Investigation of the Cost Impact of Chirality Status of the Most Commonly Consumed Drugs in Turkey

Yıl 2025, Cilt: 12 Sayı: 1, 12 - 20, 30.04.2025

Ahmet Akıcı , Caner Vızdıklar , Şeyhmus Gavaş , Nazım Haspolat , Dieudonne Havyarimana , Selcan Tülü Çolak , Volkan Aydın

https://doi.org/10.47572/muskutd.1579237

Öz

Chirality is among the factors impacting drug activity in terms of therapeutic or adverse effects. Pure enantiomeric drugs, presumed to offer greater benefits in accordance with this concept, have been recommended for new drug development. We aimed to analyse the chirality status of the commonly consumed drugs in Turkey and assess their cost implications. We evaluated top-selling 200 active substances using nationwide sales data from IQVIA Turkey, identifying chirality status of 173. These were categorized into “chiral mixtures”, “achiral”, and “pure enantiomers”, and their distribution and mean cost per unit (CPU) values by chirality status were examined. To examine the impact of chiral switching on expenses, CPUs of chiral-switched mixtures and resulting pure enantiomers, were compared. Among 173 compounds, 35.8% were achiral, 22.0% were chiral mixtures and 42.2% were pure enantiomers. Total cost was $2.09b, with pure enantiomers accounting for 46.4% and chiral mixtures 22.0%. Mean CPUs for pure enantiomers ($2.8±3.5), achiral drugs ($2.3±2.5), and chiral mixtures ($1.7±0.9) were similar (p>0.05). For drugs that underwent chiral switching, mean CPU of chiral mixtures ($1.4±0.4) was similar to that of pure enantiomers ($1.7±1.2), (p>0.05). Half of the chiral pairs that underwent switching had higher CPU for chiral mixture, while the other half had higher CPU for pure enantiomer. We demonstrated that pure enantiomers occupy a significant portion of top-selling drugs in Turkey. The observed cost similarity between commonly used pure enantiomers and chiral mixtures suggests that pure enantiomers may continue to gain preference in the market.

Anahtar Kelimeler

Drug Expenditure , Chirality , Chiral Switch , Chiral Mixture , Pure Enantiomer

Etik Beyan

The study was commenced following the approval of İstanbul Medipol University Non-Interventional Clinical Studies Ethics Committee (approval number: 565, approval date: 23.06.2022).

Destekleyen Kurum

This study did not receive any specific grant.

Teşekkür

We thank IQVIA Turkey for their contributions in data collection.

Türkiye’de en sık tüketilen ilaçların kiralite durumunun maliyete yansımasının incelenmesi

Öz

Kiralite, terapötik veya advers etkiler yönünden ilaç aktivitesini etkileyen faktörler arasındadır. Yeni ilaç geliştirilmesinde, bu kavram doğrultusunda daha fazla fayda sağladığı düşünülen saf enantiyomer ilaçlar tavsiye edilmiştir. Bu çalışmada Türkiye’de sık tüketilen ilaçların kiralite durumları ve bunların maliyete yansımaları incelendi. Çalışmada IQVIA Türkiye biriminden alınan satış verileri kullanılarak ülke genelinde en fazla satılan ilk 200 etkin madde değerlendirildi ve 173’ünün kiralite durumu tespit edildi. Bu ilaçlar “kiral karışım”, “akiral” ve “saf enantiyomer” olmak üzere üç gruba ayrılmalarının ardından kiralite durumlarına göre dağılımları ve ortalama kutu başına düşen (KBD) maliyetleri incelendi. Kiral dönüşümün maliyete yansımasını incelemek amacıyla dönüşüme uğrayan kiral karışımlarla bu işlem sonucunda meydana gelen saf enantiyomerler bu parametreler yönünden karşılaştırıldı. Kiralite durumu incelenen 173 etkin maddenin %35.8’i akiral, %22.0’ı kiral karışım ve %42.2’si saf enantiyomerdi. Toplam maliyet 2.09 milyar $ iken, maliyetin %46.4’ünü saf enantiyomerler, %22.0’ını ise kiral karışımlar oluşturmaktaydı. KBD maliyet ortalamaları bakımından saf enantiyomerler (2.8±3.5 $), akiral ilaçlar (2.3±2.5 $) ve kiral karışımlar (1.7±0.9 $) istatistiksel olarak benzerdi (p>0.05). Kiral dönüşüme uğrayan ilaçlarda kiral karışımların ortalama KBD maliyeti (1.4±0.4 $), saf enantiyomerlerinki (1.7±1.2 $) ile benzerdi (p>0.05). Kiral dönüşüme uğrayan ilaçların yarısında KBD maliyeti, kiral karışımda daha yüksekken diğer yarısında ise saf enantiyomerde daha yüksekti. Bu çalışmada Türkiye’de en çok satan ilaçlar arasında saf enantiyomerlerin önemli ölçüde yer tuttuğu ortaya konuldu. Sık kullanılan saf enantiyomer ve kiral karışımların maliyet yönünden benzer olması, saf enantiyomerlerin piyasada tercih edilme durumunun devam edebileceğini düşündürmektedir.

Anahtar Kelimeler

İlaç Harcamaları , Kiralite , Kiral Dönüşüm Kiral Karışım , Saf Enantiyomer

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