.72%) Tab. Clarithromycin (234.47%) Tab. Cephalexin (227.51%) while Ceftriaxone 500mg vial (12.35%) and Tab. Levofloxacin (57.63%) shows the least variation.

CONCLUSIONS: By performing CMA, it highlights the importance of generic medication use in reducing the health economic burden of society. Patients’ medication adherence and quality of life can be improved by the implementation of medication cost-related national-level policies and guidelines.