Economic Burden and Cost Differences Between Branded and Generic Topical Antifungals in India

India's pharmaceutical market is characterized by a significant presence of both generic and branded drugs, particularly for common ailments such as superficial mycoses (SFMs), which pose a substantial public health and economic burden. Patients in tropical countries like India, which have common superficial mycoses, need prolonged treatment because of their recurrence rates after initial treatment and due to incomplete therapy. Given the high variability in drug pricing and the imperative for cost-effective healthcare, a pharmacoeconomic analysis comparing generic and branded topical antifungals in India is crucial to inform prescribing practices and optimize resource allocation.

The price comparison of various topical antifungal medications from different brands was conducted by using the latest information from the "Monthly Index of Medical Specialties" August to October 2025, and 1mg online pharmacy and Jan Aushadhi website. The study calculated the total expenses for 30 mL and 30 g dosage forms, which included cream, ointment, lotion, eye drops, and shampoo products of each drug brand. We conducted a comparison between different drug brands through their cost ratio, and percentage cost variation (PCV) analysis was done, keeping generic medicines prices (retrieved from the Jan Aushadhi website) as baseline values.

The data analysis showed a significant variation in the costs of different brands of topical antifungals in the Indian market. After analysis, we identified itraconazole 1% ointment to have the highest cost variation at 8335.1%, followed by clotrimazole dusting powder (4740%). Ketoconazole 2% cream, bifonazole 1% lotion, and sertaconazole shampoo showed the smallest variation at 3.29%, 3.5%, and 11.3%, respectively. When generic and branded topical antifungals were compared, the highest cost variation was seen for clotrimazole 1% cream (3431.7%), and the least variation was observed for ketoconazole 2% powder (135.4%). When combination topical antifungals were compared, the highest percentage cost variation of 1479.4% was seen for clotrimazole 1%w/w and beclomethasone dipropionate 0.025%w/w cream, and the least percentage cost variation of 38.8% was seen for terbinafine (1% w/w) + ciprofloxacin (1% w/w) + metronidazole (1% w/w) + clobetasol (0.05% w/w).

The market for topical antifungal agents demonstrates substantial price variation among available products. Regulatory authorities, pharmaceutical manufacturers, and clinicians must collaborate to achieve optimal reductions in drug costs. Strict implementation of cost regulation policies, along with increased awareness among clinicians regarding the rational selection of cost-effective therapies, is essential.