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Case4-May-2017

Pradhan Mantri Bharatiya Janaushadhi Pariyojana Quality medicines at affordable prices for all
Palaneeswari M

The Indian pharmaceuticals market is the third largest in terms of volume and thirteenth largest in terms of value, as per a report by Equity Master. India is the largest producer and provider of generic drugs globally. The Indian generics pharma industry accounts for 20% of the global exports. The Indian pharma industry is expected to grow to 2,45,669 crores by 2020.

The pharmaceuticals Industry in India has evolved from mere 1500 crores in 1980 to more than 1,19,000 crores by 2012. Yet, the market in India is dominated by branded drugs, which are sold at premium rates. It is to be noted that 80% of outpatient care and 60 of all clinical treatments happen at the private healthcare centres. According to National Sample Survey Organisation (NSSO) estimates, up to 79% healthcare expenses in rural areas arises from the cost of the medicines. Thus, access to low-priced generic drugs is very critical in ensuring health care at affordable prices.

Ensuring availability of quality medicines at affordable prices to all has been the key objective of the Department of Pharmaceuticals, Government of India. Hence the department has decided to launch a nationwide campaign viz.,Pradhan Mantri Bharatiya Janaushadhi Kendra.

Jan Aushadhi is a novel project launched by Government of India in 2008 for the noble cause of Quality Medicines at Affordable Prices for All. The campaign was undertaken through sale of generic medicines through exclusive outlets namely “Jan Aushadhi Kendra”(JAK) in various districts of the country. The first “Jan Aushadhi Kendra” was opened on 25 November 2008 at Amritsar in Punjab.

Initially, the implementation of Jan Aushadhi campaign was envisaged during the 11th Five year plan period starting from 2008-2009, with the target of at least one Jan Aushadhi Kendra in each of the 630 districts of the country, and further to be extended to the sub-divisional levels as well as major towns and village centres by 2012. It was planned that the scheme would run on a self-sustaining business model, and not depend on government subsidies or assistance beyond the initial support. It was to be managed on the principle of “No Profit, No Loss”

Mission
  1. Create Awareness among the public regarding generic medicines
  2. Create demand for generic medicines through medical practitioners
  3. Create awareness through education and awareness programmes that high price need not be synonymous with high quality.
  4. Provide all commonly used medicines covering all the therapeutic groups
  5. Provide all the related healthcare products too under the scheme
Implementing Agency

BPPI (Bureau of Pharma PSUs of India), under the administrative control of the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Government of India is the implementing Agency of PMJAY. BPPI was established under the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Government of India, with the support of all the pharma CPSUs for coordinating procurement, supply and marketing of generic medicines through the Pradhan Mantri Jan Aushadhi Kendras. In April 2010, BPPI was registered as an independent society under the Societies Registration Act, 1860 and as a separate legal entity. BPPI follows the provisions of GFR 2005 and CVC Guidelines amended from time to time and also receives instructions from the Department of Pharmaceuticals.

Scheme initiation in DHAN Foundation

DHAN Foundation has been organising people in thematic institutions. These thematic institutions undertake various development initiatives on the basis of the needs in the federations. One such initiative is the SUHAM (Sustainable Healthcare Advancement) to create access to quality and timely healthcare service at affordable cost. The hospitals at Madurai, Theni, Salem, Sayalkudi, Vadamadurai, Vizag and Viraganur offer affordable health services to the needy. At present, the seven medical shops in the above hospitals have a turnover of 48 lakhs. The opportunity to provide affordable low cost generic medicine through the Jan Aushadhi would provide a salve for the poor.

To contemplate the potential to lessen the health cost, SUHAM hospitals in Vadamadurai promoted the first Jan Aushadhi pharma dispensary. It is run by the federation as a separate entity with the technical support of SUHAM trust. This new generation of primary care clinics with affordable pharma access will comfort the poor by providing good health services. This unit and the health services have the backing of the federation. The last two years’ clinical experience at Vadamadurai showcased that people in Vadamadurai are not much dependent on a particular doctor and a particular prescribed medicine for their primary care needs. Our clinic data also shows that compared to the other SUHAM hospitals, generic medicine consumption is more in Vadamadurai clinics. The average prescription value is also very low as compared to other clinics. This indicates that the members were unable to purchase high value drugs for primary care needs.

Responses from the patients on medicines

Ponnuthai (56 years old), was prescribed the Diclogel Tablet and Ranitidine for ulcer. After the course of the medicine, she gave good feedback on the gel as well as the tablet as it immediately cures her problem and her pain gets drastically reduced. Meena, (19 years old) has taken treatment for cold and fever and she was prescribed paracetamol and cough syrup. She said both medicines had given good response and fever got reduced similar to efficacy of the costlier drug. Cough syrup taste was bitter but the response was good and cough reduced. Likewise, many patients preferred the choice of generic medicine over the branded one.

Status as on 31 March 2016
Operational challenges
  1. Delay in getting stocks from the CWH unit to the concern stockist.
  2. Delay in getting stocks from the stockist at Chennai (He cited the above said point for delayed supply.)
  3. Only one distributor is available for entire Tamil Nadu.(Sree Generics at Chennai)
  4. Gaps in getting all the ordered stocks ( ordered stocks were damaged during transport, some of the ordered items not received from the stockist – Alprazolam 0.25 mg, Antacid suspension, Ciproflaxin, Monteloukest+ Levocetrizine, Iron syrup)
  5. Availability of needed combination of drugs at the
  6. Available stock also with short expiry – Levoflaxin 500 mg, (November 2016) Glimepride (April 17)
  7. We are already using our own software, For JAS, we are using their software. We could not prepare bills for company drugs (those drugs which are not
  8. Dependency on the internet for software operations and services

Stockist is not keeping stock in sufficient quantity, which reflects that fresh stock is being delayed. It affects the regular purchaser who is demanding from the JAS stock.

Development Matters Categories DHAN Foundation
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