National Free Drugs Service Initiative
In India, most patients seeking treatment for acute or chronic diseases were facing a silent crisis in access to essential drugs. India has some of the highest Out of Pocket Expenses (OOPE) when it comes to healthcare, drugs constitute over 67% of out-of-pocket expense on healthcare (NSSO 68th round).
If quality essential drugs are provided free of cost to all patients visiting public health facilities, it would bring significant saving to the patients. Hence, the provision of free drugs has one of the most important intervention towards mitigating the burden of healthcare cost. Sustainable Development Goals to achieve universal health coverage can be attained via. safe, effective, quality and affordable essential generic medicines.
Ministry of Health & Family welfare, Govt. of India has recognized the importance of essential drugs being available and accessible at public healthcare facilities. So, in 2015, the “Free Drugs Service Initiative” (FDSI) has been launched under the National Health Mission (NHM). Operational Guidelines and Model RFPs for implementing the initiative were established and shared with the states along with the budget announcement. The guidelines emphasis on procurement of generic essential medicines at low prices, eliminating irrational medicines and unscientific fixed dose combinations.
Components of FDSI
Under the initiative, support is being provided for provision of free essential medicines at public health facilities. For its effective implementation, there are various components which includes
- Procurement
- Warehousing
- IT System for supply Chain Management
- Quality Assurance
- Dissemination of Standard Treatment Guidelines
- Prescription Audit
- IEC & Training
- Grievance Redressal
| NHSRC Support to the MOHFW |
National Health Systems Resource Centre (NHSRC) provides technical support to the Ministry of Health and Family Welfare (MoHFW) for effective implementation of initiative in the states.
Key activities conducted by NHSRC- QI under FDSI:
- Revision and development of facility wise Essential Medicines List*
- Development & implementation Prescription Audit guidelines
- Development of Drug warehouse guidelines
- States Program Implementation Plans (PIPs) appraisals etc.
*ESSENTIAL MEDICINES LIST (EML) |
| Essential Medicines Lists are critical to the success of the initiative. In April 2022, revised IPHS 2022 guidelines for Health and Wellness Centre - Sub Centre, Health and Wellness Centre - PHC, CHC, SDH, and DH were released, containing facility-specific Essential Medicines Lists (EMLs).EMLs are based on HWC service packages, recommendations from expert groups, MoHFW Program Guidelines, and the National List of Essential Medicines (NLEM-2015). |
Essential Medicines List --- Facility wise |
|
|---|---|
| Level of Health Facility | Total number of medicines |
| Health & Wellness centre, Sub centre | 106 |
| Health & Wellness centre, Primary Health Care (PHC) | 172 |
| Community Health Centre (CHC) | 300 |
| Sub District Hospital(SDH) | 318 |
| District Hospital (DH) | 381 |
