Assessment Report on free Drugs - Department of Health & Family ...
Assessment Report on free Drugs - Department of Health & Family ...
Assessment Report on free Drugs - Department of Health & Family ...
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Submitted to:<br />
Executive Director,<br />
State <strong>Health</strong> Resource Centres, Chhattisgarh<br />
1 st Floor, State <strong>Health</strong> Training Centre,<br />
Kalibadi Chowk, RAIPUR - 492001.<br />
March, 2013<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong><br />
<strong>of</strong><br />
financial<br />
financial<br />
resources resources for for<br />
for<br />
guaranteeing<br />
guaranteeing<br />
access access to to <strong>free</strong><br />
<strong>free</strong><br />
generic generic medicines<br />
medicines<br />
(in (in edl) edl) at public<br />
health health facilities<br />
facilities<br />
in in Chhattisgarh<br />
Chhattisgarh<br />
Submitted Submitted by:<br />
by:<br />
IPE Global Pvt. Ltd.<br />
IPE Towers,<br />
B-84, Defence Col<strong>on</strong>y,<br />
New Delhi-110024, India<br />
Tel: +91-11-40755900, 24339533<br />
Fax: +91-11- 24339534<br />
Email: ipe@ipeglobal.com
ACKNOWLEDGEMENT<br />
At the start, IPE Global Pvt. Ltd. would like to acknowledge the support and overview<br />
provided by H<strong>on</strong>orable Commissi<strong>on</strong>er <strong>of</strong> the State Shri Pratap Singh and H<strong>on</strong>orable<br />
Director <strong>Health</strong> Services Dr. Kamal Preet Singh particularly the inputs provided during<br />
the presentati<strong>on</strong> <strong>of</strong> draft report <strong>on</strong> 18 th March, 2013.<br />
We would also like to place <strong>on</strong> record our acknowledgements to Mr. J. P. Mishra,<br />
Executive Director State <strong>Health</strong> Resource Center (SHRC), Chhattisgarh for providing the<br />
necessary platform for interacti<strong>on</strong> to carry out the work and mid-course correcti<strong>on</strong>s for<br />
the study.<br />
We would also like to acknowledge the valuable inputs and cooperati<strong>on</strong> provided by Dr.<br />
Surendra Pamboi, SPO (Store), Directorate <strong>of</strong> <strong>Health</strong> Services.<br />
We also place <strong>on</strong> record our gratitude to Dr. Ms. Neha Parakh, Programme Coordinator<br />
(TA-Medical) <strong>of</strong> SHRC Raipur for providing technical support and organizing the survey<br />
work. We also acknowledge the inputs received from Dr. Rajesh Singh in drawing out the<br />
samples.<br />
We acknowledge the inputs provided by Dr. Kamlesh Jain, Nodal Officer NPCDCS,<br />
Chhattisgarh for sharing the data and views <strong>on</strong> N<strong>on</strong> Communicable Diseases burden in<br />
the states.<br />
Last but not the least we acknowledge the program associates Dr. Premshankar Verma<br />
(Programme Coordinator), Dr. Rohit Baghel (Programme Associate), Dr. Sheetal Vyas<br />
(Programme Associate) and Dr. Roshan Gupta (Programme Associate) for coordinating<br />
the survey and data collecti<strong>on</strong> work.<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g>
List <strong>of</strong> Abbreviati<strong>on</strong>s<br />
EDL Essential Drug List<br />
PIP Project Implementati<strong>on</strong> Plan<br />
NVDCP Nati<strong>on</strong>al Vector Borne Disease C<strong>on</strong>trol Programme<br />
NLEP Nati<strong>on</strong>al Leprosy Eradicati<strong>on</strong> Programme<br />
NCD N<strong>on</strong> communicable disease<br />
NP Nati<strong>on</strong>al Programme<br />
DPT Diphtheria Tetanus and Pertussis Vaccines<br />
BCG BacilleCalmette–Guérin<br />
OPV Oral Polio Vaccine<br />
ARV Antiretroviral drug<br />
MDT Multi Drug Therapy<br />
MDR Multidrug-resistant<br />
MMR Measles, mumps, and rubella<br />
NRHM Nati<strong>on</strong>al Rural <strong>Health</strong> Missi<strong>on</strong><br />
TNMSC Tamil Nadu Medical Services Corporati<strong>on</strong><br />
PHC Primary <strong>Health</strong> Centre<br />
CHC Community <strong>Health</strong> Centre<br />
DH District Hospital<br />
OPD Out Patient <strong>Department</strong><br />
IPD Inpatient <strong>Department</strong><br />
DLHS District Level Household Survey<br />
OHA Oral Hypoglycaemic Agent<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 3
EXECUTIVE SUMMARY<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The Chhattisgarh Government is c<strong>on</strong>sidering to adopt and announce a policy guaranteeing<br />
access to <strong>free</strong> generic medicines to all at the public health facilities in the State and has asked the<br />
