DrLele Patent

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Unique benefits of the Patents Act 19

Article appearing in:

IDMA BULLETIN(Indian Drug Manufacturers Association)

Dated 30th October 2005

Vol. XXXVI(40)

______________________________________________________________

PATENTS

The Prescription that changed practice

UNIQUE BENEFITS OF THE PATENTS ACT 1970

By Padma Bhushan Dr. R.D. Lele*(Based on a lecture given on 5.10.05)

* The author is Hon. Chief Physician & Director, Nuclear Medicine Department, Jaslok Hospital & ResearchCentre, Mumbai; Hon. Director of Nuclear Medicine & RIA Dept., Lilavati Hospital & Research Centre, Mumbai;

Emeritus Professor of Medicine (for life) & ex-Dean, Grant Medical College & Sir J.J. Hospital, Mumbai;Dean (Academic), All India Institute of Diabetes, Mumbai


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Imagine that you were a doctor practicingin independent India before 1970. You haveprescribed the drug your patient needs but it isimported and no chemist has it in stock. There is anoption that is available but is way too expensive.

Its the same situation which occurs again and

again. Most of the drugs you would like to useare either not available or too expensive. Theseadverse conditions are not doing any good to yourpractice.

A life could be lost and you feel desperate andhelpless.

It is from this dark period that we have emergedto become one of the most sought after healthcaredestinations. We have the best of medical talent,world-class hospitals with ultramodern diagnostic

facilities, excellent nursing care and, moreimportantly, availability of the most advanced drugsat affordable prices.

In fact, the free availability of modern drugs inthe past three decades has had a profound impacton the way we practice medicine today. And thecontribution of Indian pharmaceutical companiesto this happy scenario has been phenomenal.Ranbaxy in antibacterials, Cipla in respiratorymedicine and antiretrovirals, Sun in psychiatricdrug therapy, Lupin in anti-tuberculosis drugs and

many others in various therapies ranging fromcardiovascular medicine to cancer chemotherapy all have transformed the therapeutic managementof almost every single disease in India.

This is a unique situation which has not been seen inany other country in the world be it in the advancedWest or in hapless Africa. We in India have beenfortunate to have the latest drugs at a fraction of theinternational prices. Your everyday ciprofloxacin isavailable in India for less than Rs. 30 for a strip of10 tablets. In Pakistan, the same strip costs almost

Rs. 370; in the USA it is an unbelievable Rs. 2,550.Atorvastatin, which is available for Rs. 25 per stripof 10 tablets in India, costs Rs. 485 in Pakistan,Rs. 565 in Indonesia and Rs. 1,090 in the USA.Efavirenz, a widely used anti-HIV drug costs Rs.807 for a pack of 30 tablets while its price in the USis Rs. 6,792 (see table 1).

This happy situation in the country is mainly theresult of some far-sighted changes, which were

incorporated in the Patents Act in 1970. You willappreciate this more as you read on.

India before 1970

The original Patents Act dates back to 1911 when

the British ruled our country.This colonial Act that was still in force, recognisedboth product and process patents. Except forthe patent holder no one else was allowed tomanufacture a patented drug, even by an entirelydifferent process. The patent holder enjoyedmonopoly rights to manufacture the drug for 20years. Obviously, the patent holder was at libertyto decide both the availability and the price of thedrug. The consequences were painful.

Acute shortages were common as imports

from countries like France, Germany and theUK were erratic, especially at the time of theSecond World War.

Drug prices in India were the highest in theworld and the Kefauver Senate Committee ofthe USA noted this in 1956.

Foreign companies commanded 80 percentof the market share. Millions of Indians weredependent almost entirely on these companiesfor their daily medicines.

These overseas companies simply imported thedrugs as it suited their commercial interests.There was hardly any investment in researchor in the manufacture of drugs within thecountry.

There was no access or availability of newdrugs.

For a country just trying to raise its head fromits colonial past, this was a huge economicburden.

If you were a doctor then, your hands were tied;

you were as helpless as your patients.

