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Free-medicines-for-all programme to be launched from October

New Delhi: India’s ambitious plan to provide free medicines to all patients attending a government hospital across the country will be launched from October, according to a government report.

Manmohan Singh

Strongly backed by Prime Minister Manmohan Singh himself, the free-medicines-for-all scheme has received its first financial allocation of Rs 100 crore from the Planning Commission for 2012-13. The entire programme is estimated to cost Rs 28,560 crore over the 12th Five Year Plan.

Report of a working group on drugs and food regulation in the 12th Plan said the plan would be operational from October this year.

An announcement on the prime minister’s official Facebook page on Saturday said the Prime Minister’s Office has asked the health ministry to set up a central procurement agency (CPA) for bulk procurement of drugs as early as possible.

At present, 78 per cent of the entire health expenditure in India is from out of pocket (OOP). Purchasing drugs alone accounts for 72 per cent of this expenditure.

Public sector provides healthcare to only 22 per cent of the country’s population.

According to the health ministry’s estimates, this will increase to 52 per cent by 2017 once medicines are provided for free from 1.6 lakh sub-centres, 23,000 primary health centres, 5,000 community health centres and 640 district hospitals.

A National List of Essential Medicines, 2011 has been prepared by the central government, which has 348 drugs including anti-AIDS, anti-psychotic, sedatives, anaesthetic agents, lipid lowering agents, steroids and anti-platelet drugs. States have also been asked to create their own Essential Drugs List (EDL), keeping in mind the diseases that worst affect their populations.

The central government will bear 75 per cent of the expenditure under the plan. [Source: IANS]

A Planning Commission panel had said drug prices have shot up by 40 per cent between 1996 and 2006. It said that during the same period the price of controlled drugs rose by 0.02 per cent, while those in the EDL increased by 15 per cent. The price of drugs that were neither under price control, nor under the EDL grew by 137 per cent.

The Commission says 39 million (3.9 crore) Indians are pushed to poverty because of ill health every year. Around 30 per cent in rural India didn’t go for any treatment for financial constraints in 2004. In urban areas, 20 per cent of ailments were untreated for financial problems the same year. About 47 per cent and 31 per cent of hospital admissions in rural and urban India, respectively, were financed by loans and sale of assets.

States have cut down on spending to purchase drugs, adding to common man’s woes. A study by the Public Health Foundation of India recently found that while India’s per capita OOP expenditure to pay for healthcare costs has gone up from Rs 41.83 in 2005 to Rs 68.63 in 2010, the per capita spending on drugs increased from 29.77 per cent to 46.86 per cent during the same period, while hospitalization costs went up from 11.20 per cent to 22.47 per cent.

Outpatient expenditure also increased from 30.63 per cent to 46.16 per cent. Catastrophic spending, or percentage of households spending more than 10 per cent of their overall income on healthcare, is nearly 15 per cent in states that have insurance in place as against 11 per cent in states that lack such policies.

One Comment

  1. DR TUSHAR KANTI NAYAK DR TUSHAR KANTI NAYAK Sunday, June 24, 2012

    Honourable Prime Minister,

    This is something great you are planning for improving the abysmally poor public health care facilility in the country. Needless to mention that in the 1970s government hospitals in the states were dispensing all kinds of medicines free and patients admitted in the hospitals were getting free meals. People do not understand why during the ‘ free market economy ‘ era for which you are being credited; the public health care delivery system has been completely deteriorated ? In government run hospitals slips for writting prescription are also not available and these are provided by charitable organisations. Hospital staffs ask patients to purchase even gauze, cotton, spirit from the market for getting a dressing done.

    Taking advantage of the above situation the mushrooming number of pharmaceutical companies are pushing their cheap preparations (using unethical medical practioners as their agents) in the hand of the patient at exorbitant prices. Media reports indicate that some well known companies are selling drugs 10 times or more than the price of the generic drug. When the public especially the poor is being looted like this by these unscrupulous elements, your government is not taking any firm steps to defend public interest.

    It is really wonderful to know that even though late, people are going to receive medicines free once again in government hospitals.

    As a concerned citizen I would like to request you to kindly look into two aspects during implementation of the programme.
    (1). Quality of the drug. In general people have a perception that drugs dispensed at government hospitals are of poor quality. The government should bring people into confidence to reverse this belief. There should be an appropriate mechanism for ensuring procurement of drug preparations of high standard and quality.
    (2). Maintaining transparency in dispensing and preventing misuse. Public always complain that ‘government supply’ drugs are not given to the patient but smuggled out of the hospital for being sold in the open market. It is worth mentioning here that in the government run ‘Jana Ausadhi’ counters it is rare to find a drug any time, the reasons are not difficult to guess. In the drug smuggling racket hospital staffs are fully involved. All this is happening due to poor record keeping in the hospital, and most records are maintained in the paper format.

    In this context it may be suggested that the proposed ‘National Population Register’ (NPR) card or the ‘Aadhaar’ card number should be used for maintaining all hospital records relating to a patient (prescription written,drug dispensed,other services). Hospitals, PHCs, Dispensaries, should be provided with appropriate computer and software for maintaining all records. This would help maintaining transparency and preventing misappropriation.

    The people wish your government to do more such good things during the years ahead.

    Warm Regards and Best Wishes.

    Sincerely Yours.

    Dr Tushar Kanti Nayak.

    (The commenter had earlier worked as Professor in Biochemistry and currently working as an independent medical practioner).

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