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Old 5th September 2012, 09:43   #1
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Default Medicinal Drugs: How much (more) we pay for the SAME?

When I moved to Bangalore, initially I have always been wondering why I pay "more" expensive drugs for my kids in Bangalore, when compared to what I was paying in Chennai.

I know, it depends on the type of fever, cold etc. But, even for the common cold that we use any paracetamol etc was much expensive. Sometimes double the cost of one I use to get in Chennai.

Since its life of kids, we do not even think twice and go with what's prescribed. But, now my doubts are cleared.

Got this link from the facebook updates.

http://www.medguideindia.com

Initially, thought it should be some usual updates and shares in FB. But wait, I tried to check some of the known drugs we have been using in family. And i was shocked to see that most of them are available at half the price.

Some of the expensive drugs from Abbott, Cipla, Ranbaxy are available with so many other alternatives.

Its not just high end tables like cholestrol or other not so common drugs, even a paracetamol (Dolo 650) is available with so much range, doctors usually write known brands.

Check it yourself.

Our doctor friends can confirm the credibility of the site.
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Old 5th September 2012, 11:58   #2
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Default Re: Medicinal Drugs: How much (more) we pay for SAME?

I am not a doctor but I can tell you for a fact that its true.
What you are talking about are basically generic drugs. The reason being simple. Company X spends billions in research to make drug A and get it approved and all. Company B takes the same chemicals used in A and copies it and sells B at one tenth of the cost. Because they have no initial billions already spent.
There are multiple cases when the chemist guy will give you a drug that has the same salt composition but is manafactured by a different company as generics offer a crazy margin over the standard drugs.
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Old 5th September 2012, 16:06   #3
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

One more portal can give information about drugs and alternative drugs.
http://www.medindia.net/
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Old 5th September 2012, 16:23   #4
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Hi all

I am not a doctor but one of my very close friends who is a doctor told me about the same thing. He said even for generic drugs like paracetamol buying it from a non reputed manufacturer increases the risk of adultration ten fold. His suggestion was to go with a reputed brand for the cheapest cost in case of generic medicines. But when it comes to Cancer control and medicnes for Heart patients, Doctors may prescribe certain drugs because they give better results than the other even if the combination is the same.

My experience with most doctors is that if you ask them whether we need to buy this medicne or would the same drug do, in some cases they directly say I could buy the same drug it was fine in some cases he would get a bit iffy and say something to the tune of "I suggest this one, But there are similar drugs in the market". This i felt was him deplomatically telling me the med he suggested was better than the others suggested but he did not want to come off as a guy who was trying to force me into buying a particular med.

Bottom line is given the amount of adultration that happens in our country. Docs generally suggest meds that they know to be effective. I generally trust my doc on the meds but definately ask him if there is a cheaper alternative.

Last edited by gandalf : 5th September 2012 at 16:24. Reason: Added point
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Old 5th September 2012, 21:31   #5
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

In Pharma industry there are two broad categories
1. Bulk drug manufacturer (Ranbaxy, reddy's, glaxo, cipla, sun pharma etc)
2. retail drug manufacturer

No 1 can also be a No 2 but not vice versa.

Cost of the drug depends upon purity (99% or 95% etc)

The cost of 99% pure drug is much higher than 95% purity ( it is just like the degree of difficulty in getting 90 to 95% percent marks)

Many of the No 2 type guys buy the 95% pure stuff from No1 guy and sells at lower price.

Further not all the retail drug manufacturer drugs confirm to to what is stated on the label. i.e Paracetamol 500mg may or may not contain 500mg. it may be 450 mg also or even less.

Type of Drugs

Generic: Out of patent regime. Any one can manufacture, once it is out of patent. ( in general it is 20 years in pharma industry) Most of the common drugs we use like paracetamol. many of the antibiotics are Generic now.

Those which are in Patent: only patent holder can manufacture -- hence costly.

Here too there is a loop hole. Government can license a guy to manufacture these drugs by paying original patent holder some fixed royalty, if it can to reduce the cost life saving drugs.
recently two indian firms got such license for some AIDS drugs
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Old 5th September 2012, 21:38   #6
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

What you are saying is true that many drugs can work out to be a lot cheaper if bought under a different brand name. But the fact is that there indeed a variation in the bioavailibilty levels of the various drugs available to you. Drugs from reputed companies generally offer you better results and at the same time there is that peace of mind that the chances of being a fake is narrowed down.

So unless cost is something really important to you, I would suggest you to stick to reputed brands. That is what I pick when I fall sick!
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Old 5th September 2012, 21:48   #7
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

In addition to what was posted earlier, many common drugs are under price control by drug controller of India. Hence the price of that particular drug can not exceed the upper limit set by GOI.

If the drug prescribed is a common one , better to stick to branded one as there is not much difference between highest priced to lowest priced one.
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Old 5th September 2012, 21:58   #8
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Quote:
Originally Posted by rkg View Post
Cost of the drug depends upon purity (99% or 95% etc)

The cost of 99% pure drug is much higher than 95% purity ( it is just like the degree of difficulty in getting 90 to 95% percent marks)
Do you have any cite for this - the 95% & 99% thing? I can't believe it can possibly be true.

Quote:
Originally Posted by drmohitg View Post
Drugs from reputed companies generally offer you better results and at the same time there is that peace of mind that the chances of being a fake is narrowed down.
If I were someone making fake medicines would I make a fake Pfizer drug which sells for Rs. 200 or would I make a fake of Mankind version of the same drug which sells for Rs. 40?
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Old 5th September 2012, 22:35   #9
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Quote:
Originally Posted by mjothi View Post
...even for the common cold that we use any paracetamol etc was much expensive. Sometimes double the cost of one I use to get in Chennai.

