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Journal ArticleDOI

Evaluation of cost effectiveness and efficacy of commonly used different antacid gel preparations

01 Jan 2013-International journal of basic and clinical pharmacology (Medip Academy)-Vol. 2, Iss: 6, pp 788-791

TL;DR: Evaluated cost effectiveness studies are beneficial in improving the prescribing pattern and will be a benefit for both doctor as well as patient.

AbstractBackground: Gastroesophageal reflux disease (GERD) is a common clinical condition in Indian population. Antacids, which are available as over the counter (OTC) are the commonly prescribed drugs for treatment of GERD. Antacids manufactured and marketed by various multinational and local companies are available in the market. There is need for evaluating the cost effectiveness and efficacy of these antacids as a matter of public concern. Hence the present study was conducted to evaluate the cost effectiveness and efficacy of the commonly prescribed antacid gel preparations. Methods: Seven different gel formulations of antacids manufactured by different companies were evaluated. Cost effectiveness was done by calculating the cost per ml of antacid and also by palatability test. Efficacy was evaluated based on acid neutralizing capacity (ANC) of antacid preparations. Results: The highest cost was 0.305 Rs. per ml and lowest was 0.135 Rs per ml. Palatability score was high at 26.80 and low at 23.85. The antacid with lowest ANC was 20.5 mEq and the highest was 26.5 mEq. Conclusion: Cost effectiveness studies are beneficial in improving the prescribing pattern. It will be a benefit for both doctor as well as patient.

Topics: Cost effectiveness (62%), Antacid (55%)

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Citations
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Journal ArticleDOI
24 Sep 2021
TL;DR: All the antacids marketed in Morocco meet the USP requirement regarding their ANC, however, the ANC value should be included in the antacid drugs’ labels so that both patients and physicians can choose the most appropriate product.
Abstract: Aim. The aim of this study was to evaluate the acid-neutralizing capacity (ANC) and other properties of antacid drugs marketed in Morocco. Methods. Samples of 12 antacids were collected from pharmacies and were subjected to the test described in the US Pharmacopoeia in order to measure their ANC. Other properties such as price and sodium content were also studied. Results. All the tested brands met the minimal requirement of 5 mEq. However, Aluminum hydroxide/Magnesium hydroxide combinations showed a superior acid-neutralizing capacity over other products and oral suspensions showed better results compared to other pharmaceutical forms. Regarding the cost of antacids, Aluminum hydroxide/Magnesium hydroxide combinations and calcium carbonate/magnesium carbonate combinations showed the most favorable ANC/price ratio. Some of the antacids studied contain a high amount of sodium. Conclusion. All the antacids marketed in Morocco meet the USP requirement regarding their ANC. However, the ANC value should be included in the antacids’ labels so that both patients and physicians can choose the most appropriate product. The ANC value should be evaluated according to the dose of the active substance instead of the minimum labeled dosage in order to allow a better result interpretation.

5 citations


Cites result from "Evaluation of cost effectiveness an..."

  • ...These findings are consistent with many other studies that have also shown great variability in terms of the cost/effectiveness ratio of antacids and recommended the economic factor to be taken into account when choosing the most suitable product [34-36]....

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Journal ArticleDOI
TL;DR: F1 showed high antacid and buffering properties when tested in vitro and highlights the need for future research on specific OTC non-prescribed antacid formulations with respect to their price, efficacy and side effects.
Abstract: Background: Hyper-acidity is excessive formation of acid (pH=1.5-3.5) in the stomach by parietal cells which causes a burning sensation in the chest. The preservation of gastric acid insult is crucial because of the implications of hyperacidity in gastroesophageal reflux disease (GERD), peptic ulcers and duodenal ulcers. Acidity is controlled by use of some over-the-counter (OTC) antacid formulations containing magnesium or aluminum hydroxides. Methods: In the present study, the preliminary antacid test (PAT), the pH acid neutralizing capacity (ANC), acid neutralizing potential (ANP) along with buffering capacity of two well-known quick release formulations (F1 [Digene Ultra Fizz] and F2 [a standard, commercially available product]) were determined. Results: According to US pharmacopeia USP, both the antacid formulations passed the PAT test. PAT results revealed that the pH of the acid-antacid solution was higher in F1 (8.20±0.02) as compared to F2, (6.53±0.01). The ANC results revealed that F1 (46.89±0.6 mEq/dosage) had higher neutralizing capacity as compared to F2(30.12±1.3 mEq/dosage). Higher ANP was observed for F1 (245 mins), and it was 2.7 times that of F2 (90 min). The onset of action for both the antacids was <2 seconds. Additionally, buffering capacity was evidently observed during ANP analysis in the case of F1. Independent T test performed for all the tests revealed that the data obtained was highly significant (p<0.01). Conclusions: F1 showed high antacid and buffering properties when tested in vitro. The present study highlights the need for future research on specific OTC non-prescribed antacid formulations with respect to their price, efficacy and side effects.

