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जिल्हा परिषद व पंचायत समिती निवडणूक बाबत माहीती

Background :-

        The idea of Niramaya has its roots in the farmers suicide research that Ms GUNJAN KINNU, Chief Executive Officer, Zilla Parishad, Wardha did in the year 2006. It was found that the cost of Health care constitute a major portion [(6%) of gross income of the family] of expenditure and it increases manifold with the occurrence of any major ailment in the family. Though there exists system of giving agriculture loans there is no provision of health care or consumptive loan for the poor. It was further realized that 40-50% of medical expenditure is on the medicines, therefore price of the drugs emerges as major point of intervention of ensuring affordable health care to the poor. A further research into the pharmaceutical industry of the country revealed that the manufacturing cost is just a fraction (2-20 %) of the Minimum Retail Prize of most of the branded drugs and the companies make huge profits on the branded drugs. The generic drugs though cheaper have problem of quality and potency as the market is full of spurious and substandard generic drugs, thereby making it difficult to make prescription of generic drugs mandatory. Further, in the absence of any strong regulations and pharmaceutical policy an unholy nexus develops between pharmaceutical companies, Medical Representative, doctors and chemists, wherein doctors are given all kinds of sops to prescribe high costing medicines even when low costing equally effective medicines are available in the market. The lack of awareness among the consumers about price differential across brands has further strengthened this nexus:-

        It is in this background that Niramaya scheme was conceptualized with the two fold objective of providing.

  1. Low costing but effective medicines to the poor patients.
  2. Disseminating information among consumers regarding existing cost differences between different brands.

Operationalization of the Scheme:-

        Since 79% of Health case expenditure is out of pocket it was important to enlist the support of the private doctors and chemists along with government doctors for the wider ramification of the intervention. A sensitization meeting was held on 2nd January which was attended by most of the doctors and chemist of the Arvi Taluka. A presentation based on the price difference between generic drugs and branded drugs was shown and doctors and chemist were encouraged to give their opinions on the subject. The idea was to find a solution in partnership. Based on this interaction a core team of doctors under the leadership of Dr. Pawde and chemists was chosen to study the problem and suggest solutions. Every Thursday of the week we would meet around 11 pm at night and refine the ideas. At first the idea of making generic drugs compulsory for prescription was floated but the doctors turned it down on the ground that the market is flooded with spurious substandard generic drugs and it is difficult to control as to which drugs are actually dispensed to the patient. Therefore, it was decided to prepare a comparative list of branded drugs and essential drugs and doctors were encouraged to prescribe low costing but effective drugs to the poor patients. On perusal of the comparative list it was discovered that substantial difference 2 to 200 times exist between brands.

        Next came the issue of how to make doctors prescribe medicines out of the list. To do so we created a brand name of Niramaya all the partners of Niramaya family were to display Niramaya logo in their clinic and shops. This would indicate to the patient that doctors are displaying the board prescribe economical drugs to the patients. We gave full publicity to Niramaya Swast Aushadi Yojana through the medium of press and articles in News papers were written to inform people about cost differences. At the launch of the scheme all the sarpanchas, ANMs, Aganwadi workers were called and they were informed about the scheme.

        Further we got in touch with Locost India of Baroda and asked them to provide some of their products manufactured by them at the chemist shops in Arvi taluka. This proved to be a great boon in the initial phase of implementation of scheme for their drugs had very little difference between manufacture cost and MRP and hence were very low costing drugs. Introduction of Low cost helped to popularize the concept.

        Within a short time the scheme gained movement and in Arvi around 100 Doctors and 40 Chemists participated in the scheme. Having succeeded in Arvi with Niramaya, we decided to extend the movement to the other parts of Wardha. On April 7, 2008, it was launched in Wardha.

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