Zero prescription policy in force at JJ hosp amid questions over stocks

A 2023 Comptroller and Auditor General (CAG) report had flagged widespread shortage of essential drugs in state-run hospitals including JJ Hospital

Mumbai: After months of delay and bureaucratic hurdles, Sir JJ Hospital in south Mumbai – the state’s largest government-run hospital – has begun implementing the long-anticipated ‘zero prescription’ policy, which mandates that all prescribed medicines and surgical items be dispensed solely through the hospital’s in-house pharmacy, eliminating the need for external purchases.

JJ Hospital

The policy, announced by the Brihanmumbai Municipal Corporation (BMC) in November 2023, aims to reduce patients’ out-of-pocket expenditure across government-run hospitals and dispensaries in the city. For implementation, hospitals were required to scale up their stock of medicines, antibiotics, and surgical supplies from 1,200 items to over 4,000 items, many of which were previously unavailable or available in limited quantities at civic hospitals. The BMC had, in 2024, allocated ₹500 crore towards implementation of the policy.

Dr Ajay Bhandarwar, dean, JJ Hospital, confirmed that policy was now officially in force at the hospital.

“A circular has been issued and doctors have been instructed to comply with the zero prescription policy. Adequate medicines have been stocked to support the transition,” Bhandarwar told Hindustan Times. “We’re committed to making this a success for the sake of our patients.”

Execution of the policy, however, remains a challenge, said senior officials at the hospital, speaking on condition of anonymity. JJ Hospital receives only about one-third of its annual budgetary requirement for medicines which leads to inconsistent stocking of essential drugs and forces doctors to hand over prescriptions to patients, pushing them towards costly private pharmacies, the officials said.

“Doctors have been directed to prescribe only those medicines that are currently available in the hospital inventory,” one official said. “If patients or their relatives still insist on specific branded medications not in stock, a formal letter will be issued permitting external purchase.”

The hospital will not bear any responsibility for outcomes related to drugs purchased from outside, the official added.

A 2023 Comptroller and Auditor General (CAG) report had flagged widespread shortage of essential drugs in state-run hospitals including JJ Hospital, with critical departments such as oncology, cardiology, and nephrology facing stock-outs for over six months. A study by Public Health Foundation of India, a nonprofit, had found that over 68% of outpatient expenses in government hospitals stemmed from medicine purchases. Moreover, research shows that nearly 60 million people in the country fall into poverty every year due to health-related expenditures, making policies like zero prescription not just beneficial, but also essential.

Dr Abhay Shukla, public health physician and national co-convenor of Jan Swasthya Abhiyan, a civil society group, said the policy could be a clinically significant intervention in ensuring treatment continuity.

“The zero prescription policy is a critical step towards reducing catastrophic health expenditures, which often lead to patients dropping out of care. But its clinical impact will depend on uninterrupted drug availability, efficient procurement processes, and real-time stock monitoring. Without these systemic safeguards, the initiative may end up being symbolic rather than transformative,” he said.

Brinelle D’Souza, senior faculty at the Tata Institute of Social Sciences (TISS) and co-convener of Jan Swasthya Abhiyan–Mumbai, said successful implementation of the policy was essential for improving health equity.

“Access to free medicines is not just a welfare measure – it is a clinical imperative, especially in public hospitals that cater to low-income populations. To ensure it delivers real outcomes, it must be backed by a resilient supply chain, decentralised inventory control, and regular third-party audits. Otherwise, we risk replicating the same access barriers within a new system,” she said.