Pattern and Cost Evaluation of Antidepressant Prescriptions Using Who-Core Indicators: A Hospital-Based Observational Study

Background: Depression is a major mental health condition worldwide that significantly impairs daily functioning and quality of life. Effective and rational use of antidepressant medications is essential for optimal outcomes and cost-effective healthcare delivery, particularly in resourcelimited settings. Objectives: This study aimed to evaluate the prescribing patterns of antidepressants using WHO-CORE prescribing indicators and assess the cost-effectiveness of prescribed antidepressants through direct cost comparison of branded and generic formulations. Methodology: A hospital-based observational study was conducted among 217 patients diagnosed with depressive illness at the Psychiatry Outpatient Department of Santosh Hospital. Prescriptions were analyzed prospectively. Sociodemographic and drug-related data were collected using a structured proforma. Prescribing patterns were assessed with WHO-CORE indicators, and cost comparison was performed between branded and generic antidepressants. Data were analyzed using SPSS version 25. Results: Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (32.72%) and citalopram (32.26%) were the most prescribed antidepressants. Overall, 60.6% of prescriptions included drugs listed in the National List of Essential Medicines (NLEM) 2022. Cost analysis showed that the mean cost of branded antidepressants (₹139.60 ± 86.38) was significantly higher than that of generics (₹33.13 ± 35.08), with a highly statistically significant difference (p < 0.001). Conclusion: This study highlights rational prescribing patterns aligned with WHO-CORE indicators and emphasizes the substantial cost advantage of generics over branded drugs. Promoting generic prescribing could enhance affordability and access to mental health treatment.