State <strong>Health</strong> Resource Centre, its technical support agency, to make an assessment <strong>of</strong> financial<br />
envelope required to fulfil the commitment.<br />
Background<br />
IPE Global Pvt Ltd was selected through a ‘Quality cum cost based ‘evaluati<strong>on</strong> process.<br />
Enhancing public expenditures <strong>on</strong> health is likely to have a direct impact <strong>on</strong> poverty reducti<strong>on</strong> also.<br />
Provisi<strong>on</strong> <strong>of</strong> <strong>free</strong> drugs to all accessing public health system a means <strong>of</strong> reducing OOP expenditure<br />
and increasing accessibility a model already in place in states <strong>of</strong> TN, Rajasthan, Orissa, Kerala.<br />
For Chhattisgarh, <strong>on</strong>e <strong>of</strong> the key Challenges identified is improving access and reducing OOP<br />
expenditure by ensuring availability <strong>of</strong> <strong>free</strong> medicines (generic ) from government hospitals (from<br />
EDL) and across the counter availability <strong>of</strong> generic drugs in general in the state.<br />
The government has set up the Chhattisgarh Medical Services Corporati<strong>on</strong> to improve inventory<br />
management, prevent stock outs and expiry <strong>of</strong> medicines. The organizati<strong>on</strong> has notified the Essential<br />
drug list and operates Jan Aushadhi (Generic Drug) Stores.<br />
Chhattisgarh state has the 3 tier healthcare delivery system at par with the nati<strong>on</strong>al system. Primary<br />
healthcare is delivered through Primary <strong>Health</strong> Sub centers and Primary <strong>Health</strong> Centers (PHC).<br />
Sec<strong>on</strong>dary healthcare is delivered through CHCs and DHs. Tertiary healthcare through DHs and<br />
Medical College Hospitals.<br />
Study<br />
The assignment required an answer to the following questi<strong>on</strong><br />
“How much m<strong>on</strong>ey will be required by Government <strong>of</strong> Chhattisgarh to achieve the objective <strong>of</strong><br />
providing good quality ‘Free Medicines for All’ as part <strong>of</strong> the goal <strong>of</strong> ‘<strong>Health</strong> Care for All’?”<br />
The broad framework <strong>of</strong> the study required-<br />
1) To work out the demand projecti<strong>on</strong> taking into account different data sets as each <strong>on</strong>e in<br />
isolati<strong>on</strong> will have a demerit to influence reliability.<br />
2) The study results are probabilistic keeping in view the short time frame in which the report<br />
was required to be generated otherwise l<strong>on</strong>g term prospective study would have been ideal.<br />
3) The Study design is cross secti<strong>on</strong>al and includes sec<strong>on</strong>dary and primary data collecti<strong>on</strong> and<br />
Prescripti<strong>on</strong>s survey across various categories <strong>of</strong> health facilities (tertiary, sec<strong>on</strong>dary and<br />
primary health care level).<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 4
Hybrid method for demand assessment<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
A Hybrid method for Demand assessment which is a combinati<strong>on</strong> <strong>of</strong> C<strong>on</strong>sumpti<strong>on</strong>, Morbidity<br />
Method and analytical methods was used.<br />
Prescripti<strong>on</strong> Survey<br />
Good statistically enabled samples <strong>of</strong> prescripti<strong>on</strong>s were studied for frequency and quantity<br />
<strong>of</strong> drugs from EDL. The challenge here was that the preparati<strong>on</strong>s prescribed were <strong>of</strong>ten not generic.<br />
We c<strong>on</strong>verted the prescripti<strong>on</strong>s into generic forms for the purpose <strong>of</strong> recording data. Qualified<br />
pers<strong>on</strong>nel well versed with pharmacy sciences c<strong>on</strong>ducted the survey and data analysis and to assess<br />
prescripti<strong>on</strong> patterns for EDL and Specialist drugs.<br />
Primary data was collected from OPD and IPD prescripti<strong>on</strong>s <strong>of</strong> drugs from Medical Colleges, Districts<br />
Hospitals, CHCs and PHCs for estimati<strong>on</strong> <strong>of</strong> drugs c<strong>on</strong>sumpti<strong>on</strong>.<br />
Statistical tools and probability methods were used for data analysis to arrive to a scientific result for<br />
