Prescription cost analysis and economic impact of drug treatment in patients with chronic illness, attending the medicine out-patient department in a tertiary care hospital at South Delhi.

Abstract

Objectives: The prevalence of chronic diseases is rising globally along with the consumption of nutraceuticals. It is documented that 80% of the deaths due to chronic illnesses occur in low and middle-income countries, including India. In addition, chronic diseases not only affect the patients but also their family income. Besides Southeast Asia is also the fastest-growing market for nutraceuticals with less stringent cost regulation. Hence, this research primarily focuses on the financial impact of the drug treatment for chronic illness, extensively comparing the therapeutic and non-therapeutic drug (nutraceutical) costs.

Methods: This was a retrospective, cross-sectional study with a sample size of 7877 prescriptions of medicine outpatient clinic, extracted from the hospital information system after 5 level screening for their inclusion in the study. The cost of drugs prescribed to the patient for chronic illness was calculated per month and its impact on the monthly family income was evaluated. The data analysis was stratified into the cost of therapeutic drug treatment and non-therapeutic drug treatment which was correlated with various chronic diseases and demographic parameters.

Results: A total of 465 patients were enrolled after screening and a high prescription rate of 88% for non-therapeutic treatment was reported. The total average monthly cost of chronic illness treatment was INR 1879 (22.42 USD), with therapeutic drug treatment of INR 1319 (15.74 USD) and non-therapeutic drug treatment of INR 560 (6.68 USD). Comprising 36% of patients, males spent higher amount on therapeutic drug treatment (INR 1780 or USD 21.26), while women spent higher on non-therapeutic drug treatment (INR 593 or USD 7.08). A catastrophic 11% of patients from 'lower' socioeconomic spent ≥ 10% of family income on non-therapeutic treatment.

Conclusion: Our study highlights the financial strain that chronic illnesses impose on families, emphasizing the need for policymakers to improve access to specialized care and cost capping of nutraceuticals.