Antibiotic price disparities: A comparative analysis of Jan Aushadhi, National Pharmaceutical Pricing Authority and commercial markets

Objectives: Access to affordable antibiotics is essential for public health, particularly in low- and middle-income countries like India. However, significant price disparities exist across different pricing models, including Jan Aushadhi (JA), National Pharmaceutical Pricing Authority (NPPA)-regulated and commercial market sources. This study evaluates these disparities to assess economic feasibility and accessibility. Materials and Methods: A cross-sectional observational study was conducted at King George’s Medical University, Lucknow, from January to February 2025. Antibiotic price data were collected from JA lists (2024), NPPA price lists (2024) and online/offline commercial markets. Price variations were analysed using percentage price difference and cost index (CI). Statistical significance was determined using paired t -tests ( P < 0.05). Results: Among 130 anti-infective drugs, 15 common antibiotics were analysed. NPPA-regulated prices were consistently higher than JA prices, while maximum market prices exceeded NPPA ceilings by up to 14.73 times (Ofloxacin 400 mg). Minimum market prices fluctuated, occasionally undercutting JA prices. The disparities raise concerns about price regulation inefficiency and financial barriers to antibiotic access. Conclusion: This study highlights major antibiotic price variations, demonstrating the need for stricter NPPA enforcement, real-time price monitoring and JA expansion. Aligning India’s pricing policies with global best practices (National Health Service, Patented Medicine Prices Review Board) can enhance affordability and accessibility while mitigating antimicrobial resistance risks.