India now

These conditions forced the Government to changethe Patents Act in 1970. The new Act stoppedrecognising product patents in the vital areas ofmedicine, food and atomic energy. In other words,it put the interest of the nation before that of the


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patent holder. It set us doctors free. For the Indianindustry and the Indian consumer this was a much-needed shot in the arm. It changed the face of theindustry and the health of the nation.

Many of us may not be able to relate to conditionsbefore 1970. Most of us are now used to the freedom

to prescribe the best drugs. We are confident thatour patients can get their medicines at realisticprices. New generations of drugs help us to stayahead in practice and patient care. In short, thingsare so healthy that we are not even bothered aboutsomething like patents. But we only have to peepinto what is happening in other countries (even ourneighbours) to realise how much we owe to thePatents Acts Amendment 1970 (see Table 1).

Let us take a moment to count our blessings, aspatients, as doctors and as Indians.

Indian companies have introduced more than500 new molecules in the last 20 years.

Most of these new drugs have been madeavailable in the country within a short time aftertheir introduciton worldwide. (Salbutamol,Atorvastatin, Clopidogrel, Fluticasone,Omeprazole, Citalopram and many more).

Many new formulations were launched forthe first time in the world (e.g. Triple-drugantiretroviral combinations, combinationanti-platelet drugs, long-acting anticholinergicinhalers).

Drug prices are the lowest in India. Absence ofmonopoly helps to further drive down the prices.Take ciprofloxacin again. It was launched at Rs.18 per tablet in May 1989 and has now droppedto below Rs. 3 per tablet. Omeprazole whichcame in at Rs. 9.50 per capsule in April 1991 isnow just about a rupee. Adefovir, an antiviralfor Hepatitis B, was launched as recently asMarch 2004 at Rs. 35 and it has already slippedto Rs. 19. Atorvastatin, a cholesterol reducer,

launched at Rs. 21.00 in October 1999 is nowjust Rs. 2.40 per tablet. Hepatitis B vaccine waslaunched at Rs. 450 in 1994 and is now justRs. 100 per vial (see Table 2).

It is a matter of pride for all of us that Indiancompanies are proving that it is possible to makedrugs that are as good as the best at a fraction ofthe patented prices that still prevail in othercountries.

India has become a major net exporterof pharmaceuticals. This was consideredimpossible before 1972. It is India, which hasmade a dramatic impact worldwide in the drugtreatment of diseases such as HIV/AIDS.

Over 95 percent of the drugs available today in

India are produced locally. For us doctors andfor our patients, this means assured availabilityof the drugs we need at prices we can afford.

Among all drugs approved in the world, 90percent are marketed in India. This is thanks toour steady demand for the best and the latest,the advances made in domestic research andmanufacturing and, above all, the Patents Act1972.

What lies ahead ?

The Government of India has re-amended thePatents Act of 1970 and has decided to recogniseproduct patents for all molecules for which patenthas been applied for after January 1995. There wasno debate on this vital issue of utmost nationalimportance before the Act was passed in March2005.

These amendments are likely to have a far-reachingconsequence on the easy availability of moderndrugs that we are so used to today. In due course, a

monopolistic situation will emerge for all new drugmolecules. This will be better understood when weexamine some of the arguments put forth in favourof the new Patents Act.

Argument: Had product patents been allowed(Multinational Corporations) MNCs wouldhave made a significant contribution to theIndian industry.

Fact: Prior to 1972, when the patent law wasloaded in favour of foreign companies, therewas hardly any manufacture in India. Products

were simply imported leading to shortages andhigh drug prices. Why should things be anydifferent now ?

Argument: There will only be a marginalincrease in drug prices for new molecules.

Fact: Facts do not support this claim. Even intodays highly competitive environment, forthe same drug, MNCs charge a much higherprice than Indian companies. For instance,


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Amlodipine 10 mg of Pfizer is priced at Rs.7.20 per tablet in comparison to Rs. 1.00 pertablet of other Amlodipine brands.

