Delhi’s essential drug list under review, likely to come down to 1,080
Delhi’s essential drug list is a list of medicines that are available for free at all Delhi government hospitals, dispensaries, polyclinics and mohalla clinics. The list is updated every two years.
The Delhi government’s essential drug list (EDL) — which at present comprises 1,390 medicines — is under review and is likely to be whittled down to around 1,080 medicines, an official from the health department said.
The city’s EDL is a list of medicines that are available for free at all Delhi government hospitals, dispensaries, polyclinics and mohalla clinics. The list is updated every two years.
In 2016, the list was revised under the AAP government for the first time. The number of medicines on the list, which stood at 400 at the time, was increased to 1,390. In comparison, the national list of essential medicines (NLEM), the retail prices for which are fixed by the central government, includes 376 medicines.
Experts, however, said an essential medicine list with more than 1,000 medicines lacks rationale. A member of the committee that formulated the 2015 NLEM, on condition of anonymity, said, “The list has to include a minimum number of drugs for maximum benefit.”
The committee member maintained, “Essential medicines are selected on the basis of the effectiveness of the drug – which ones would benefit the most number of people at the least cost without compromising on quality. There has to be a clear-cut exclusion criterion.”
In 2013, the 24-member committee that had formulated the Delhi list had clearly stated the inclusion and exclusion criteria. The list had been divided into core medicines that are needed for the treatment of conditions that are a priority for the government and complementary medicines that are needed for higher-level management of the priority conditions.
However, the 2016 Delhi list, which is currently under review, did not mention inclusion and exclusion criteria and each hospital department was asked to provide a list of demands, which was later compiled together.
Officials from the Delhi government said the list was expanded because the state could afford it. “We have the money. Delhi spends one of the highest percentages of its budget on healthcare. With the extended list, we are able to provide almost 100% of the medicines that patients require,” said Dr Vijoy Kumar, director of the Central Procurement Agency, which is responsible for purchase of drugs and equipment for all Delhi government hospitals, dispensaries, polyclinics and mohalla clinics.
The Central Procurement Agency has a budget of ₹180-190 crore for the purchase of medicines. Besides this, government-run hospitals have individual budget of ₹10-80 crore for emergency procurement.
“The government needs to optimise health resources. Medicines are not the only expenditure; money is also spent on manpower, infrastructure, equipment and regular upkeep. It is also needed for emergency measures such as in case of dengue,” said a doctor working in a Delhi government hospital, on condition of anonymity.
Vendors, on the other hand, alleged that some of the recommendations for inclusion to the list might lead to wastage and corrupt practices.
“For example, common injectable antibiotics have been suggested as a kit that will include saline, a collapsible bag and connectors needed to deliver the medicine to the patient. But all the things included in the kit are available at hospitals separately, which leads to duplication,” a medicine vendor, who supplies to the Delhi government, said.
The vendor said, “Nurses usually inject the antibiotics to the existing saline bag or the intravenous line. As a result, the things that come in the kit get wasted. Additionally, a kit would cost four to five times more than what the individual items would cost.”
According to him, most of the 156 items that have been proposed for the new list have only single bidders, meaning it could drive up the product costs for the government in absence of competitive pricing.
“By no stretch of imagination can this be called the essential drug list. Rather, it is a fancy drugs list,” the vendor said.