JAN AUSHADHI

Over the years India, has developed a strong capability in producing quality branded and generic medicines in most of the therapeutic categories, evolving from an mere Rs 1500 crores industry in 1980 to a more than Rs 68,000 crores industry in 2008. However,although these medicines are reasonably priced, as compared to the prices of their equivalent medicines in most other countries, yet a large population of poor people in the country, find it difficult to afford the more expensive branded category of medicines. Accordingly, ‘ensuring availability of quality medicines at affordable prices to all’, has been a key objective of the Government. some of the important steps taken to enable this are:

Price control of Scheduled Drugs through the National Pharmaceutical pricing authority (NPPA): Under the

1. Drug Price Control Order, 1995, NPPA): Under the Drug Price Control Order, 1995, NPPA has been given the mandate to control and fix the maximum retail prices of a number of scheduled/listed bulk drugs and their formulations, in accordance with well defined criteria and methods of accounting, relating to costs of production and marketing Notably therefore, the prices of these medicines have remained quite stable and affordable.
2. Price regulation of Non-Scheduled Drugs: Apart from the scheduled medicines under DPCO,1995, the NPPA monitors the prices of other medicines not listed in the DPCO schedule, such that they do not have a price variation of more than 10% per annum. This has further helped in keeping the prices of most of the non-scheduled medicines stable and affordable.
3. Uniform VAT of 4% on medicines: Government has fixed a uniform and low rate of 4% VAT on medicines in the country. This policy has been adopted, in almost all the States in the country, and has reduced the incidence of sales tax on medicines and thereby assisted in keeping their prices low.
4. Reduction in Excise duty from 16% to 4% Further and in addition to above low, VAT rates, the [present government had, as part of the Budget for the year 2008-09 reduced the excise duty on medicines from 16% to 8%. This has been further reduced to 4 percent as from 8th December, 2008. This has again, played a crucial role in keeping the prices of most of the medicines at reasonable levels.

Not satisfied with the above regulatory and financial steps for ensuring greater availability of medicines at affordable prices to all, specially the poorer masses, the government has decided to launch a country wide Jan Aushadhi Campaign. It is well known that due to market led consumer awareness and availability, branded medicines are sold by drug manufacturers at higher prices than their unbranded generic equivalents, which are as good in therapeutic value. Therefore, if generic medicines are made more accessible and available in the market, everyone would benefit. Seizing this opportunity, the Pharma Advisory Forum in its meeting held on 23rd April, 2008 under the Chairmanship of Shri Ram Vilas Paswan, Hon’ble Union Minister of Chemicals & Fertilizers and Steel, Decided to launch a Jan Aushadhi Campaign. A key initiative under the campaign would involve opening of jan aushadhi stores where, unbranded quality generic medicines would be sold which are available at lower prices, but are equivalent in potency to branded expensive drugs.

Jan Aushadhi Campaign: Key Objectives

The Jan Aushadhi Campaign would:

1. Make quality the hallmark of medicine availability in the country, by ensuring, access to quality medicines through the CPSU supplies and through GMP Compliant manufacturers in the private sector.
2. Despite constraints of budget in the Central and State governments, extend coverage of quality generic medicines which would reduce and thereby redefine the unit cost of treatment per person. For example branded Diclofenac tablets are available at the average market rate of Rs 36.70* for a pack of 10 tablets.
3. Jan Aushadhi Stores would be sell this at Rs 3.10* which is less than 10% of the market price of the branded category. Thus with the same cost 10 times more persons could be treated with same efficacy and cure.
4. Develop a model which can be replicated not only in India but also in other less developed countries in their common goal of improving quality affordable health care by improving access to quality medicines at affordable prices for all.
5. Not be just restricted to the Public Health System but be adopted with zeal and conviction by the Private Sector and thereby spread its coverage to every village of this country. The jan aushadhi campaign is open for all. Since generic equivalents are available for all branded drugs, the campaign will provide access to any prescription drug or Over The Counter (OTC) drug for anybody. It will be as much available to the disadvantaged sections of the society as much to the advantaged richer population segment of the country.
6. Create awareness through education and publicity so that quality is not synonymous with high price but less is more that is to say that, with a lesser price, more medicines would be available, more patients would be treated and more people will lead a healthier life.
7. Be a public program involving State governments, the Central government, Public Sector enterprises, private Sector, NGOs, Cooperative bodies and other institutions.
8. Create a demand for generic medicines By All for All by improving access to better healthcare through low treatment costs and easy availability wherever needed in All therapeutic categories.

The Jan Aushadhi Campaign will accordingly:

1. Promote greater awareness about cost effective drugs and their prescription.
2. Make available unbranded quality generic medicines at affordable prices through public-private partnership.
3. Encourage doctors, more specifically in government hospital to prescribe generic medicines.
4. Enable substantial savings in health care more particularly in the case of poor patients and those suffering from chronic ailments requiring long periods of drug use.

Important Next Steps

1. A list of Unbranded Generic medicines, commonly used by patients for chronic and other diseases, has been prepared. The National List of Essential Medicines, 2003 (NLEM, 2003) has also been used for this purpose.
2. This will be considered as Common List (CL). Each State would be able to have an add-on list called the State List (SL) based on the use of any specific medicine in the area.
3. The State Governments/NGOs/Charitable/cooperative/Government bodies will be encouraged to establish jan aushadhi stores in Government hospital premises or at other suitable location in all the Districts of all the States and union Territories.
4. Under the jan aushadhi campaign jan aushadhi stores will be opened in al the districts in the country in phases. Accordingly, States have been identified for opening of the jan aushadhi stores in the first phase along with the proposed nodal organizations responsible for coordinating the activities. After successful operationalisation of the program in these districts, other districts in other States would be considered in subsequent phases.