Bina Devi (name changed) spends most of her earnings on the health needs of her family. Often, her family does not have enough money for a hearty millet or rice porridge for dinner. Much of the money they earn goes towards their healthcare costs. Bina Devi’s son often falls ill with cough, cold, or an upset stomach. Her father-in-law needs daily medication for diabetes.
Medical expenses are a big part of the monthly household budget. There is no one to turn to for financial help, since they have already borrowed money from everyone they know. Bina Devi is exhausted and worried about the future of her family.
Jan Aushadhi Kendra
To help people like Bina Devi and her family, the government has many initiatives. One of these is ‘Jan Aushadhi Kendra’ — a store that sells generic medicines at a low cost.
The program was launched in 2008 and renamed as the Pradhan Mantri Bharatiya Jan Aushadhi Pariyojana (PMBJP).
Today, there are more than 16,400 Jan Aushadhi Kendras across the country.
Centre for Media Studies (CMS), New Delhi, completed a study recently to look at the effectiveness of the Jan Aushadhi Kendras in urban locations of Assam and Rajasthan (https://journals.sagepub.com/doi/10.1177/17411343251379754).
Today, there are more than 16,400 Jan Aushadhi Kendras across the country.
The study looked at whether households have been able to save money by buying their medicines from Jan Aushadhi Kendras. These were households where a member of the family has a chronic health condition. As part of the study, the CMS team also met people who were not buying their medicines from Jan Aushadhi Kendras. This article draws some of the findings from this study.
Socio-economic impact of savings
Households spent INR 900 per month (median value) on family members’ medical expenses every month. More than half of this (56%) went towards medicines.
One in four households reported saving over INR 1000 every month on medicines.
Costs at private medical stores for medicines for chronic illnesses like diabetes, hypertension or gastric problems were four times higher when compared to costs at Jan Aushadhi Kendras.
Households that regularly buy their medicines from Jan Aushadhi Kendras saved an average of INR 550 every month due to lower medicine costs.
Money saved by the households went towards providing nutritious food, better health facilities for family members, children’s education, and savings for future needs.
Perception and Experiences
Nearly 50% of the households that were aware of Jan Aushadhi Kendras and knew that they had one within a range of 1–3 km. About 45% had Kendras located less than 1 km from their residence.
Most people who regularly purchased medicines at the Jan Aushadhi Kendras said that non-availability of medicines in sufficient amounts was a concerning factor. Interestingly, majority of the households also reported a high degree of satisfaction with the Jan Aushadhi Kendra and its other features.
Over half (56%) of those who had a Jan Aushadhi Kendra nearby but were not purchasing medicines from the Kendra said that a key reason was that their doctor did not prescribe generic medicines.
An equal number of people (52%) said they had trust issues about generic medicines. Availability of medicines was also reported as a concern.
A government official told the team that those from mid-income and well-to-do communities also purchase from the Jan Aushadhi Kendras. They do so because they know that the composition of medicines is what is important and so understand that there may not be a difference in quality between a branded and a generic medicine.
Over half (56%) of those who had a Jan Aushadhi Kendra nearby but were not purchasing medicines from the Kendra said that a key reason was that their doctor did not prescribe generic medicines.
Challenges
The study also identified several challenges. These include delayed supply of medicines, ordering and distribution related challenges, and hesitation among the medical community to prescribe generics.
Opportunities for improvement
The study identified several possibilities for improvement.
From the perspective of those running the Jan Aushadhi Kendras, these included improving medicine supply, sourcing medicines which have a reasonable duration before expiry, and allowing lower value order sizes.
To help more people access lower cost medicines, opportunities for improvement included increasing awareness about the availability of low-cost and good quality medicines at the Jan Aushadhi Kendras, and encouraging doctors to prescribe generic medicines.
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Benefits
People save a considerable sum of money by buying their medicines at the Jan Aushadhi Kendras.
The ‘trust factor’ is real, since people find that the medicines they buy are of good quality.
Conclusion
Some of the current challenges of supply, pharmacist difficulties in responding to beneficiaries’ needs and the reluctance of medical practitioners to prescribe generic medication, are real.
However, Jan Aushadhi Kendras can provide significant cost savings to a large population in need. Having more Jan Aushadhi Kendras across the country will help several others like Bina Devi reduce their spending on health.