Also, in cases where there is no competition,the MNC prices are exorbitant and beyond thereach of the Indian patient.

Xigris 20 mg (Eli Lilly) Rs. 54,450 per vial

Pegylated Interferon Rs. 22,830 per vial30 mcg (Fulford)

Fentanyl 50 mcg (J&J) Rs. 710 per patch

Visudyne (Novartis) Rs. 72,500 per vial

Argument:About 95 percent of the productsmarketed today are not covered by patents.

Fact: According to the 2005 amendment,products patented internationally after January

1, 1995 can only be marketed by the patentholder in India. In times to come, severalnew drugs patented after January 1995 willbe marketed only by MNCs. These drugs willenjoy monopoly rights and no Indian companywill be able to manufacture these products.Chances are because of resistance and otherreasons, these may be the very drugs thatIndian patients might require. Doctors mayhave to limit themselves to what is available.Patients may have to pay exorbitant prices forthe products they need to keep good health.

Argument:There are cheaper, alternative non-patented drugs available to the patient.

Fact: As doctorswe are aware of how bacterialresistance can turn yesterdays magic bulletsinto ineffective duds today. Over time, olderdrugs become less effective and there is aconstant need for new and more effectivedrugs. If new drugs are beyond the reach of theIndian patient because of high prices, physicianswill be forced to prescribe older generation

drugs. Patients will be deprived of new drugsunless it suits the interest of the monopolypatent holder to make the drugs available at anaccessible price. This is currently the situationin all developing countries, except India.

Argument: The cost of R&D for a newmolecule is in the region of $800 million andhence the high cost of formulations based onthe patented new molecules.

Fact: The figure of $800 million is impressive butmany believe this is highly inflated. Companieshave been known to pass off a number ofnon-research expenses like opportunity costsand marketing costs as research expenses.Much of the new drug research is carried

out by government-funded institutionslike universities and public hospitals. Theseinstitutions then transfer their almost-readyresearch to the industry.

Also, a majority of new molecules inventedtoday are me-too ones and are mere molecularmanipulations of existing drugs. Imipenemwas followed by meropenem and ertapenem.Lovastatin was followed by simvastatin,atorvastatin, rosuvastatin and pitavastatin.Omeprazole was followed by lansoprazole,pantoprazole, esomeprazole and rabeprazole.

There are many more such examples.

Do we believe that each such me-too moleculealso costs $800 million for their research anddevelopment?

Argument: Government has providedsafeguards to check drug prices.

Fact: Under certain circumstances, theGovernment can override the patent and granta licence for the compulsory manufacture of adrug. Other safeguards include the provisionof Government intervention and pricenegotiations. These safeguards appear adequatein theory but history shows a differentpicture. Various countries, which have similarprovisions, have shown that these safeguardsare ineffective and impractical to implement.

Argument: The government is bound tohonour international treaties.

Fact: The new patent law is framed under theWorld Trade Organizations Agreement on

Trade-Related Aspects of Intellectual PropertyRights (TRIPS). The government argues thatthe new patent law is necessary to honour ourcommitment under TRIPS. Others counterthis by questioning why the Indian governmenthas not done enough to use the flexibilitiesavailable under the same TRIPS. The agreementshould provide sufficient flexibility to tailorthe patent law to suit the countrys needs.


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The Government should have provided forautomatic license of right of manufacture tosomeone other that the patent holder, with theinnovator guaranteed a royalty amount.

Argument: With its vast pool of scientifictalent and large force of skilled labour, India is

capable of inventing new molecules.

Fact: There is no doubt of Indias skills inscience. Possibly, there are already manyIndians making a significant contribution topath-breaking research in various laboratoriesin the world. Innovators definitely deserve theirrewards but is the Patents Act only for them?Or is our priority to provide quality medicinesat reasonable prices to the less fortunatemillions? We do not have a well-organisedmedical insurance system. If we also take away

the competition, the very competition that hasbeen seen to bring prices down, can we expectthe MNCs to safeguard the interests of the onebillion Indians? Can our public hospitals thattake care of our masses afford to buy highlypriced patented medicines?

