Prices of essential medicines set to see a hike from April 1

Subject :Schemes

Concept :

The prices of about 384 essential medicines and over 1,000 formulations are likely to witness an increase of over 11%, due to a sharp rise in the Wholesale Price Index (WPI).
The yearly increase in the prices of medicines listed in the National List of Essential Medicines (NLEM) is based on the WPI.
The price surge is expected for various routine and essential drugs such as painkillers, anti-infection drugs, cardiac drugs, and antibiotics.
The National Pharmaceutical Pricing Authority (NPPA) announced that the annual change in WPI was 12.12% for the calendar year 2022.
Every year, the NPPA announces a change in the Wholesale Price Index (WPI) in accordance with the Drugs (Price Control) Order, 2013.
Experts have pointed out that the latest WPI figures are the highest seen since the DPCO 2013 came into force and this is the second consecutive year that the WPI is more than the annual permitted price hike for non-scheduled formulations (10%).
Experts have also raised concerns as such a drastic increase in the prices would distort the accessibility and affordability of essential medicines.
However, Health Ministry officials believe that the price increase will ensure that there would be no shortage of medicines in the market, and that manufacturers and consumers mutually benefit.
It was previously seen that when a 10% increase was allowed, various manufacturers kept the rate under 5% because of market forces and a similar trend is expected.

National List of Essential Medicines

The National List of Essential Medicines (NLEM) is a list released by the Ministry of Health and Family Welfare.
The medicines listed in the NLEM are sold below a price ceiling fixed by the National Pharmaceutical Pricing Authority (NPPA).
NPPA caps medicine prices and changes only based on wholesale price index-based inflation.
In India, it was framed on the lines of the Essential Medicines List (EML) released by the WHO.
The Ministry of Health and Family Welfare prepared and released the first National List of Essential Medicines of India in 1996 consisting of 279 medicines. This list was subsequently revised in 2003, 2011, 2015 and 2022.

Purpose:

Guide safe and effective treatment of priority disease conditions of a population.
Promote the rational use of medicines.
Optimize the available health resources of a country. It can also be a guiding document for:
State governments to prepare their list of essential medicines
Procurement and supply of medicines in the public sector.

Criteria for a Medicine to be Included in NLEM

Several factors are looked at before including a drug in the NLEM. These are:
Essentiality: A medicine may be essential considering the population at large and should fit into the definition mentioned earlier.
Changing disease burden: With time, the disease burden keeps changing in the country. At one point, TB might be more important to tackle. At the next moment, another disease like Covid-19 may become more important. So, the prevalent disease is considered while preparing the list.
Efficacy and Safety: The medicine must have “unequivocal” evidence of efficacy and wider acceptance based on its safety to be included in the list.
Cost-Effectiveness: The total price of the treatment must be considered while including the drug in NLEM. Only unit price may not be the best benchmark for this.
Fixed Dose Combinations (FDCs): The single-dose medicines are considered for inclusion in NLEM. FDCs are only included if they have a proven advantage concerning the therapeutic effect.
Turnover: High sales turnover alone is not considered a good benchmark for inclusion in the NLEM. Other factors are also required to be essentially considered for it.

When is a Medicine Deleted from NLEM?

A drug is deleted from the list if it gets banned in India. Also, it is removed if reports of concerns about drug safety emerge.
If medicine with better efficacy or favourable safety profile and better cost-effectiveness is now available, then it is removed from NLEM.