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India-WHO Essential Drugs Programme implemented by

India-WHO Essential Drugs Programme implemented by Delhi Society for Promotion of Rational Use of Drugs (1997 - 2002) Dr Sangeeta Sharma. Delhi State. Population – 14 million Total no. of hospitals beds – 4000 Teaching hospitals – 2 Total number of health centers – 158.

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India-WHO Essential Drugs Programme implemented by

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  1. India-WHO Essential Drugs Programme implemented by Delhi Society for Promotion of Rational Use of Drugs (1997 - 2002) Dr Sangeeta Sharma

  2. Delhi State • Population – 14 million • Total no. of hospitals beds – 4000 • Teaching hospitals – 2 • Total number of health centers – 158 Drug annual budget – $ 8 million

  3. Drug Policy STGs Formulary Rational prescribing Quality assurance Unbiased Info Pooled procurement Research Monitoring Essential Medicines List

  4. Impact on prices (1):Drugs purchased from essential medicines list, at competitive prices (Rp)

  5. Impact on prices (2)Holding the price line Prices in (Rs.)  10% 59% 37% 43% Years

  6. Impact on availability in public facilities:Medicines actually dispensed at various level of health facilities (Delhi state, 2002) Teaching Secondary PHC Percent Health facilities

  7. Impact on drug quality in public facilities:Results of quality tests (Delhi state)

  8. Impact on rational prescribing:Medicines prescribed from EML (Delhi, 2002) Teaching Secondary PHC Percent Health facilities

  9. Overall impact (Delhi State, 1995-2000):Pooled availability of drugs, percent prescriptions by generics, from EML Percent Year under review

  10. Budget saved Procured large quantities and more drugs Pooled procurement Essential Medicines List Enhanced access to drugs

  11. WHO India Essential Drugs Programme:Expansion of Delhi programme into other states, executed through local NGO Himachal Pradesh Punjab Components • State drug policy • Essential drugs lists by level of care • Pooled procurement • Efficient distribution • Quality assurance • information patients & prescribers • Training in rational prescribing • Studies on drug use, pharmacoeconomics Haryana Delhi State Rajasthan Bihar Madhya Pradesh Gujarat West Bengal Maharashtra Andhra Pradesh Goa 13 states - total population 580 million Tamil Nadu

  12. Conclusions • Wise drug selection underlies all other improvements in public procurement and supply • Effective management saves money and improves the performance and accessibility No extra public funds spent other than on GMP inspections

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