Pharmacoeconomic analysis of price disparities among anti-alzheimer drug brands in the Indian market

Background: Alzheimer’s disease (AD) is a leading cause of dementia, with a rapidly increasing burden in India. Although pharmacotherapy can halt disease development, treatment is mostly out-of-pocket, making drug affordability a key concern. Wide pricing disparities between branded generics may further impede access and adherence. The study objective of this study was to evaluate inter-brand cost variation among anti-Alzheimer drugs available in the Indian pharmaceutical market. Methods: A cross-sectional pharmacoeconomic analysis was conducted by using the data obtained from the Current Index of Medical Specialties (CIMS) and MIMS website. Commonly prescribed drugs such as donepezil, rivastigmine, memantine, and their combinations were analyzed. Cost ratio and percentage of cost variation were calculated for each formulation. Results: Prices varied significantly across all medicines. Rivastigmine displayed the most fluctuation, especially in 1.5 mg capsules (1634.13%; price ratio 17.34). Memantine 10 mg pills varied by 364.72%, whilst donepezil exhibited a lower but still considerable variance, with a maximum of 120.44%. Fixed-dose combinations showed moderate variability, with the largest being donepezil 5 mg plus memantine 5 mg (117.44%). Substantial discrepancies between the top and lowest expensive brands emphasize the possibility of cost savings. Conclusion: Significant inter-brand price disparities exist among anti-Alzheimer medications in India, with rivastigmine showing the highest variability, followed by memantine and donepezil. Promoting cost-conscious prescribing and the use of lower-priced, bioequivalent alternatives could reduce economic burden and improve treatment continuity in patients with AD.