The Jan Aushadi Pariyojana: A primer for Indian doctors

M3 India Newsdesk
Dec 08, 2017
Here is a primer for the practicing doctors on the "Janaushadhi" scheme which might help them to take better decisions if confronted by patients with dilemma.

Earlier this year the Medical Council of India reiterated that the medical fraternity should prescribe drugs with generic names.The government too, wants doctors to prescribe cheaper generic drugs and these are made available at the Jan Aushadhi stores across the country.The Janaushadhi yojna completes 9 years of being this year.This initiative, though far from being complete, has indeed ramped in the year gone by. The initiative was renamed as Pradhan Mantri Jan Aushadhi Yojana and renamed again as the Pradhan Mantri Bharatiya Janaushadhi Pariyojana (PMBJP).
Under the new administration, the program got a big push and the scheme has drastically brought down medicine prices for the drugs under its ambit. For example, the anti-diabetic drug glimepiride is priced at INR 4.02 under the government scheme while it costs INR 54 in regular stores.However, doctors still shy away from prescribing generic medicines.The reason often cited is about the faith and trust of the quality of medicines.
Here we attempt to provide some basic information on this ambitious and well-intentioned initiative with an aim to help the practicing doctors gain a better understanding how the  PMBJP functions.

Some salient features of the revamped scheme are discussed here.

Product range
The list covers 23 major therapeutic categories including anti-infective, anti-diabetics, cardiovascular, anti-cancer among many others.The therapeutic categories covered by the scheme were too little in its previous form.
Supply chain
Unlike earlier practice where only public sector companies were tasked with supply, now, nearly 125 suppliers who hold WHO GMP certification have been allowed to supply to the scheme.
Earlier, only medicines manufactured by CPSUs were being supplied to Pradhan Mantri Bhartiya Jan Aushadhi Kendra. Since CPSUs are not able to make a supply of all the medicines proposed to be supplied to PMBJK, procurement of medicines which the CPSUs are not able to supply are being made from the private manufacturers. These medicines after getting tested from empanelled NABL Laboratories and sent to PMBJK through Super stockists/CEF agent/Distributors appointed by BPPI (Bureau of Pharma Public Sector Undertakings of India).
Quality control
The Bureau of Pharma PSUs of India (BPPI), which is overseeing the program tests the medicines procured from the suppliers for its quality. Each drug batch is tested at BPPI’s empanelled National Accreditation Board for Testing and Calibration Laboratories (NABL) accredited laboratories for quality assurance, safety, and efficacy of medicines and conformation with required standards. The annual turnover of PMBJP has leapfrogged to INR 73.66 crore in 2017-18 (as on October 30, 2017) from INR 33.4 crore in 2016-17 and INR 12.43 crore in 2015-16.
 
 
Railway shops
Indian Railways plans to open Jan Aushadhi Kendras at nearly 1,000 railways stations. Petroleum Minister Dharmendra Pradhan announced in August this year that government would open Jan Aushadhi stores at PSU-run petrol pumps too. This would make it much easier for people to gain access to these services.

Hitches
Supply still remains a problem, but the BPPI has assured that the problem will be taken care of through the implementation of direct procurement from nearby warehouses. Next, the government had also received feedback that doctors were earlier not writing generic names, which caused problems for patients to understand the medicines being given to them. On that front, the government is now pushing informally through talks with key medical organizations to ensure that the doctors write the generic names of the medicines along with brand names, or if possible, practice writing only generic names. In April this year, the prime minister promised a legal framework to ensure that doctors prescribed low-cost generic medicines instead of expensive branded medicines.
One of the issues highlighted by a news report was that the practice of accepting the lowest tender could potentially lead suppliers to cut corners on quality and affect patient health adversely.
However, the government has sought to allay these concerns by noting that each batch is tested and substandard products are rejected, with possible penal action and blacklisting for suppliers whose products are repeatedly found to be below quality. Moreover, the government has noted that the WHO GMP quality levels are globally acceptable and hence, testing against these norms was sure to filter out any bad quality products.
Overall, although there remain multiple issues regarding the implementation of the scheme, the program is likely to benefit patients through easier and cheaper availability of necessary medications. If the issues highlighted above are ironed out soon, the scheme might well be one of the best schemes that have recently been launched by the government.

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