India is host to a number of life-threateningdiseases like TB, malaria, diabetes, asthma, AIDS,cancer, cardiovascular disorders and other tropicaldiseases specific to our country. Many of us get tosee almost all of them within a single day. Imaginethe plight of your patients who come back to you

because they cant get or cant afford what youhave prescribed and what they need, as a result ofthe new Patent Act changes. A situation to be evenmore feared is the move to further tighten the lawsto grant even greater monopoly e.g. scuttling outthe right to information and so on.

The constitution of India guarantees THE RIGHTTO HEALTH. Non-access to vital and life-savingdrugs will be tantamount to genocide. We Indiansmust resist all attempts to take us back to the oldmonopolistic era.

Thats the only way we can ensure the future healthof the nation.


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Table 1: International Prices Vis-a-vis Indian Prices Select Products

Drug & Dosage Pack Price inIndia (Rs.)

Price inPakistan (Rs.)

Price inIndonesia (Rs.)

Price inUSA (Rs.)

Price in UK(Rs.)

Anti-Bacterial

Ofloxacin 200 mg 10s 25.00 216.66 441.67 2377.76 595.84

Cefadroxil 500 mg 10s 36.19 190.03 210.21 2784.76 214.32

Ciprofloxacin 500 mg 10s 29.00 368.36 926.75 2552.44 1079.20

Norfloxacin 400 mg 10s 17.59 104.73 130.63 1782.88 277.40

Lomefloxacin 400 mg 6s 58.50 N.A. 440.00 3042.16 N.A.

Clarithromycin 250 mg 4s 60.00 104.72 110.00 793.76 237.12

Sparfloxacin 200 mg 6s 33.00 N.A. 299.70 1765.72 N.A.

Gatifloxacin tablets 400 mg 10s 39.90 N.A. 1771.78 4137.76 N.A.

Levofloxacin tablets 500 mg 10s 39.90 599.77 875.00 4677.20 1964.60

Opthalmology

Ciprofloxacin 0.3% Eye Drops 5 ml 5.88 157.67 256.00 2035.44 375.44

Norfloxacin 0.3% Eye Drops 5 ml 8.96 82.45 N.A. N.A. N.A.

Dorzolamide 2% Eye Drops 5 ml 195.25 670.71 N.A. 1366.64 481.08

Latanoprost 50 mcg eye drops 2.5 ml 250.52 807.56 1356.25 2446.40 998.64

Dorzolamide 2% + Timolol 0.5%eye drops

5 ml 220.00 702.26 N.A. 2063.60 763.80

Loteprednol 0.5% eye drops 5 ml 55.25 N.A. N.A. 1410.20 N.A.

AntiInflammatory

Diclofenac 50 mg 10s 4.34 36.79 161.12 733.48 191.52

Piroxicam 20 mg 10s 8.93 71.37 305.76 1161.16 196.84

Meloxicam 7.5 mg 10s 9.50 1213.96 291.08

Aceclofenac 100 mg tabs 10s 19.00 N.A. N.A. 121.60

Anti-Ulcerants

Ranitidine 150 mg 10s 5.19 64.39 216.33 1012.44 16.72

Famotidine 40 mg 14s 5.03 269.50 238.00 2414.28 965.20

Omeprazole 20 mg 10s 9.90 358.80 634.08 2030.16 792.68

Lansoprazole 30 mg 10s 35.00 425.15 462.78 2097.04 542.64

Pantoprazole 40 mg 10s 15.00 450.37 1683.00 589.00

Rabeprazole 20 mg tabs 10s 9.50 N.A. 1960.20 574.56

Cardiovasculars

Atenolol 50 mg 14s 5.60 62.42 322.56 809.60 N.A.

