Generic medicine access: One Janaushadhi Kendra per 1.71 lakh residents in state

This issue is even more serious in Jharkhand, which has the poorest coverage, with one centre for every 3.7 lakh citizens. Other states facing similar access challenges include Rajasthan, West Bengal, Andhra Pradesh, Assam, Madhya Pradesh, and Bihar, each with just one generic drug store for every 3.68 lakh, 3.29 lakh, 3.17 lakh, 2.69 lakh, 2.49 lakh, and 2.46 lakh citizens, respectively. This limited access raises significant questions about the program’s effectiveness, particularly for low-income patients. In contrast, states with lesser populations, like Karnataka with 1,088 centres, Kerala with 980 centres, and Tamil Nadu with 924 centres, appear to have a more extensive distribution of these centres, highlighting disparities in accessibility to affordable medications across Maharashtra.

Generic medicines are unbranded versions of pharmaceutical drugs, with the same active ingredients and efficacy as brand-name drugs but at a lower cost.

The WHO found that medicine expenses constitute 63 per cent of India’s household health spending, pushing many into poverty. To address the issue, the Central government introduced PMBJP to enhance generic medicine access and reduce costs by up to 70 per cent. However, limited access questions the programme’s impact, especially for low-income individuals.

“For optimal delivery of unbranded generic medicine, the ratio is insignificant. There should be at least 2-3 generic medicine stores per PHC, which necessitates the establishment of at least 7,000 stores across the state and at all levels of public health care delivery system,” said Dr Soumitra Ghosh from School of Health Systems Studies, TISS.

The Central government’s drive to promote generic medicines encounters numerous challenges, including monitoring gaps in warehouses, limited regional drug supplies, insufficient suppliers, coordination issues, inadequate pharmacist training, and the supply of generics with short expiry periods, as highlighted by medical experts.

Jan Arogya Abhiyan, a Maharashtra-based NGO, recently pointed out numerous programme flaws and noted that the Janaushadhi Kendra proportion is less than one per cent.

Dr Ghosh, who conducted a study at 11 Janaushadhi Kendras in Mumbai and Palghar, found that the overall availability of the surveyed essential medicines in PMBJP outlets was only 47 per cent. “This implies that even the existing ones are grossly underutilised from the perspective of improving the access to low-cost generics,” he added.

In Mumbai, although 66 Janaushadhi Kendras were supposed to be operational, some listed locations, like the one near Crystal Hospital in Dahisar and D-Mart in Thakur Village, Kandivali East, were found closed on enquiry by The Indian Express.

However, the state health department is currently working on enhancing the availability of generic medicines across the state by establishing more than 2,000 Janaushadhi Kendras. The state government has granted permission to the National Federation of Farmers’ Procurement, Processing and Retailing Cooperatives of India Ltd (NACOF) to create 24-hour generic medicine stores within government hospital premises managed by the public health department.

Speaking about this initiative, Additional Chief Secretary, Public Health Department Milind Mhaiskar stated, “All government healthcare facilities, including primary health centres (PHCs), will provide access to generic medicines through stores of nearly 250 sq feet within their premises, ensuring convenient patient access. This reflects the government’s noteworthy commitment to promoting generic medicine usage.”

Civic society’s push for generic medicine focus surged when the National Medical Commission mandated generic drug prescriptions. Due to extensive opposition, NMC shelved the initiative.

Ravi Dadhich, CEO of India’s Pharmaceuticals and Medical Devices Bureau (PMBI), expressed a goal to establish 10,000 Janaushadhi Kendras by year-end. He said, “We regularly write to states to increase their efforts in setting up these stores. The states should also take more personal initiatives. Additionally, 320 applications have been received from Primary Agricultural Cooperative Societies under the Ministry of Cooperation.”