Lok Sabha Question No. 535 (UNSTARRED), answered on 2022-12-09
Subject: Medicine Accessibility in Rural Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: D.K. Suresh, K. Muraleedharan, Anto  Antony

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 535 TO BE ANSWERED ON 09 TH  DECEMBER, 2022

## MEDICINE ACCESSIBILITY IN RURAL AREAS

535: SHRI D.K. SURESH:

SHRI K. MURALEEDHARAN:

SHRI ANTO ANTONY:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  the  Government  is  aware  that  the  price  of  various  drug  portfolios  have  increased despite active regulation of the price of drugs, if so, the reasons therefor;
- (b)  whether  the  Government  is  aware  that  medicine  accessibility  in  rural  India  has  not  been scaled  up  even  after  large  spending  on  schemes  such  as  Ayushman  Bharat,  if  so,  the  reasons therefor;
- (c)  whether  the  Government is  aware that  branded drugs under the Affordable Medicines and Reliable  Implants  for  Treatment  (AMRIT)  pharmacies  are  not  available,  if  so,  the  reasons therefor; and
- (d)  the  steps  taken/proposed  to  be  taken  by  the  Government  to  improve  medical  assistance  in pharmacies that are understaffed?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND

## FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a): As per the information provided by Department of Pharmaceuticals (DoP), the National Pharmaceutical  Pricing  Authority  (NPPA)  under  DoP  fixes  the  ceiling  price  of  medicines specified  in  the  first  schedule  of  Drugs  (Prices  Control)  Order,  2013  (DPCO,  2013).  All manufacturers of medicines have to sell their products within the ceiling price (plus applicable Goods  and  Service  Tax)  fixed  by  the  NPPA.  The  annual  increase  allowed  in  the  case  of Scheduled  formulations  is  upto  the  level  of  annual  revision  in  Wholesale  price  index  (WPI). NPPA also  fixes  retail  price  of  a  new  drug  under  DPCO,  2013  for  existing  manufacturers  of scheduled formulations. The notified retail prices are applicable only to the applicant manufacturing/ marketing companies. For other non-scheduled formulations, a manufacturer is at liberty to fix the maximum retail price of a non-scheduled formulation launched by it. In case of non-scheduled  formulation,  no  manufacturers  can  increase  MRP  by  more  than  10%  of  MRP during  preceding  12  months.  Instances  of  overcharging  are  dealt  with  by  NPPA  under  the relevant provisions of DPCO, 2013. In addition, Para 19 of DPCO, 2013 provides for fixation of ceiling price or retail price of any drug in public interest for such period, as deemed fit, in case of extra-ordinary circumstances.

(b): To supplement States' efforts,  National  Health  Mission  (NHM),  has  launched  the  Free Drugs Service Initiative to ensure free medicines to healthcare seekers at all levels of the public health  system.  To  ensure  the  provision  of  free  essential  medicines  NHM  provides  budgetary support to the States/UTs through Program Implementation Plans (PIPs). Under the Indian Public Health Standards (IPHS), facility wise Essential Medicines Lists (EMLs) has been recommended to the States/UTs.

Under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY), in order to ensure that the hospitals do not overcharge and rates do not vary across hospitals, Empanelled Health Care Providers (EHCP) are paid as per specified package rates. A package consists of all the costs associated with the treatment, including pre and post hospitalisation expenses. These are bundled packages which include all aspects of treatment including pre-admission diagnostics and post discharge medicines for 15 days. The treatment packages include super speciality care like oncology, neurosurgery, cardio-thoracic and cardiovascular surgery.

As of 4 th December 2022, 4.18 Crore hospital admissions worth Rs. 48,934.9 Crores have been authorized under the scheme. Thus, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana has  facilitated  the  availability  of  free  medicines  to  eligible  beneficiaries  availing  healthcare services under the scheme

(c): 238 AMRIT Pharmacies are operating in 28 States/UTs. AMRIT Pharmacies are acting as a single point of supply for all medical requirements of the hospitals including Branded/Branded Generic/Generic  drugs,  surgical  items,  consumables  and  implants  especially  for  tertiary  care hospitals.  For  the  medicine  requirements,  AMRIT  Pharmacy  is  keeping  stock  of  01  (one) Branded  Stock  Keeping  unit  (SKU)  and  one  or  two  Branded  Generic/Generic  SKUs  for  a composition and strength as per the prescription pattern of the Hospital and of the General public of that locality.

(d): Since 2014, the number of institutes approved by The Pharmacy Council of India (PCI) for Diploma in Pharmacy (D.Pharm) has increased from 710 to 3333 and for Degree in Pharmacy (B.Pharm), it has increased from 930 to 2411. There are approximately 33857 pharmacists posted at CHC and below level facilities in the country against the requirement of 36530 as per Indian Public Health Standards.

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