Innovative Healthcare Practices in West Bengal for Reducing Patient Out-of-Pocket Expenses

1. REDUCTION OF‘OUT OF POCKET’ EXPENSES OF PATIENTS THROUGH INNOVATIVE PRACTICES OF THE GOVERNMENT OF WEST BENGAL

2. INNOVATIVE PRACTICES IN THREE (3) KEY AREAS FOR REDUCTION OF OUT OF POCKET EXPENSES • FAIR PRICE MEDICINE SHOPS THROUGH • PUBLIC PRIVATE PARTNERSHIPS (PPP) • FAIR PRICE DIAGNOSTIC FACILITIES & • DIALYSIS SERVICES THROUGH PPP • FREE DRUG POLICY IN ALL HOSPITALS • AND POLICY ON FREE SERVICES AT • PRIMARY AND SECONDARY HOSPITALS

3. 1. FAIR PRICE MEDICINE SHOPS (FPMS) THROUGH PPP • Established as an additional source of supplies within the Government Hospitals round the clock that dispense drugs at high discounts on Maximum Retail Price (MRP) for the benefit of the patients • 35 FPMS established in first phase. Roll out in other hospitals undertaken based on positive impact of the scheme • 90 FPMS out of 121 already functional at present with discounts ranging from 48% - 77.20 % on MRP. • Products/services include medicines, consumables cardiac & orthopedic implants

4. Additional Delivery System of Medicines & Consumables24 Hours at affordable cost through a chain of Fair Price Medicine Shops.

5. FAIR PRICE MEDICINE SHOPS (FPMS) THROUGH PPP • Quality Assurance • Quality and other important parameters for procurement of stocks in the FPMS have been incorporated in the scheme. In addition, provisions for additional quality audits apart from statutory quality testing of drugs have also been incorporated in the scheme. • Monitoring Mechanism • On line tracking of performances viz. sales, inventory of stocks of the FPMS through web based software installed in the FPMS

6. FAIR PRICE MEDICINE SHOPS (FPMS) THROUGH PPP • Benefits & reduction of out of pocket expenses The Ministry of Health, Government of India has requested all the State Government to consider adopting the West Bengal model with or without modifications in accordance with their requirements.

7. 2. FAIR PRICE DIAGNOSTIC FACILITIES & DIALYSIS SERVICES THROUGH PPP • Access to advance Diagnostic Imaging Facilities & Dialysis Services at affordable cost for reduction of out of pocket expenses of the patients • Equipments (Digital X-Ray, CT Scan, MRI scan and Dialysis machines) procured by the State Government by utilizing available funds (147 crore INR) • Services through operation & management partners under PPP round the clock • Total of 47 Hospitals covered under the scheme for different services. Already, services became functional in 20 hospitals

8. FAIR PRICE DIAGNOSTIC FACILITIES & DIALYSIS SERVICES THROUGH PPP • The selected O&M partners pay a fixed concession fee for each of the services in the concerned hospital. Selection of O&M partners undertaken on the amount of concession fee offered by the technically qualified applicants • The concession fees are fully utilized for the benefit of free services to the poor patients under this scheme. Adjustment of concession fee vis-à-vis free services are system generated in the soft ware installed in the centre • The O&M partners collect user charges from hospital patients on approved rates which are significantly lower than the market rates

9. FAIR PRICE DIAGNOSTIC FACILITIES & DIALYSIS SERVICES THROUGH PPP (Dialysis in progress )

10. FAIR PRICE DIAGNOSTIC FACILITIES & DIALYSIS SERVICES THROUGH PPP Initial Benefits & Reduction of Out of Pocket Expenses

11. 3. FREE DRUG POLICY AND FREE SERVICES IN THE HOSPITALS • Reform in the free drug policy from June 2011 to enhance availability of essential and vital drugs free of cost to the ailing patients in all the Government Hospitals for reduction of out of pocket expenses • Significant increase in the budget allocation for drugs which is at present Rs 403 crore annually • Revamping in the entire policy on procurement of drugs. Pre-qualification of participating organizations in the tender now made mandatory to ensure quality medicines from the manufacturers

12. FREE DRUG POLICY FOR SUPPLIES OF ESSENTAIL DRUGS IN THE HOSPITALS A dedicated web enabled software ‘SMIS’ (Store Management Information System) introduced to generate procurement orders against fund allotments. No manual processing of orders and bills are allowed. Quality audit for drugs strengthened. Inclusion of NABL accredited testing laboratories have been made Benefits for the patients Substantial increase in the availability of essential and vital drugs for free supplies to the ailing patients with benefits of more than Rs 400 crore annually

13. FREE SERVICES IN PRIMARY AND SECONDARY HOSPITALS The State Government has issued Order to allow free services for therapeutic, surgeries, Beds, Diagnostics and Pathological investigations to all patients in primary and secondary hospitals in the State Benefits for the patients All patients in the hospitals are treated at par with principles of equity and universal access to health care services

14. CONCLUSION Summary of reduction of out of pocket expenses in two years through innovative practices of the Government of West Bengal

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