The Union Health Ministry has taken up the task of revising the National List of Essential Medicines (NLEM) and has asked for stakeholders’ participation in the process.
According to a circular issued by the Indian Council of Medical Research (ICMR), “The mandate includes - medicines, medical devices, medical disposables and consumables, hygiene and other healthcare products.”
“A meeting will be held on February 22 under the chairmanship of Balram Bhargava, Secretary, Department of Health Research, for the same,” a senior official confirmed.
The list is drawn out by the Ministry on basis of Essential List of Medicines released by World Health Organization every few years.
“Currently, NLEM includes only 20 per cent of drugs of all those that are in the market, which then go on to come under price control,” said another senior official.
Experts, however find regulation of medical devices through NLEM problematic. “We are still unsure if MoHFW will regulate medical devices using scientific evidence based on Health Technology Assessment in India (HTAI), a body that was set up precisely for this purpose,” said health economist Denny John.
Need to assess evidence
John said that imposing just price control in medical devices without assessing the scientific evidence may lead to over prescribing of such devices like cardiac stents or devices for knee replacement. “I don't understand why NLEM is extending it's mandate and going into devices when HTAI, a body formed in 2017 already exists,” questioned John.
Giving a recent example of price regulation for stents, John said if we need judiciary to intervene to cut down prices of cardiac stents even 60 years after Independence, then there is a serious problem in the way the systems work in our country. “In countries such as the UK, a body called NICE engages in regulating prices at which the private purchasers will buy devices from suppliers, a cost that the National Health System (NHS) then reimburses. The regulation is based on transparency and evidence,” explained John.
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