Brand-Level Price Variation of Calcium Supplements in India: A CIMS 2023–24 Cross-Sectional Cost-Variation Study
Year: 2025
Type: article
Abstract: Background: Brand-to-brand price dispersion for identical medicines can erode affordability and adherence in out-of-pocket settings. Calcium supplements—used widely in India as plain salts and as fixed-dose combinations (FDCs) with vitamin D₃ and other micronutrients— are marketed by multiple brands at varying prices. We quantified brand-level price variation using a national compendium. Methods: We conducted a cross-sectional descriptive cost (price-variation) analysis using the Current Index of Medical Specialties (CIMS) 2023–24. Eligible entries were calcium preparations in tablet or syrup/suspension forms. For each identical strength and dosage form, we extracted per-unit maximum retail prices (MRPs) for all listed brands and derived the minimum and maximum price, absolute difference, and percentage price variation (%PV = [(max − min)/min] × 100). Single-brand listings were retained (%PV = 0 by definition). All calculations were performed in a spreadsheet; no inferential testing was planned. Results: Brand multiplicity within an identical preparation ranged from 1 to 34. Substantial dispersion was observed between the least- and most-expensive brands. The highest %PV occurred among calcium + multivitamins/minerals combinations (7,729.78%). Plain salts showed smaller spreads; calcium carbonate 500 mg exhibited 15% variation. Several calcium + vitamin D₃ combinations had wide ranges, for example: 1250 mg + 500 IU (two brands; ₹5.90–₹14.83; difference ₹8.93; 151.35%), 500 mg + 1000 IU (three brands; ₹6.14–₹12.90; difference ₹6.76; 110.09%), and 500 mg + 250 IU (15 brands; ₹1.23–₹10.89; difference ₹9.66; 785.36%). Single-brand categories (e.g., some strengths of calcium carbonate or calcium + vitamin D₃) yielded %PV = 0. Conclusion: Within the same calcium dose and formulation, brand choice alone can multiply patient costs several-fold—especially for multiingredient combinations. Generic-name prescribing with price-checked brand options and per-unit MRP–based formularies may improve affordability and adherence. Limitations include reliance on compendium MRPs and cross-sectional design; future work should link dispersion to utilization and persistence.
Authors: Shriram Kaurav, Anjali Kushwah, Meghana Shinde, Tasneem Hussain, Manan Parmar
Institution: Mahatma Gandhi Memorial Medical College
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W7089513358
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