Saturday, December 3, 2011

Why is the Jan Aushadhi Scheme an utter failure?

How it all began?

Union minister Sri Ram Vilas Paswan launched Jan Aushadhi Scheme in April 2008 with great fanfare. The objective was to make generic drugs available to poor at substantially lower prices than branded drugs which are almost unaffordable. Shops were opened in big hospital complexes, supply of drugs arranged from big manufacturers. The intention was to set up one Jan Aushadhi shop in each district head quarters. The table given below compares prices of branded drugs and generic ones of a few typical drugs:

Where are we now?
So far, 113 Jan Aushadhi Stores have been opened in the States of Punjab, Haryana, Rajasthan, Uttarakhand, Andhra Pradesh, Odisha, West Bengal, Jammu & Kashmir, Himachal Pradesh, NCT of Delhi & UT of Chandigarh. Sri Srikant Kumar Jena, Minister for Chemicals and Fertilizers laments: “Since opening up of Jan Aushadhi Stores mainly depends upon the health policies followed by State Government, besides the support and cooperation they extend to open such stores, in the identification of agencies to manage such stores, allotment of space etc., it is difficult to prescribe any timeline for launching stores in the remaining States.”. The official website for Janaushadhi scheme gives prices of some 320 essential medicines in generic form available in these shops. In reality, almost all shops set up so far, display empty shelves. In NIMS, Hyderabad the Jan Aushadhi shop always says No Stock, while a next door chemist has a roaring daily turn over of more than 4 lakhs!

Problems and issues:

All kinds of problems have cropped up: Shops have no stocks as already indicated. Doctors refuse to prescribe generics though they have been directed to do so, especially in the case of govt hospitals. IMA has advised that doctors need to prescribe generics only if so requested by patients or write out equivalents as a substitute. Hand in glove with manufacturers, doctors take their commission / cut and leave poor patients to be exploited, by prescribing only branded products. Competitors in trade threaten generic only shops to close down through unfair means. 

Supply chain from manufacturer to retailers is mismanaged; moreover the suppliers hitherto have only been large scale public sector companies who are so big that the requirements of a few Generic shops is peanuts for them and are not interested in doing business coming through Jan Aushadhi chain. Now Govt has started looking into Middle level players too.  Most importantly there is no awareness among public and doctors – Most doctors do not know what / how to prescribe generics! Many Doctors also harbor wrong belief that low priced medicines are useless, forgetting that the drugs are produced by reputed manufacturers  in the same factory adopting same methods and controls applicable both for branded ones as well for generic ones!. Another reason is that Health is in concurrent list – so many State governments have to co-operate for any scheme to be successful.

Andhra Pradesh holds out hope!

In the case of Andhra Pradesh, AP Medical Services and Infrastructure Development Corporation (APMSIDC) is keenly interested in making availability of generics a reality. They plan to set up more than 175 generic shops under the brand “Jeevanadhara” through out the state. Reputed NGOs like Red Cross, Andhra Pradesh Senior Citizens Confederation (APSCCON) have been approached to implement the scheme. Govt would provide space, support for procuring drugs, publicity for shops opened under this plan. As there appears to be some political will to make it a success, there is every hope that Jeevanadhara would succeed. Let us wait and see.


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