the study. The frequency <strong>of</strong> prescripti<strong>on</strong> as well as quantity was analysed using mean and standard<br />
deviati<strong>on</strong> for each drug. Assuming that prescripti<strong>on</strong> pattern will follow a normal distributi<strong>on</strong>,<br />
probability, model for normal distributi<strong>on</strong> was used to get a projecti<strong>on</strong> for 90% probability.<br />
Historical C<strong>on</strong>sumpti<strong>on</strong> data<br />
Primary data was collected from stores <strong>of</strong> different z<strong>on</strong>es for demand estimati<strong>on</strong> <strong>of</strong> essential drugs<br />
and c<strong>on</strong>sumables. A tool was developed to capture data <strong>of</strong> c<strong>on</strong>sumpti<strong>on</strong> for durati<strong>on</strong> <strong>of</strong> three years.<br />
It included stock c<strong>on</strong>sumed over 3 years including periods <strong>of</strong> stock outs.<br />
However, Most <strong>of</strong> the historical store data had wide gaps in that the figures were available for 2<br />
years <strong>on</strong>ly. The supply <strong>of</strong> most drugs was also erratic, with periods <strong>of</strong> over stocking and l<strong>on</strong>g stock<br />
outs. Data obtained from the store c<strong>on</strong>sumpti<strong>on</strong> therefore could not be relied up<strong>on</strong> fully.<br />
Morbidity pattern<br />
Demand assessment for certain drugs was carried out/validated using the morbidity<br />
patterns. This was especially used for drugs used in NCD and in diseases covered in Nati<strong>on</strong>al<br />
Programme.<br />
Expert / Analytical estimati<strong>on</strong><br />
For drugs used in niche areas such as <strong>on</strong>cology, psychiatry and ophthalmology etc. and which did not<br />
get covered in the prescripti<strong>on</strong> survey we ratified the demand by the c<strong>on</strong>cerned specialists.<br />
Discussi<strong>on</strong>s were held with specialists both at Chhattisgarh and at Delhi before arriving at a best<br />
estimate for these items.<br />
C<strong>on</strong>sumables which are required for day to day care delivery and are more than <strong>of</strong>ten loaded <strong>on</strong> to<br />
the patients were also taken in the ambit <strong>of</strong> study, as their provisi<strong>on</strong> by the government will reduce<br />
the OOP expense for the public<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 5
Price estimati<strong>on</strong><br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Given that the Chhattisgarh Government has set up the Chhattisgarh Medicare Services Corporati<strong>on</strong><br />
for centralized procurement <strong>of</strong> drugs, and that such large procurements will result in extremely<br />
competitive rates, we factored that the price per item would be much below the market price <strong>of</strong> the<br />
drugs.<br />
Data <strong>on</strong> rates at which drugs were procured over the past 2/3 years by the DME and DHS in the state<br />
were sought. However, this could cater to <strong>on</strong>ly 30% <strong>of</strong> the items covered.<br />
For the rest <strong>of</strong> the items we relied <strong>on</strong> Tamil Nadu Medical Stores Corporati<strong>on</strong>, Rajasthan Medical<br />
Stores Corporati<strong>on</strong> and Kerala Medical Stores Corporati<strong>on</strong> tender rates. The price under which<br />
TNMSC obtained drugs was found to be much lower <strong>on</strong> account <strong>of</strong> the benefits <strong>of</strong> larger scale and<br />
length <strong>of</strong> operati<strong>on</strong>s. This was addressed by adding a twenty per cent weightage to all TNMSC price<br />
rates utilized.<br />
Results<br />
In view <strong>of</strong> the short time frame in which a good estimate <strong>of</strong> the financial envelope was to be<br />
ascertained, various data sources were used to get a correct demand estimate for each drug.<br />
From the Store c<strong>on</strong>sumpti<strong>on</strong> data and the prescripti<strong>on</strong> survey, drug demand for each level <strong>of</strong> facility<br />
was worked out. Based <strong>on</strong> the prevalence rates and morbidity patterns, the drug demand was<br />
calculated for the entire state populati<strong>on</strong>.<br />
A triangulati<strong>on</strong> <strong>of</strong> data was d<strong>on</strong>e for each item and the final estimate was chosen.<br />
Scenario 1<br />
