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Healthcare and Access to Medicines

Vijaykumar Shivpuje*

*The views expressed in this presentation are the speaker’s own and do not represent the views of the organization

he represents.

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Roadmap

Introduction

Current situation of access to medicines in India

Generic drugs:

- What are generic drugs?

- Are they safe?

Case studies

Jan Aushadhi campaign

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Availability of medical services

Priorities of the expenses

Pricing of the drugs

Current situation of access to medicines

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Category Name of drug Dosage Pack Average

market price of

branded drug

Antibiotic Ciprofloxacin 250 mg 10 54.00 Rs.

Pain killer Diclofenac SR 100 mg 10 51.91 Rs.

Common cold Cetirizine 10 mg 10 37.50 Rs.

Fever Paracetamol 500 mg 10 13.56 Rs.

Current situation of access to medicines

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Generic drugs

A generic drug is a drug defined as "a drug product that iscomparable to brand/reference listed drug product in dosage form,strength, route of administration, quality and performancecharacteristics, and intended use.“ It has also been defined as aterm referring to any drug marketed under its chemical namewithout advertising.

Prescriptions may be issued for drugs specifying only the chemicalname, rather than a manufacturer's name; such a prescription canbe filled with a drug of any brand meeting the specification. Forexample, a prescription for lansoprazole can be filled with genericlansoprazole, Prevacid, Helicid, Zoton, Inhibitol, or Monolitum.

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Category Name of drug Dosage Pack Average

market price of

branded drug

Prices of generic

medicines sold in Jan

Aushadhi outlets

Difference

Antibiotic Ciprofloxacin 250 mg 10 54.00 Rs. 11.10 Rs. 5 times

higher

Pain killer Diclofenac SR 100 mg 10 51.91 Rs. 3.35 Rs. 15.5 times

higher

Common cold Cetirizine 10 mg 10 37.50 Rs. 2.75 Rs. 13.5 times

higher

Fever Paracetamol 500 mg 10 13.56 Rs. 2.45 Rs. 5.5 times

higher

Current situation of access to medicines

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Question in Loksabha on 6th August 2013

Shri KIRODI LAL

Will the Minister of CHEMICALS AND FERTILIZERS be pleased to state:-

(a) whether there is a huge difference in the prices of non-branded generic medicines being sold at the

Jan Aushadhi Stores (JAS) and that of branded medicines in the country;

(b) if so, the details thereof and the reasons therefor; and

MINISTER OF STATE (INDEPENDENT CHARGE) OF THE MINISTRY OF STATISTICS AND

PROGRAMME IMPLEMENTATION AND MINISTER OF STATE IN THE MINISTRY OF CHEMICALS

AND FERTILIZERS (SHRI SRIKANT KUMAR JENA):

(a) & (b): Yes Sir. There is a huge difference in the prices of non-branded generic medicines being sold

at the Jan Aushadhi Stores (JAS) and the prices of branded medicines sold in the open market in the

country.

The prices of branded medicines are generally higher than the prices of equivalent generic medicines

due to promotional efforts made in selling of such products. Besides some branded drugs enjoy patent

protection and a number of drugs are not covered under the regulation through the Drug Prices Control

Orders. In the case of generic drugs sold at Jan Aushadhi Stores, the medicines are directly supplied

through stockists/CPSUs at actual cost plus limited margins. It is a conscious decision of the

Government to keep the prices of the medicines at affordable levels for the benefit of all.

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Jan Aushadhi Campaign

What it is?

The aim of this campaign is to make available quality medicines ataffordable prices for all, especially the poor and the disadvantaged.Under this campaign, less priced quality unbranded genericmedicines will be made available through Jan Aushadhi stores whichinherently 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 theCentral Pharma PSUs which will ensure both quality and timelysupply. Medicines not available currently with the CPSUs will besourced from quality SME units. This will also give support to thePharma SME sectored as well as promote public-private partnershipand avenues for achievement of corporate social responsibilitiesgeared towards affordable Medicare for the masses. The JanAushadhi Campaign has now been formalized as Generic DrugScheme with the approval of the Planning Scheme.

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Jan Aushadhi Campaign

Eligibility:

Under this Scheme, State Government has to provide space in Government Hospitalpremises for the running of the outlets (Called as Jan Aushadhi Stores).

Government hospitals, NGOs, Charitable Organizations and public societies likeRed Cross Society, Rogi Kalyan Samiti typically constituted for the purpose can beoperating agencies for the JAS. The operating agency for JAS is nominated on thebasis of the recommendations of the State government.

Operational expenditure is met from trade margins admissible for medicines. TheState Government has to ensure prescription of unbranded generic medicines by theGovernment doctors.

The Jan Aushadhi Programme is accordingly a self sustaining business model notdependent on government subsidies or assistance. It is run on the principle of “Notfor Profits but with Minimal Profits”.

The Central Government would provide only a one-time assistance of Rs. 2.00 lakhsas furnishing and establishment costs and further Rs. 50,000 as one time start up costto NGO etc,. setting up the Jan Aushadhi Outlet.

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Jan Aushadhi Campaign

Status:

At present, 157 JAS opened in the states of

Punjab,

Haryana,

Uttarakhand,

Orissa,

Rajasthan,

Andhra Pradesh,

Union Territories of Chandigarh and

Delhi.

However, only 93 are currently functioning.

State governments of Andhra Pradesh and Kerala have launched their own subsidized

medicine programme by setting up government owned chains.

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A person suffering from a disease is a patient and

not the consumer. The medicine should be meant

for healing and not selling.