"EVALUATING NSAIDs PRICE DISPARITIES: INSIGHTS FROM JAN AUSHADHI, E-PHARMACIES AND NPPA PRICE CAP"

Abstract

Objectives

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in India for pain, inflammation and fever management. However, significant price disparities exist across different distribution channels, including government-subsidized PMBJP (Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana) stores, online pharmacies and NPPA (National Pharmaceutical Pricing Authority)-regulated pricing. This study aims to evaluate price variations of NSAIDs across these platforms.

Methods

This cross-sectional observational study was conducted at King George’s Medical University, Lucknow over four weeks in January 2025. Data were collected from the PMBJP drug list (2024), NPPA portal (2024) and online pharmacies (PharmEasy, Netmeds, Tata 1mg, and Apollo Pharmacy). Maximum and minimum market prices were recorded for each NSAID, and comparative analysis was performed. Descriptive statistics were used to compute percentage variations and paired t-tests were applied to assess statistical significance. The Cost Index Formula was utilized to quantify price disparities between market prices and regulatory limits.

Results

NSAIDs displayed considerable price disparities across different pricing platforms. Mefenamic Acid 500 mg exhibited the highest price inflation (35 times PMBJP price), while Tramadol 50mg showed a 23 times markup. Paracetamol 500 mg, with a cost index of 98.00, indicated extreme price variability. Certain NSAIDs, such as Etoricoxib, Nimesulide and Etodolac, lacked NPPA price caps, leading to unregulated price fluctuations (8-12 times PMBJP prices). While PMBJP provided the lowest prices, some market minimum prices matched or even undercut PMBJP rates, suggesting the influence of competitive pricing. NPPA ceiling prices remained significantly higher than PMBJP rates, raising concerns about the effectiveness of price regulation policies

Conclusion

Despite NPPA regulations, NSAID price variations remain substantial, with private retailers often exceeding price limits. The PMBJP initiative effectively reduces costs, but its limited reach affects accessibility. Expanding PMBJP centers and ensuring frequent NPPA price revisions aligned with market trends can improve affordability. The study underscores the need for stronger enforcement of price regulations and policy adjustments to bridge gaps between government pricing and market realities