Diltiazem 60 mg 10s 30.00 50.23 32.50 410.52 86.64

Lisinopril 5 mg 10s 17.90 39.90 226.78 511.72 213.56

Enalapril Maleate 5 mg 10s 11.99 37.11 119.17 523.60 203.68Amiodarone 200 mg 10s 58.00 112.94 211.50 1710.72 197.60

Amlodipine Besylate 5 mg 10s 5.90 87.05 228.78 696.96 353.40

Terazosin 2 mg 10s 55.78 107.57 190.81 978.56 123.88

Losartan Potassium 50 mg 10s 17.00 N.A. 319.00 731.28 490.96

Telmisartan 40 mg tabs 10s 58.00 N.A. 315.86 846.56 307.80

Valsartan 80 mg caps 10s 69.00 283.13 448.24 731.72 446.12


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Price inUSA (Rs.)

Price in UK(Rs.)

Anti-viral/fungal

Ketoconazole 200 mg 10s 107.29 202.81 280.00 2005.52 377.72

Zidovudine 100 mg 10s 58.00 N.A. 340.50 902.88 843.60

Terbinaline 250 mg 7s 175.00 208.94 486.45 3028.08 880.08

Lamivudine 150 mg 10s 88.00 N.A. 1815.00 2333.76 1927.36

Efavirenz 200 mg caps 30s 807.00 N.A. 6792.72 5279.72

Lamivudine 150 mg + Zidovudine300 mg tabs

10s 205.00 N.A. 5025.24 4035.60

Valacyclovir 500 mg tabs 3s 74.00 251.79 246.12 603.24 498.56

Tenofovir 300 mg tabs 30s 4500.00 N.A. N.A. 20064.00 N.A.

Nelfinavir 250 mg tabs 100s 2400.00 N.A. N.A. 11097.68 N.A.

Anti-histamine

Cetirizine 10 mg 10s 7.80 31.03 166.67 928.40 193.04

Loratadine 10 mg 10s 19.50 90.72 220.50 1421.20 -

Fexofenadine 120 mg 10s 29.40 125.27 135.00 - 158.08

Anti-Anxiolytics/Psychotics

Alprazolam 0.5 mg 10s 7.00 46.52 212.50 1034.88 -

Risperidone 4 mg 10s 28.00 917.62 N.A. 2574.44 1688.72

Trazodone HCl 50 mg 10s 20.60 34.65 72.00 952.16 186.96

Buspirone 5 mg 10s 8.35 82.47 181.17 399.08 237.12

Sertraline 50 mg 10s 24.00 N.A. 526.78 1199.44 483.36

Fluoxetine 20 mg 10s 8.60 275.94 506.98 1748.56 360.24

Citalopram 10 mg tabs 10s 16.00 364.78 N.A. 1344.20 243.20

Escitalopram 10 mg tabs 10s 39.90 359.79 N.A. N.A. 404.32

Anti-Cancer

Mitoxantrone 2 mg/ml 10 ml 385.00 N.A. 13760.00 63911.76 10632.40

Carboplatin 150 mg Vial 693.00 1662.78 3702.60 21625.12 4652.72

Vincristine 1 mg Vial 48.00 328.68 535.00 N.A. 1077.68

Etoposide 100 mg Vial 190.00 482.06 174.68 6005.56 1030.56

Imatinib Mesylate 100 mg Caps 10s 850.00 8516.66 9821.96 9329.76 9863.28

Gemcitabine 200 mg Injn 200 mg Vial 900.00 7190.38 2788.50 5997.20 2473.80

Anti-emetics

Ondansetron HCl 8 mg Injn 4 ml 20.00 N.A. 665.20 11285.12 911.24

Cholesterol Reducer

Lovastatin 20 mg 10s 28.90 159.34 433.33 1180.96 N.A.

Simvastatin 10 mg 10s 35.00 245.98 412.50 1268.08 489.44

Rosuvastatin 10 mg tabs 10s 150.00 N.A. N.A. 1108.80 489.44

Ezetimibe 10 mg tabs 10s 120.00 N.A. N.A. 1122.00 714.40

Atorvastatin 10 mg tabs 10s 24.00 483.85 565.95 1087.68 489.44


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Price inUSA (Rs.)