5 citations


Cites background from "Evaluation of cost effectiveness an..."

  • ...Various invitro tests are available to evaluate the performance of antacids such as acid neutralizing capacity (ANC), pH stat, among others.(15) ANC is a measure to determine ability of an antacid to neutralize acid and is expressed as number of milli-equivalents of HCl that can be neutralized by one standard dose of antacid preparation....

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References
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Journal ArticleDOI
TL;DR: Novel aspects of the new definition include a patient-centered approach that is independent of endoscopic findings, subclassification of the disease into discrete syndrome, and the recognition of laryngitis, cough, asthma, and dental erosions as possible GERD syndromes.
Abstract: The Montreal Definition and Classification of Gastroesophageal Reflux Disease: A Global Evidence-Based Consensus

3,011 citations


Journal ArticleDOI
TL;DR: These experiments indicate that when antacids are prescribed, dosage should be determined by the milli-equivalents of neutralizing capacity rather than by an arbitrary volume or number of tablets of different antacid, that the variable is likely to vary among different commercial products.
Abstract: An in vivo test of the efficacy of liquid antacids given after a meal was shown to yield reproducible results. An average dose-response curve, obtained with the use of various doses of a single antacid, was different in subjects whose peak histamine response exceeded 25 mEq per hour and in those whose response was less than 16.6 mEq per hour. In individual subjects, however, the peak histamine response did not accurately predict the in vivo reduction in gastric acidity by antacid. Although the relative in vivo potency of equal volumes of four different antacids varied widely, this potency could be predicted with reasonable accuracy by means of an in vitro test, which showed the potency per milliliter of antacid to vary 17-fold among different commercial products. These experiments indicate that when antacids are prescribed, dosage should be determined by the milli-equivalents of neutralizing capacity rather than by an arbitrary volume or number of tablets of different antacids, that the variable ...

172 citations



Journal ArticleDOI
TL;DR: These findings support anecdotal observations and claims often made by parents that cephalosporin antimicrobial suspensions taste good and are readily accepted by children and that penicillin suspensions have an unpleasant taste and aftertaste and are poorly accepted.
Abstract: Children of preschool age most often receive medications in liquid form, and smell and taste are major determinants in achieving compliance. We compared smell, taste and other characteristics of 14 commonly prescribed antimicrobial suspensions in a blind test in 30 adult volunteers to determine whet

53 citations


Journal Article
TL;DR: GER prevalence was high in pregnancy, often in second and third trimester, and non-vegetarianism and aerated beverages increased the risk of reflux in pregnancy.
Abstract: Background and aimPrevalence of gastroesophageal reflux (GER) increases during pregnancy, due to several factors like decreased lower esophageal sphincter pressure, increased intra-abdominal pressure secondary to the enlarged gravid uterus and alteration in gastrointestinal transit. The present study aimed to determine the prevalence of GER in pregnancy in a southern State of the Indian subcontinent and determine the risk factors associated with it.MethodsConsecutive pregnant females (n = 400) at various stages of pregnancy attending the antenatal clinic or admitted in the antenatal wards were enrolled. Patients with heartburn or regurgitation or both (n = 182) for at least a week were defined as cases, and controls were those without these symptoms (n = 218). Data on demographic variables and symptoms were analyzed using Pearson chi-square, Yates corrected chi-square and Fischer exact test and student independent t-test as appropriate; p < 0.05 was considered significant.ResultsDemographic characteristics between cases and controls were similar. The mean age of cases (23.68±3.37 years) was similar to that of controls (23.25±3.31 years). The overall prevalence of GER was 45.5% (182/400), 77 (19.3%) had heartburn (GER-HB), 54 (13.5%) had regurgitation (GER-R) and 51 (12.8%) had both (GER-HB + R). Age and gravida did not influence the frequency of symptoms. Symptoms were more frequent in the second (43.1%) and third trimester (54.1%) as compared to the first trimester (9.5%) in pregnant women with GER (p < 0.001). Atypical symptoms were uncommon. GER was common among non-vegetarians (p = 0.02) and frequent aerated beverage users (p = 0.001).ConclusionsGER prevalence was high in pregnancy, often in second and third trimester. Non-vegetarianism and aerated beverages increased the risk of reflux in pregnancy.

31 citations