Ensuring universal health care with Jan Aushadhi Kendras
The scheme reaffirms the government’s commitment to ensure that no citizen is left behind in availing quality health services
Medicines protect health and save lives. But medicines cost money and spending on them constitutes a major component of out-of-pocket expenditure. To alleviate this stress on citizens, the government provides free medicines through public hospitals and through over 1.7 lakh Ayushman Arogya Mandirs. Ayushman Bharat Pradhan Mantri Arogya Yojana (AB PMJAY) provides free inpatient care, including all the necessary medicines, to over 55 crore individuals. Prices of many essential drugs are also regulated.
These efforts have contributed to a consistent decline in out-of-pocket expenditure — from 64% of the total health expenditure in 2013-14 to 39% in 2021-22. But more needs to be done to further reduce the financial burden on health care. The larger objective of the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) is precisely this. PMBJP aims to provide quality generic medicines through a network of Jan Aushadhi Kendras (JAKs). Presently, more than 15,000 such outlets are operating across 776 districts delivering health benefits to approximately one million people every single day. The product range of JAKs covers 2,047 medicines and 300 surgical and health care items. The medicines sold at JAKs are on average 50% to 80% cheaper than their branded counterparts sold in the open market. For instance, the average price of a common medicine for high blood pressure, namely, Telmisartan (40 mg), in the market is ₹72 per 10 tablets. The price of the same generic drug sold at a JAK is only ₹12 per 10 tablets.
A robust system guarantees the quality of medicines and surgical products sold at all JAKs. All medicines are procured from manufacturers who follow the good manufacturing practices (GMP) guidelines of the World Health Organization and are certified in this regard by the drug controller. Further, these production units are audited by PMBJP for quality. On receipt of these medicines in the warehouses, all the batches are tested in reputed National Accreditation Board for Testing and Calibration Laboratories (NABL) accredited laboratories. The government also carries out regular comparisons of these medicines with the most popular branded medicines in terms of various parameters such as assay, solubility, etc, to check and confirm that they are as efficacious.
On October 31, 2023, the prime minister inaugurated the 10,000th outlet at AIIMS in Deoghar and simultaneously launched the scheme to increase the number of JAKs from 10,000 to 25,000 in next two years. Opening of more than 4,500 kendras in the past 11 months is a testament to the speed and scale of this expansion.
Under PMBJP, online applications are invited from entrepreneurs and NGOs or organisations for establishing JAKs in a franchise-like model. For making these units viable and self-reliant, the entrepreneurs are assisted and facilitated by the Pharmaceuticals and Medical Devices Bureau of India (PMBI), a society working under the ministry of chemicals and fertilisers. The eligible applicants are assisted by PMBI in drug licence issuance and financial incentives are provided to create the necessary infrastructure. PMBJP has created opportunities for entrepreneurship and self-employment, enabling pharmacists and small business owners to run sustainable outlets. As many as 6,000 JAKs (40% of all) are run by women. The initiative contributes to the local economy by generating thousands of jobs — entrepreneurs are estimated to have earned ₹1,268 crore.
One area of priority for the government is the menstrual health of girls and women. JAKs provide highly subsidised and oxo-biodegradable sanitary pads at only ₹1 per pad. In the last five years, approximately 74.5 crore such pads have been sold through this channel.
In all, during the past 10 years, total savings to the people because of the scheme have been estimated at more than ₹30,000 crore. The scheme is helping families save on every purchase. This is particularly so for those who need medicines for chronic ailments. A recent study in Assam and Rajasthan estimated that PMBJP user households saved ₹550 per month on an average compared to non-PMBJP households. A quarter of the former saved over ₹1,000 per month.
PMBJP reaffirms the government’s commitment to ensure that no citizen is left behind in availing quality health services. By providing a range of quality medicines at highly affordable prices, this scheme is fostering the cardinal principle of universal health coverage, namely, access to health care without financial hardship.
Vinod Paul is member (health), Niti Aayog. The views expressed are personal