The study has worked out the demand assessment for each item based <strong>on</strong> the current levels <strong>of</strong> work<br />
load and service delivery at the various levels <strong>of</strong> facilities i.e. Tertiary, Sec<strong>on</strong>dary and Primary care.<br />
Based <strong>on</strong> the current demand, the financial envelope that the Government <strong>of</strong> Chattisgarh will<br />
require to table for providing <strong>free</strong> generic medicines (listed in the EDL) at all level <strong>of</strong> public<br />
healthcare delivery facilities (Medical Colleges; District Hospitals; CHCs & PHCs) is INR 143.92Crores.<br />
Scenario 2<br />
Around 30% <strong>of</strong> the State’s populati<strong>on</strong> accesses the Government funded public health care delivery<br />
system in the state. We anticipate an increase in patr<strong>on</strong>age <strong>of</strong> public health care delivery <strong>on</strong>ce the<br />
government starts providing assured <strong>free</strong> medicines.<br />
Based <strong>on</strong> the model utilized by the Planning Commissi<strong>on</strong>, it is anticipated that over a period 52% <strong>of</strong><br />
the state’s populati<strong>on</strong> will be serviced by the Public <strong>Health</strong>care facilities and the outreach<br />
programmes. The budget for provisi<strong>on</strong> <strong>of</strong> <strong>free</strong> generic drugs will then be INR 175.58 Crores (Rupees<br />
One Hundred and Seventy Five Crores)<br />
The estimated Cost <strong>of</strong> providing for medicines for NCD al<strong>on</strong>e in the current study is INR 25.66 Crores.<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 6
Recommendati<strong>on</strong>s’<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
It is recommended that a similar exercise is undertaken by the Government over the next 2 years.<br />
This will fine tune the item wise demand assessment and also help in ascertaining the prescripti<strong>on</strong><br />
patterns at various facilities. This will also help in designing interventi<strong>on</strong>s for promoting scientific<br />
prescripti<strong>on</strong> practices.<br />
The overall financial envelope is a small comp<strong>on</strong>ent <strong>of</strong> the health budget when <strong>on</strong>ly the price <strong>of</strong> the<br />
item is being factored. However there is a cost <strong>of</strong> procurement, storage, transport and distributi<strong>on</strong><br />
which also needs to be taken into account. Further the procurement process should be visited to<br />
ensure that there is a procurement cycle for most <strong>of</strong> the items and inventory c<strong>on</strong>trol tools like fixing<br />
re order levels after catering to safety stocks and buffer stocks using e procurement system for<br />
greater efficiency and transparency and minimizing stock outs will be the key factors for successful<br />
implementati<strong>on</strong> <strong>of</strong> the intent.<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 7
C<strong>on</strong>tents<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CHAPTER 1: INTRODUCTION ....................................................................................................... 10<br />
1.1 BACKGROUND: ................................................................................................................................ 10<br />
1.2 STATE HEALTH STATISTICS .................................................................................................................. 14<br />
1.3 STATE HEALTH FINANCE .................................................................................................................... 16<br />
1.4 HEALTH FINANCE ............................................................................................................................. 16<br />
1.5 TAMIL NADU MODEL -THE FIRST ONE .................................................................................................. 18<br />
CHAPTER 2: STUDY DESIGN & DISCUSSION ................................................................................. 20<br />
2.1 OBJECTIVE OF THE STUDY ................................................................................................................... 20<br />
2.2 SCOPE OF THE STUDY ........................................................................................................................ 20<br />
2.3 STUDY DESIGN ................................................................................................................................. 21<br />
