OBJECTIVES: To compute the annual cost of FDC drugs used in the treatment of Type2 Diabetes Mellitus (T2DM) and study the variation in the costs. METHODS: Indian Council of Medical Research (ICMR) and International Diabetes Federation (IDF) guidelines were used to understand the treatment of T2DM. Current Index of Medical Specialities (CIMS) Oct- Jan 2015 issue and Indian Drug Review (IDR) issue 1, Jan 2015 were used to capture the prices of medicines available in the Indian market. The annual cost of treatment and variation in the annual cost of drugs was studied. RESULTS: Recommended first line FDC according to International Diabetes Federation is metformin + sulfonylurea. If we initiated the treatment with metformin + glimepiride (500mg + 1mg) OD, then annual cost of treatment was found to be Rs.438-2744. A maximum variation of 533% was noted in the least-highest cost of treatment. A minimum of 1% variation was observed for metformin + glipizide (2.5mg + 400mg) OD, among combination therapy in its least-highest cost of treatment.

Likewise, if the treatment is initiated with other combination therapy, say metformin + pioglitazone (500mg +15mg) BD, then annual cost of treatment was found to be Rs.1387-6935. This showed a maximum variation of 665% in its least-highest cost of treatment.

On the other hand metformin + voglibose (500 + 0.3mg) combination showed a minimum price variation of 86% only. CONCLUSIONS: It was concluded that a maximum of 6 fold variation was observed in the least-highest costs of treatment with metformin + voglibose (500mg + 0.3mg). A wide variation exist in the minimum and maximum price of anti-diabetic FDC manufactured across the different brands available in the Indian market.