OBJECTIVES: To compute the cost of FDC drugs used in the treatment of hypertension and study the variation in the costs.  METHODS: Standard treatment guidelines (STG), 4^th edition and Joint National committee (JNC), 8^th guidelines were perused to understand the management of hypertension. 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 drugs available in the Indian market. Annual cost of treatment and its variation was studied. RESULTS: First line FDC according to STG & JNC8 is calcium channel blockers/diuretics with beta-blockers or ACEI. If we initiated the treatment with amlodipine + atenolol (5mg + 50mg) OD, then the annual cost of treatment was found to be Rs.365-2909. A maximum variation of 697% was noted in the least-highest cost of treatment. A minimum of 144% variation was observed for amlodipine + lisinopril (5mg + 5mg) OD, in its least-highest cost of treatment.

Likewise, if the treatment is initiated with other combination therapy, say ramipril + hydrochlorothiazide (2mg +12.5mg) OD, then annual cost of treatment was found to be Rs.365-2792. This showed a maximum variation of 665% in its least-highest cost of treatment.

On the other hand hydrocholrothiazide + metoprolol (12.5 + 100mg) combination showed a minimum price variation of 9% only. CONCLUSIONS: It was concluded that a maximum of 8 fold variation was observed in the least-highest costs of treatment with amlodipine + atenolol (5mg + 50mg) in the year 2015. The average percentage price variation of different brands of the same oral antihypertensive drug manufactured in India is very wide.