Price in UK(Rs.)

Osteoporosis

Alendronate Sodium 10 mg 10s 49.00 539.52 N.A. 1017.72 627.00

Risedronate Sodium 35 mg tabs 4s 200.50 N.A. 3101.56 1542.80

Anti-epileptic

Lamotrigine 25 mg 10s 29.00 162.75 N.A. 1321.32 276.64

Levetiracetam 500 mg tabs 10s 178.00 N.A. 1114.52 662.72

Anti-platelet

Ticlopidine 250 mg 10s 75.50 163.69 383.38 1198.56 N.A.

Clopidogrel Bisulphate 75 mg tabs 10s 27.43 N.A. 838.13 1855.04 958.36

Anti-asthmatic

Salmeterol Xinafoate 200 doses 130.25 1407.56 1980.00 4043.16 7412.28

Budesonide 200 doses 277.25 444.28 886.26 6644.00 2812.00

Fluticasone Propionate 120 doses 190.50 N.A. 562.65 2796.64 969.76

Montelukast 4 mg tabs 10s 59.25 364.99 N.A. 1321.76 487.92

Salmeterol 25 mcg 120 doses 210.50 598.60 782.65 N.A. 1378.64Fluticasone 50 mcg inhaler For-moterol 6 mcg + Budesonide 100mcg Inhaler

120 doses 190.50 N.A. N.A. N.A. 2508.00

Urology

Doxazosin 2 mg 10s 25.00 124.60 341.56 748.88 382.28

Oxybutynin 5 mg 10s 50.00 N.A. 459.80 120.84

Sildenafil 50 mg tablets 4s 48.00 N.A. 1356.93 4455.44 1616.52

Tadalafil 20 mg tabs 4s 118.00 N.A. N.A. 1778.40

Anti Prostate

Finasteride 5 mg tabs 10s 66.00 352.00 366.67 860.20 378.48

Tamsulosin 0.4 mg caps 10s 53.13 N.A. 875.16 522.88Dutasteride 0.5 mg caps 10s 98.00 N.A. 1153.24 628.52

Anti Diabetic

Pioglitazone 15 mg tabs 10s 9.00 N.A. 1522.40 655.12

Miglitol 50 mg tabs 10s 95.00 N.A. N.A. 345.88 N.A.

Miscellaneous

Nimodipine 30 mg 10s 70.00 186.11 251.50 3514.28 295.64

Tizanidine 2 mg 10s 54.50 93.53 202.11 594.88 399.00

Midazolam 1 mg/ml 5 ml 27.50 64.54 61.89 700.04 68.40

Imiquimod 5% Cream 3s 150.00 N.A. 1921.04 975.08

Adefovir 10 mg tabs 10s 190.00 N.A. 7817.48 7980.00

Galantamine 4 mg tabs 10s 94.00 N.A. 1107.48 741.00

NOTE:1. Retail prices in India & wholesale prices in other countries considered.2. Conversion rate of exchange considered: 1 USD = Rs. 44.00, 1 GBP = Rs. 76.00, 1 Pak Rs. = Rs. 0.73, 1 Indonesian Rp = Rs. 0.005 and

1 Bht = Rs. 1.04 as on 12.7.20053. Sources for prices: USA prices Red Book 2004

UK prices UK MIMS June 2005Pakistan Pharmaguide January 2004India IDR May/June 2005Indonesia IIMS Vol. 32, No. 2, 2003Thailand TIMS Vol. 32, No. 2, 2003

Date: September 2005


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Table 2: Examples of Price Reductions in Drugs due to intense Competition in India

Drug Unit price at launchin Rs. (as on)

Current unit pricein Rs.

