Lok Sabha Question No. 1657 (UNSTARRED), answered on 2019-07-02
Subject: Price of Medicines
Ministry: CHEMICALS AND FERTILIZERS
Asked by: Sanjay Jaiswal

## GOVERNMENT OF INDIA MINISTRY OF CHEMICALS & FERTILIZERS DEPARTMENT OF PHARMACEUTICALS

LOK SABHA UNSTARRED QUESTION NO. 1657

TO BE ANSWERED ON 2 nd  July, 2019

## Price of Medicines

## 1657. DR. SANJAY JAISWAL:

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

- (a) the date since when a decline has been registered in the prices of medicines after the efforts by the Government;
- (b) the number of life-saving medicines and the extent to which their prices have been reduced;
- (c) the  time  by  which  the  target  of  providing  free  medicines  to  the  poor  people would be achieved; and
- (d) whether the Government has identified the areas for this purpose and if so, the details thereof?

## ANSWER

## MINISTER IN THE MINISTRY OF CHEMICALS AND FERTILIZERS (SHRI D. V. SADANANDA GOWDA)

(a) & (b): India has a long history of price control and first comprehensive order was  promulgated  under  section  3  of  Essential  Commodities  Act  called  the  Drugs (Price  Control)  Order,  1970  (DPCO).  Subsequently,  the  Government  promulgated DPCO, 1979, DPCO, 1987, DPCO, 1995 and DPCO, 2013. The emphasis under all the  previous  DPCOs  was  to  control  the  price  of  scheduled  formulations  through control in price of bulk drug. However, in the policy shift under DPCO, 2013, the price of essential medicines / formulations were brought under price control.

Drugs (Prices Control) Order, 2013 (DPCO) came into effect from 15/05/2013. National List of Essential Medicines 2011 (NLEM-2011) was adopted as the original Schedule-I  of  DPCO.  Subsequently,  in  March  2016,  National  List  of  Essential Medicines 2015  (NLEM-2015)  was  notified as revised Schedule-I  of  DPCO. Government has fixed the ceiling prices of 530 scheduled medicines under Original Schedule-  I  of  the  DPCO  and  857  scheduled  formulations/packs  under  revised Schedule -I of DPCO (upto 31/05/2019).

## Statement  showing  reduction  in  price  with  respect  maximum  price  under original Schedule I (NLEM-2011)

| %reduction with respect to Maximum Price   |   No. of drugs |
|--------------------------------------------|----------------|
| 0<= 5%                                     |             80 |
| 5<=10%                                     |             50 |
| 10<=15%                                    |             57 |
| 15<=20%                                    |             43 |
| 20<=25%                                    |             65 |
| 25<=30%                                    |             49 |
| 30<=35%                                    |             26 |
| 35<=40%                                    |             34 |
| Above 40%                                  |            126 |
|                                            |            530 |

## Statement  showing  reduction  in  price  with  respect  maximum  price  under revised Schedule- I (NLEM-2015) up to 31/05/2019

| %reduction with respect to Maximum Price   |   No. of formulations |
|--------------------------------------------|-----------------------|
| 0<= 5%*                                    |                   234 |
| 5<=10%                                     |                   138 |
| 10<=15%                                    |                    98 |
| 15<=20%                                    |                   100 |
| 20<=25%                                    |                    93 |
| 25<=30%                                    |                    65 |
| 30<=35%                                    |                    46 |
| 35<=40%                                    |                    24 |
| Above 40%                                  |                    59 |
| Total formulations in NLEM 2015            |                   857 |

Further,  National  Pharmaceutical  Pricing  Authority  (NPPA)  has  capped  the prices of 42 non-scheduled anti-cancer medicines under 'Trade Margin Rationalisation'  Approach.  By  this  MRP  of  526  brands  of  these  medicines  were reduced by upto 90% and this would result in approx. annual savings of around Rs. 984 Crores to the patients.

(c) & (d): Pursuant  to  the  Union  budget  announcement  in  2014,  Operational Guidelines  along  with  Model  Request  for  Proposals  (RFP)s  for  implementing  the National  Health  Mission  (NHM)  Free  Drug  Service  Initiative  were  developed  and shared with the States on 2nd July, 2015. To nudge State towards adoption of policy to provide free essential generic drugs in public health facilities, upto 5% additional funding  (over  and  above  the  normal  allocation  of  the  state)  under  the  NHM  was introduced as an incentive. Advocacy by the Ministry of Health and Family Welfare under the National Health Mission was done with all the States for provision of free essential drugs in all public health facilities under this initiative. Accordingly, all the States/UTs  have  reported  to  have  notified  policy  to  provide  free  drugs  in  public health facilities.

Support  under  the  NHM  is  provided  not  only  for  drugs  but  also  for  various components necessary for effective implementation of Free Drug Service Initiative viz.  strengthening/setting  up  robust  systems  of  procurement,  quality  assurance,  IT backed  supply  chain  management  systems  like  Drugs  and  Vaccines  Distribution

Management  Systems  (DVDMS)  developed  by  The  Centre  for  Development  of Advanced Computing (CDAC), ware housing, prescription audit, grievance redressal, Information, Education and Communication (IEC), training, dissemination of Standard Treatment Guidelines, etc. The DVDMS provides real-time status of drugs and vaccines  in  different  health  facilities  to  help  in  better  planning,  execution  and control  on  demand  and  supply  at  all  the  levels  thereby  avoiding  stock  outs  and wastages. A few states are also implementing the same through their State enabled IT System.

Based  on  the  National  List  of  Essential  Medicines  (NLEM),  the  indicative numbers of drugs/formulations to be provided at facilities have been provided in the guidelines  (District  Hospitals  -  544,  Community  Health  Centres  -  455,  Primary Health Centres -285 and Sub-centres - 57). However States have the flexibility to add more. Hence the Essential Drugs List (EDL) of States vary from State to State. Operational  Guidelines  are  placed  at  website  of  NHM  i.e.  www.nhm.gov.in  under NHM  Components  >  Health  Systems  Strengthening  >  Free  Drugs  &  Diagnostics Service Initiative Tab.

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