Analysis of hematinic formulations available in the Indian market

OBJECTIVES: To analyze the hematinic formulations available in Indian market for their varieties of dosage forms, iron salts used, content of elemental iron, frequency of administration, additional nutrients, and cost. MATERIALS AND METHODS: Hematinic formulations listed in Indian Drug Review (2009) were analyzed for the iron salts contained and the elemental iron content. Preparations containing iron ± folic acid ± vitamin C were considered as ‘acceptable’ formulations. For proper comparison, cost of 100 mg elemental iron in each formulation was calculated. Acceptable oral formulations containing iron with folic acid were further classified according to iron salts, and the median cost of various iron salts was compared. We also identified oral solid formulations that required administration more than three times a day. Prices of ‘acceptable’ iron preparations were compared with that of ‘irrational’ formulations. RESULTS: Out of 621 formulations, 365 were oral solid formulations, 232 were oral liquids, and 24 were for parenteral administration. Formulations containing iron salts like ferrous sulphate, ferrous sulphate (dried), carbonyl iron, and ferrous fumarate are cheaper than formulations containing other iron salts. Among the 365 oral (solid) iron formulations, we found 60 that would require administration more than three times a day to provide a therapeutic dosage of elemental iron. As compared to irrational formulations, the cost of acceptable formulations was in a significantly narrow range; however, the median cost of acceptable products was significantly higher than that of the irrational ones, except in case of the parenteral preparations. CONCLUSION: The drug regulation authorities should tune the drug price in such a way that rational formulations cost less than the irrational ones.