Aamir praises revolutionary Rajasthan policy on generic drugs: will other states follow?
Jaipur: The chief minister’s free medicine scheme, an ambitious project launched by the state government last year, may have gone unnoticed but for the praise from actor Aamir Khan, whose television show took up the issue of lack of health amenities for poor. He posed the project as an exemplar for other states to follow. This came soon after the Rajasthan came under scanner for alarming rise in incidents of female feticide in the state.
Amir said ‘Aisa kaam desh ke kone kone mein phele (such initiatives should be taken up across the country)’. Rajasthan Medical Services Corporation (RMSC) managing director Dr Samit Sharma who was a part of the show as a guest, elaborated on the scheme launched on October 2, 2011. RMSC is a part of the health, medical and family welfare department which procures medicines, and supplies those to various government distribution centres. These generic medicines are then made available to the poor free of cost.
A generic drug could cost 10-20 times less than the same medicine sold under a brand. Sharma gave an example of a particular branded medicine for blood cancer treatment that costs around Rs 1.25 lakh. The generic medicine, however, is available at just Rs 12,000.In another startling example, Sharma said a particular brand of medicine used for diabetes treatment costs Rs117, but RMSC purchases 10 tablets of the same medicine at Rs1.97.
Despite constant threats from the drug mafia, Sharma said, the scheme has been a success in the state. In Rajasthan, around 14,964 drug distribution centers are distributing free medicines in urban and as well as in rural areas. Sources said around 400 generic medicines are being distributed free of cost to patients and the government provides financial assistance of up to Rs 50,000 to those who wish to set up such centres.
When Sharma was narrating an incident about the death of her maid’s son because she could not purchase the medicines, tears in Khan’s eyes rolled down on his cheeks. Sharma said that when his had gone out for some 10 days, his maid’s son suffered from vomiting and stomach ailments. The chemists demanded Rs400 to purchase the medicines. Since, she did not have the money, she could not purchase it and her son died.
Background information
From the Rajasthan Medical Services Corporation (RMSC) website:
‘RMSC shall effect the procurement and distribution of Drugs and Medicines, Surgical and Suture items to the Government Medical Institutions in the state of Rajasthan. Main objectives of Corporation are:
Executing procurement of good quality Drugs, Surgical & Sutures at reasonable prices in the State of Rajasthan to meet the requirements of Government Medical and Health Institutions allowing healthy competition among pharmaceutical manufacturers.
Streamlining the distribution of drugs to institutions and ensuring availability of drugs at all times.
Strengthening the system of Quality Control over drugs procurement and distribution to make quality an essential attribute of the Corporation and promoting rational use of drugs.
To achieve the objectives, procurement policy is being enunciated.
DRUG PROCUREMENT POLICY
A. Old Scenario:
As per the Old Drug Procurement Policy 1988, the Pharma Public Sector Undertakings (PSU’s) registered under the Ministry of Indian Petrochemicals and Fertilizer were given purchase preference up to 100%, for medicines manufactured by them. Small scales Industries (SSI) of the purchasing state were given purchase preference up to 80%, provided, they match the L-1 rates.
The Stores Purchase Organization under Medical and Health Directorate was doing the Rate Contract for Medicines, consumables, equipments and instruments. Out of these, the Rate Contracts of very few items (Approximate 30%) was possible. The facility of procurement was decentralized and the purchase orders were given by various Department Heads and purchase officers (PMO/CMHO/CHC in-charge etc). Due to lengthy processes in the Rate Contracts, more time, efforts and money were spent. In the this system, there was no provision for Annual Maintenance Contract and Comprehensive Maintenance Contract for all equipments. The facility of logistics and distribution was not inbuilt in the system; there is need for computerization and improvement in Quality Control System. There was a shortfall in the system in assessing the medicine requirement, consistency in sample verification and Medicine Stores management.
B. New Policy:
In order to have efficient management to overcome all these shortcomings, Rajasthan Medical Services Corporation Limited has been established and procurement policy has also been modified.
Under new policy, procurement of Drugs, Surgicals & Sutures are to be made by Competitive Bidding. Purchase preference is now restricted to 25% only, out of which 10% for state PSU’s and 15% for state SSI’s, that too on condition that it would be necessary for them to match with the L1 rates obtained through tendering.
The following technical and managerial improvements are envisaged with modified drug procurement policy which is to be enforced through RMSC:-
The procurement of medicines at lowest rates could be ensured due to the centralized bulk purchase. As the rates received would be much lower, this will result in additional availability of drugs, equipments and instruments. Due to streamlined procedure, the State Government will save on time and money.
As a comprehensive quality control mechanism has been incorporated therefore procurement of good quality medicines would be ensured.
It will be possible to build capacities for procurement through Competitive Bidding in Government under the Corporation
Due to computerization of entire operations, it will be possible to get the timely information on the expected expiries of the medicines and stocks which are likely to be expired soon will be utilized on priority and will be shifted to some other places according to the requirement.
It will be possible to ensure an efficient management of drug distribution system in the State.
For the annual maintenance of equipments, a system of Annual Maintenance Contracts and Comprehensive Maintenance Contracts would be established.
It will be possible to ensure transparency and the competitiveness in the entire procurement system.’