india

Updated: May 14, 2019 05:39 IST

Two years after expanding the state essential drugs list (EDL) from 406 to include 1,390 medicines in 2016, Delhi government has whittled it down to 920 medicines in 2017, and 816 medicines in 2018, according to data from Delhi government’s outcome budget report.

The EDL catalogues all medicines and consumables that are available for free in Delhi government hospitals and dispensaries.

In 2016, the state government expanded its EDL following the AAP government’s announcement that all state-run hospitals will dispense all medicines free.

“At that time, all the departments in state government hospitals were asked to provide a list of medicines that were being prescribed by them and a committee of clinicians compiled them to create the essential drug list. It was later observed that some of the medicines were required in very small quantities, so it made no sense to add them to the EDL. The hospitals have local purchasing power and can procure these medicines as and when needed,” a senior Delhi government’s health department official , said.

The expanded list also had the same formulations in different potency and combinations, which made the number of medicines on the list appear inflated, explained experts.

“The 406 medicines in the 2013 EDL were available in almost 800 formulations, but the 2016 list counts each of these formulations – like paracetamol tablet and paracetamol syrup – as two different drugs. So, the number of medicines procured by the central procurement agency (CPA) remained almost the same,” another senior official from the health department said. The CPA procures drugs, consumables and equipment in bulk for all government hospitals.

The list is being rationalised, Delhi health secretary said. “From what I know, it is not the number of drugs but too many formulations and alternatives that were in the list which have been reduced,” Dr Sanjeev Khirwar, Delhi health secretary, said.

“I do not think that the list should be reduced. There are around 1,500 drugs in the Delhi market and the state government’s 800 formulations will be for 400 drugs. So, if the government is only providing 400 of 1,500 medicines, there will be a huge gap in patient care. The national list must be expanded, too. If the budget does not permit it, then we must follow the UK system wherein instead of asking patients to buy some medicines from private shops, the government charges for the prescription. The government can charge ₹5 or ₹10 for every prescription and provide all medicines,” Dr CM Gulhati, editor, Monthly Index of Medical Specialities (MIMS), said.

The Delhi list needs to be further rationalised, said one of the officials. “The numbers have come down, but there is a need for further rationalisation. In 2016, the list was created by compiling medicines needed by doctors and was not based on a formula. Also, the new list did not specify which medicines were to be available at what level of the facility. In the next revision, we will have to categorise the medicines depending on whether they should be available in the mohalla clinics, polyclinic or the hospitals,” the official said.

“I believe all medicines should be available at all levels of government’s health-care facility; if a heart patient has been diagnosed and put on some long-term drugs at a super speciality hospital, why should (s)he have to come back each time to the hospital to get medicines?” Dr Gulati said. Even now, of the 816 medicines, only 86 are dispensed at mohalla clinics and 242 at Delhi government-run dispensaries.