P.K. Mohanty writes: Over the years, India has developed a strong capability in producing generic medicines in almost all the therapeutic categories. These medicines are being sold mostly as branded medicines which pushes up the retail price of these medicines. There is still a large population of poor people in the country which finds it difficult to afford these medicines. In fact access to quality health care is a challenge in a developing country like India. According to NSO estimates, upto 79% cost of health care in rural areas is due to cost of medicines. This problem gets further aggravated as upto 80% of expenditure on health care is out-of-pocket. With 65% of India’s population not having access to modern health care (WHO estimates 2008) the entire problem is compounded several times.
Unbranded Generic Medicines Vs Branded Medicines
Access to quality medicines at affordable prices is a key challenge for the Government. In this connection the prices of branded medicines are generally higher than generic medicines due to various reasons inter-alia including branded drugs having patent protection and a number of drugs having limited regulation through the Drug Prices Control Order, 1995 etc,. A sample comparison of some of the prices, shows the vast difference between the Generics Price and the Market price. Therefore, making available medicines at affordable prices has been taken up by the newly created Department of Pharmaceuticals.
|Name of salt||Dosage||Pack||Market Price (Rs.)||Generics Price (Rs.)||Difference|
|Antibiotic: Ciprofloxacin||250 mg||10||55.00||11.10||5 times higher|
|Pain Killer: Diclofenac||100 mg||10||36.70||3.50||10 times higher|
|Common Cold: Cetrizine||10 mg||10||20.00||2.75||7 times higher|
|Fever: Paracetamol||500 mg||10||10.00||2.45||4 times higher|
|Pain & Fever Nimesulide||100 mg||10||25.00||2.70||9 times higher|
|Cough syrup||110 ml bottle||33.00||13.30||2.5 times higher|
Jan Aushadhi Campaign
For fulfilment of this goal, a campaign in the name of ‘Jan Aushadhi Campaign’ has been launched. The aim of this campaign is to make available quality medicines at affordable prices for all, especially the poor and the disadvantaged. Under this campaign, less priced quality unbranded generic medicines will be made available through Jan Aushadhi stores which inherently are less priced but are of same and equivalent quality, efficacy and safety as compared to branded generic medicines.
The generic medicines are being supplied in the first instance by the Central Pharma PSUs which will ensure both quality and timely supply. Medicines not available currently with the CPSUs will be sourced from quality SME units. This will also give support to the Pharma SME sectored as well as promote public-private partnership and avenues for achievement of corporate social responsibilities geared towards affordable Medicare for the masses. The Jan Aushadhi Campaign has now been formalized as Generic Drug Scheme with the approval of the Planning Scheme.
Under this Scheme, the State Government has to provide space in Government Hospital premises for the running of the outlets (JAS). Government hospitals, NGOs, Charitable Organisations and public societies like Red Cross Society, Rogi Kalyan Samiti typically constituted for the purpose can be operating agencies for the JAS. The operating agency for JAS is nominated on the basis of the recommendations of the State government. Operational expenditure is met from trade margins admissible for the medicines. The State Government has to ensure prescription of unbranded generic medicines by the Government doctors. The Jan Aushadhi Programme is accordingly a self sustaining business model not dependent on government subsidies or assistance. It is run on the principle of “Not for Profits but with Minimal Profits”. In order to encourage and provide the initial trigger for above, it is envisaged that the Central Government would provide only a one-time assistance of Rs. 2.00 lakhs as furnishing and establishment costs and further Rs. 50,000 as one time start up cost to NGO etc,. setting up the Jan Aushadhi Outlet.
Jan Aushadhi stores
The Jan Aushadhi Campaign of the Government is expected to make a contribution by way of achieving the socio-economic goal of affordable health are through ensuring availability of quality drugs at affordable prices for all. At present, 231 medicines are being supplied in the 44 JAS opened in the states of Punjab, Haryana, Uttarakhand, Orissa, Rajasthan, Andhra Pradesh, UnionTerritories of Chandigarh and Delhi.
The scheme is also expected to lead to reduction of state health expenditure on branded medicines, more patient coverage, popularization of the use of unbranded generic medicines which will bring down the actual out-of-pocket costs of medicines for the common man due to wider availability (at present only 2% of the total medicines supplied in the market are unbranded medicines) and finally better and more affordable health care driven by the reduction in costs of medicines as the majority component of health care expenses.
The assistance sought is for just one time facilitative incentive to the Jan Aushadhi outlet operating agency which would be an NGO/Charitable body/Cooperative body/health care driven societies like the Red Cross Society/Rogi Kalyan Samiti, etc., who would do the actual operation of the outlet on the principle of minimal profits obtained from the minimal margins included in the cost of the medicine itself. There is no subsidy or recurring assistance envisaged either by the State or the Central Government. Cooperation of the State Governments is essential for locating the outlets in the district hospital premises. The concern of the Members of Parliament regarding the issue of availability of medicines at affordable prices is being sought to be addressed under the Scheme. The Generic Drugs Scheme is an attempt in this direction based on a viable business model not requiring government subsidy. The programme does not envisage grant of any upfront subsidy other than the assistance indicated above to provide some support from the Government/BPPI to NGOs etc.
Benefits of the Scheme
The Jan Aushadhi Campaign will help:
· Improve access to healthcare in as much as cost of treatment would come down substantially. This would enable the Public Health System to increase the coverage.
· Secure a socio-economically viable mechanism/institutional arrangement for efficacious sales of Pharma CPSU products, thereby improving their viability.
· Promote & encourage private industry to sell their quality unbranded generic products through these retail outlets.
· Ensuring successful implementation of the Jan Aushadhi campaign would dispel the myth that quality of medicines is linked to price and demonstrate that quality medicines can be sold at substantially lower prices.
· Educate doctors that unbranded generic medicines provide a better option that branded products since quality of generic medicines can be equally efficacious and safe at much lower prices.
· Create consumer awareness by involving private, charitable bodies and NGOs by making them part of the campaign.
· Reduce promotional cost and profits for the benefit of patients.