Since its life of kids, we do not even think twice and go with what's prescribed. But, now my doubts are cleared.

Got this link from the facebook updates.

http://www.medguideindia.com

Some of the expensive drugs from Abbott, Cipla, Ranbaxy are available with so many other alternatives.

Its not just high end tables like cholestrol or other not so common drugs, even a paracetamol (Dolo 650) is available with so much range, doctors usually write known brands.

Check it yourself.

Our doctor friends can confirm the credibility of the site.
This website and a couple of similar ones did come to my notice some time ago, and someone (who's a Team-BHPian too) asked me a direct question about how reliable the alternative drugs are (as you ask how credible the website is). I will quote myself here, with the same reply I gave him, and I hope it might explain things a little better.

Quote:
I have never heard of some of the pharmaceutical cos. that produce the cheaper versions of certain drugs, but that may not mean much. On the other hand, in a country where "fraud" is more the rule rather than the exception, I would not really want to trust such cos. with critical medicines, where quality control and/or purity may be suspect.

If a co. which you recognize as a pan-India / MNC brand is making a drug at a cheaper price than another, by all means, go for it. At least there ought to be some accountability. Again, certain drugs have a sustained release coating, which is expensive compared to the same drug without such a coating - the website ... does not distinguish between the two, and the consequences for an armchair expert trying to save small change may be detrimental.
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Old 5th September 2012, 22:47   #10
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Quote:
Originally Posted by carboy View Post
If I were someone making fake medicines would I make a fake Pfizer drug which sells for Rs. 200 or would I make a fake of Mankind version of the same drug which sells for Rs. 40?
What you are saying is true. But a more reputed company would have better checks and policies in place to fight against this menace compared to a small time establishment. And hence my remarks above.
Also I believe most fake drugs are sold in low income areas and around govt hospitals where the majority of the patients that come are from a poorer background. They would not be interested in the brand and would rather pick a cheaper alternative.

Ofcourse there is no study for the same but its just about what seems more logical to you.
In the end you can just narrow down your odds and hope for the best.
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Old 6th September 2012, 10:04   #11
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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Originally Posted by carboy View Post
Do you have any cite for this - the 95% & 99% thing? I can't believe it can possibly be true.
You do not get citation for such things. It is from the horse's mouth. One of my close relative is in Pharma industry.

II. One of my colleague( Vet) sent the medicines supplied to his hospital( govt one) to Pune for verification. The report clearly stated none of the drugs under the test contained actual quantities as mentioned on the strip. ( this was in 1990-92) Of course he got memo from bosses for sending the drugs for testing.

Our Moral standards have increased manifold since then.

III. Not only purity but also quantity is dubious, some times even in established brands
( 490 mg in place of 500 mg does not make much difference to customer, but for company it makes sense in terms of overall profit. This is what we see in every field be it grocery items, food packs or soaps)

IV. It is very easy to start a pharma industry ( start only with tablets) buy bulk drug make tablets and sell.
Bulk drug manufacturing is costly
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Old 6th September 2012, 10:12   #12
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

One point is being skipped. How effective is the formulation, the way it is delivered can make a big difference. Some may be quicker acting than others. So the same Paracetamol may be microfined with very fast absorption, or normal. I am even aware of the formulation being ineffective since the tablets just passed through the GI Tract without disintegrating!

Let me put a different extreme example. You buy calcium tablets. One chap sells it really cheap, but it is Calcium Sulphate which is not absorbed. Many others are based on Sea Shells (carbonate which is absorbed) while some others may be on more expensive salts like Citrates.
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Old 6th September 2012, 11:15   #13
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

The major pharma companies spend a lot of money for spreading FUD (fear, uncertainty and doubt). It clearly looks like its working.

How many reported cases have there been of generics not having bio equivalence or not working or anything like that? If it's that rampant, it shouldn't be difficult to find many cases, right?

The Indian Pharma industry is well regulated especially for generics. The generic companies follow the same rules and regulations. Manufacturing medicines is not rocket science with todays technology. Most meds can be manufactured to high quality at low costs.

A good indicator of FUD is that no specific examples are ever cited - just general rumours and suggestions.

Last edited by carboy : 6th September 2012 at 11:29.
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Old 6th September 2012, 11:35   #14
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Quote:
Originally Posted by carboy View Post
The major pharma companies spend a lot of money for spreading FUD (fear, uncertainty and doubt). It clearly looks like it's working.

.
Exactly as you can see in the opening post Abbott, Cipla, Ranbaxy are all generic manufacturers but still their drugs are priced higher sometimes for same formulations.

A lots of cost is towards the promotions and educational conferences.
And doctoes generally write the brand for which med. representatve visited last or constantly pestered them,

In urban areas with higher paying capacity like Bangalore doctors do not put lot of mind share to minor deviations in price because it does not matter much to the target customer.

In Rural areas / Semi urban places where paying capacity is less and patients have heart wrenching stories doctors are more sensitive and prescribe the cheaper alternatives.

Please note I do not mean to imply in any way that it is menifestation of corruption of something most of the times it is just that a doctor practicing in a metro amoung high income groups does not want to search / apply his brain in to the pricing of the drug.

This is one of the reason that an MD/MS in city like Bangalore charges 150 -300 Rs per visit and a super speacialist MCH or DM charges 500 /600 Rs where as in smaller cities MD/MS charge 50-75 Rs and DM/MCH in niche area charge 150/300 Rs.

Source of Info : Doctors in family some of them are running Nursing homes in smaller cities with less income and paying capacity.

Last edited by amitk26 : 6th September 2012 at 11:49.
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Old 6th September 2012, 11:39   #15
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

http://www.team-bhp.com/forum/shifti...s-you-off.html (What to do when a doctor rips you off)
My experiences on the same
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