A research study claims that Indians lack access to essential medicines despite the government approving thousands of drugs to ensure their wider availability.

The study has been jointly conducted by researchers at the Newcastle University in the United Kingdom, Lakshya, a society for public health education and research based in Mumbai, and the Tata Consultancy Services.

The study, published in the Journal of Global Health on January 27 this year, assessed the rational use of drugs shown to be safe and effective and the availability of six essential medicines in 124 private pharmacies in Maharashtra. It has found that despite there being multiple approved products listed in India databases, few were available in private pharmacies at a price people could afford. India’s 2015 national list of essential medicines consist of 376 drugs.

“These medicines should be widely available across India in public health facilities such as health centres and hospitals. However, due to limited resources supplies in public health facilities, patients are forced to turn to the private sector where medicines are more expensive,” Dr Colin Millard from Newcastle University told PTI.

Few available

Millard, a senior lecturer in Medical Anthropology at the Institute of Health and Society at the varsity, said in theory, competition within India’s vast market for generic drugs should ensure essential medicines are available in private retail outlets at a price people can afford. “We set out to test this by carrying out a study of six essential medicines in 124 private retail pharmacies in four districts of Maharashtra—Dhule, Sangli, Nagpur and Mumbai city,” he said.

The six essential medicines were: artemisinin (malaria), lamivudine (HIV/AIDS), rifampicin (tuberculosis control), oxytocin (reproductive health), fluoxetine (mental health) and metformin (diabetes).

“We compared what we found in the pharmacies with three open access Indian pharmaceutical databases - CIMS India, Medindia, and Medguide, and the commercial database Pharmatrac,” he said.

The published study found that although multiple brands of essential medicines—running into thousands—were listed as available in India, only a few of these were available in pharmacies. Metformin was the only medicine with high availability, rifampicin which was present in about half the pharmacies (64.5 per cent). The other four medicines were available in less than half, according to the study.

Need for database

Millard said that another area of concern was that medicines were available in multiple brands of fixed dose combinations where two or more drugs are combined in a set ratio in a single dose form, usually a tablet or a capsule.

The study has called for Central Drugs Standard Control Organisation (CDSCO) to review the number of brands on the market, taking into consideration sales, availability, price and the grounds for approval. It has concluded there is an urgent need for a consumer friendly central database which will enable people to verify manufacturing approval, efficacy and compare prices.