More brands of Calcitriol plus Calcium than Cholecalciferol (Vit D) in India, both have huge price ranges

Price Dispersion of Vitamin D Supplements Over Time – An Initiative for Prescriber Education

Indian Journal of Endocrinology and Metabolism 25(2):p 142-147, March–April 2021. | DOI: 10.4103/ijem.ijem15921

Chugh, Preeta K.; Dabas, Aashima1

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Objectives:

High prevalence of vitamin D deficiency mandates prescribing an appropriate form of vitamin D that allows attainment of sufficiency in a cost-effective manner. We aimed to compare vitamin D products in Indian market in terms of composition and cost in 2020 with 2013 to understand price dispersion over 7 years.

Methods:

Constituents, formulations, and prices of ‘branded’ and generic vitamin D products were sourced from various drug information compendia and online sources. Price per defined daily dose (DDD), percentage cost variation, and change in prices over 7 years (2020 vs. 2013) was determined.

Results:

There has been a disproportionate increase in the number of brands and cost variation of cholecalciferol and calcitriol in the last 7 years. The percentage cost variation increased almost 10 times for calcitriol and 4.4 times for alfacalcidiol tablets and cholecalciferol granules. An analysis of >1,100 products in 2020 showed that the predominant form was calcitriol which was combined with calcium in >90% of the products with huge cost variation (>3000%). Ergocalciferol and cholecalciferol were available in 22 and 15 different strengths respectively. Median price/unit of cholecalciferol (60,000IU) was lower for tablets/capsules compared to other formulations; but with >1000% cost variation.

Conclusion:

A wide cost variation exists with the use of different vitamin D brands and preparations with conventional cholecalciferol tablets and capsules being a low-priced alternative. Quality control measures and strict enforcements of existing regulations are essential to ensure that competitive prices of branded generics are translated into availability and affordability for the population.

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Note: Calcitriol faster acting?, highly regulated by the body, prescription only in US, requires a $100 test, not stopped by poor liver, kidney nor 4 Vitamin D genes

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