Assessing the economic value of oral antifungals: A comparison of branded and generic options in India

Abstract

Introduction: India's pharmaceutical market is characterized by a significant presence of both generic and branded drugs, particularly for common ailments like fungal infections, which pose a substantial public health and economic burden. In tropical countries like India, superficial fungal infections are quite common, and frequent relapses after treatment have increased the need for long-term therapy, significantly increasing the cost of treatment, so the treatment of fungal infections can raise the economic burden on the patient. Given the high variability in drug pricing and the imperative for cost-effective healthcare, a pharmacoeconomic analysis comparing generic and branded oral antifungals in India is crucial to inform prescribing practices and optimize resource allocation. Methods: The cost of different brands of commonly used oral antifungals was sorted out by referring latest “Current Index of Medical Specialties” February- April 2025, and 1mg online pharmacy and the Janaushadhi website. The cost of 10 dosage forms (Tablets/capsules) in INR of each brand, Cost Ratio, and Percentage Cost Variation for individual drug brands was calculated. At last, the cost ratio and percentage cost variation of various brands were compared with generic drugs. Results: The data analysis showed a significant variation in the costs of different brands of oral antifungals in the Indian market. Percentage variation in cost for oral preparations of proton pump inhibitors marketed in India was found to be griseofulvin 500mg (886.2%), ketoconazole 200mg (3214.2%), fluconazole 200mg (1763%), itraconazole 200mg (38438%), terbinafine 250mg (3789.6%), posaconazole 100mg (8772.8%), voriconazole 200mg (8335.2%) and clotrimazole 100mg (856.9%). Conclusion: There is a wide variation in the prices of oral antifungals available in the market. Regulatory authorities, pharma companies, and physicians should maximize their efforts to reduce the cost of drugs. There is a need for strict actions for cost policy regulation and sensitization of doctors for the selection of appropriate drugs.