Second-generation antihistamines (SGAs) are the most commonly used drugs for AR nowadays. The cost of medicines is very important determinant in drug compliance; selection of low cost quality drugs would thus be helpful in improving compliance. Literature search revealed no such study done in India and the current study was thus planned to compare the variation in the cost of different SGAs used for the treatment of allergic rhinitis in India. The study results would help doctors, pharmacists

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... selecting the least costly options among the available SGAs. Methods: The costs in Indian rupee (INR) of different generic and branded SGAs available in Indian market were referred from CIMS, drug today and the website www.medindiaguide.com. The dose for each drug was taken as per WHO defined daily dose (DDD) for allergic rhinitis. The highest and lowest price for ten tablets/capsules of each SGA manufactured by different pharmaceutical companies was noted. The percentage cost variation and cost ratio were then calculated for each drug. Results: Eight oral SGAs with a total of 1050 oral tablets or capsules manufactured by different companies are available for use in AR in India. The highest number of manufacturers were for levocetirizine (483), and lowest for mizolastine (2). Fexofenadine (INR 123.56) was the costliest and levocetirizine the cheapest (INR 2.3) SGA. Maximum variation in price was seen with cetirizine (4300%). The cost ratio was highest for cetirizine (44), and lowest for mizolastine (1.1). Cetirizine is the only SGA from the National List of Essential Medicines (NLEM) 2015 of India; also the only SGA in the DPCO 2013 list of controlled drugs and formulations. Conclusions: There is huge variation in the price of same SGA being manufactured by different companies. Between the least expensive and the most expensive cetirizine, there is a huge cost variation of 4300%.