% fall inprice

No. of manufacturers

Antibiotic/Antibacterial

Ciprofloxacin 500 mg Tablet 18.00 (May 89) 2.90 84 158

Norfloxacin 400 mg Tablet 7.75 (Nov. 87) 1.75 77 77

Pefloxacin 400 mg Tablet 10.00 (Sept. 91) 4.40 56 25

Ofloxacin 200 mg Tablet 26.00 (Apr. 90) 2.50 90 83

Azithromycin 250 mg Capsule 22.00 (July 94) 7.95 64 32

Sparfloxacin 200 mg Tablet 20.00 (Nov. 96) 5.50 73 62

Levofloxacin 500 mg Tablet 95.00 (Nov. 99) 4.00 96 26

Ceftazidime Injection 1 gm vial 334.17 (April 89) 198.00 41 12

Cefuroxime axetil 250 mg Tablet 37.59 (March 91) 5.40 86 29

Cefepime 1 gm Vial 399.00 (Oct 2003) 125.00 69 15

Cefpodoxime 200 mg Tablet 29.00 (May 2002) 19.90 32 18

Moxifloxacin 400 mg Tablet 90.00 (July 2001) 65.00 28 3

Rosiglitazone 2 mg Tablet 3.55 (July 2000) 2.00 44 11

Anti-AIDS

Zidovudine 100 mg Caps 18.53 (January 93) 5.80 69 6

Lamivudine 150 mg Tablet 38.00 (Aug. 98) 8.80 77 6

Stavudine 40 mg Caps 41.00 (June 99) 3.70 91 6

Nevirapine 200 mg Tablet 135.00 (Mar. 2000) 13.35 90 6

Didanosine 100 mg Tablet 36.00 (Dec. 2000) 30.00 17 6

Indinavir 400 mg Caps 50.00 (Apr. 2001) 23.30 53 6

Lamivudine 150 mg + Stavudine 40 mg +Nevirapine 200 mg Tabs

31.00 (July 2001) 21.30 32 6

Lamivudine 150 mg + Zidovudine 300 mg +

Nevirapine 200 mg Tablet

40.00 (Nov. 2001) 22.50 44 6

Anti-Platelet

Clopidogrel 75 mg Tablet 30.00 (Feb. 2001) 2.74 85 35

Glaucoma

Latanoprost eye drops 1142.00 (July 2000) 250.52 79 3

Hormonal Drugs

Tibolone 2.5 mg Tablet 35.36 (Sept. 1997) 17.00 52 5

Alzheimers Disease

Rivastigmine 1.5 mg Caps 116.00 4.50 96 4

Donepezil 5 mg Tablet 50.00 (June 2001) 7.00 86 5

Pain Management

Celecoxib 200 mg Caps 7.00 (March 2000) 2.50 65 20

Hepatitis B

Adefovir10 mg Tablet 35.00 (March 2004) 19.00 46 2

Hepatitis B 20 mcg vaccine 450.00 (1994) 100.00 78 13


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Drug Unit price at launchin Rs. (as on)

Current unit pricein Rs.

% fall inprice

No. of manufacturers

Prostate

Bicalutamide 150 mg Tablet 90.00 (Sept. 2003) 35.08 61 2

Tamsulosin 400 mcg Caps 8.90 (June 2002) 5.31 40 8

Finasteride 5 mg Tablet 8.50 (Dec. 96) 6.60 23 6

Anti-allergic

Desloratidine 5 mg Tablet 3.60 (Nov. 2001) 1.99 45 15

Cetirizine 10 mg Tablet 3.00 (Aug. 93) 0.78 74 67

Anti-asthamtic

Montelukast 10 mg Tablet 24.00 (Feb. 2002) 10.50 56 5

Anti-cancer

Zoledronic acid 4 mg Injection 2800.00 (June 2003) 1400.00 50 5

Pamidronic acid 90 mg Injection 5200.00 (Mar 2001) 1800.00 66 6

Letrozole 2.5 mg Tablet 158.00 (April 2003) 6.00 100 4

Obesity

Sibutramine 10 mg Caps 15.00 (Dec. 2000) 7.50 50 8

Source: IDRMay/June 2005


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