Universal Access to Medicines in India- A Baseline Evaluation of the Rajasthan Free Medicines Scheme

Universal Access to Medicines in India - Mukhyamantri Nishulk Dava Yojana, also called the Chief Minister's Free Medicines Initiative was launched by the Government of Rajasthan in October 2011 and was developed in compliance with the state government's commitment to provide essential medicines free of cost to all patients visiting public healthcare facilities in Rajasthan. The initiative also contributes to the vision and direction of WHO’s efforts in the South-East Asia Region of improving access to pharmaceuticals, a key component for advancing universal health coverage and robust health systems.

The baseline evaluation of the Rajasthan Medical Services Corporation was conducted using scientific and robust research methodology, with evidence drawn from facility surveys in addition to available secondary data. Several crucial aspects of the scheme were analyzed, such as procurement processes and patterns, trends in public investments on medicines, quality assurance processes, supply chain management processes, storage systems and processes, impact on private spending on drugs, availability and stock-out of drugs, procurement price variations and prescription patterns.

The primary objective of the study was to document evidence that could point to improved access to medicines and reduced out-of-pocket expenditure in 150 facilities included in the study. The study was jointly undertaken by the WHO Country Office for India, Public Health Foundation of India (PHFI) and Prayas (an NGO based in Rajasthan).

Some of the key recommendations generated by the study were: ensuring government commitment to adequately and sustainably fund the national health system for reliable supply of essential medicines; assuring quality control mechanisms for enhanced safety and efficacy of medicines; continuous supply of high quality generic drugs; streamlining the national and state procurement and supply chain management systems; enforcing rational use of medicines, including the use of essential drug lists and standard treatment guidelines; and continued advocacy and engagement with prescribers at state and district levels.