2.3.1 INTRODUCTION ............................................................................................................................. 21<br />
2.3.2 STUDY DESIGN .............................................................................................................................. 21<br />
2.4 PRESCRIPTION SURVEY ...................................................................................................................... 22<br />
2.4.1 Training <strong>of</strong> Surveyors ............................................................................................................ 22<br />
2.4.2 Survey Tool ............................................................................................................................ 23<br />
2.4.3 Sample .................................................................................................................................. 25<br />
2.4.4 Data analysis & Statistical Correlati<strong>on</strong> ................................................................................. 26<br />
2.4.5 Additi<strong>on</strong>al informati<strong>on</strong> collected .......................................................................................... 27<br />
2.4.6 Limitati<strong>on</strong>s ............................................................................................................................ 27<br />
2.5 HISTORICAL CONSUMPTION DATA ...................................................................................................... 28<br />
2.5.1 Sample ............................................................................................................................. 28<br />
2.5.2 Analysis <strong>of</strong> data keeping stock outs in account ............................................................... 28<br />
2.5.3 Limitati<strong>on</strong>s <strong>of</strong> data .............................................................................................................. 29<br />
2.6 ASSESSMENT THROUGH MORBIDITY PATTERNS ..................................................................................... 29<br />
2.6.1 Applicable for NCD .......................................................................................................... 29<br />
2.7 EXPERT INPUT / ANALYTICAL ASSESSMENT ............................................................................................ 29<br />
2.8 PRICE ESTIMATION ........................................................................................................................... 31<br />
CHAPTER 3 DATA ANALYSIS & REPORT GENERATION .................................................................. 32<br />
3.1 TRIANGULATION OF DATA ................................................................................................................. 41<br />
3.1.1 Demand for Anti Rabies Vaccine ........................................................................................... 44<br />
3.1.2 Demand for Insulin for treatment <strong>of</strong> Diabetes Mellitus ........................................................ 45<br />
3.2 TOTAL FINANCIAL ENVELOPE .............................................................................................................. 47<br />
3.3 FINANCIAL ENVELOPE FOR EACH LEVEL OF FACILITY ................................................................................. 49<br />
3.4 FUNDING FOR OUTREACH PROGRAMME .............................................................................................. 49<br />
CHAPTER 4 STUDY CONSTRAINTS / LIMITATIONS ........................................................................ 50<br />
4.1 ITEMS NOT INCLUDED IN STUDY .......................................................................................................... 50<br />
4.2 PROBABILISTIC STUDY ....................................................................................................................... 50<br />
4.3 CAN BE REFINED OVER YEARS.............................................................................................................. 50<br />
CHAPTER 5 RECOMMENDATIONS ............................................................................................... 51<br />
5.1 FOLLOW UP STUDY ........................................................................................................................... 51<br />
5.2 ONGOING PRESCRIPTION AUDIT .......................................................................................................... 51<br />
5.3 RATIONALISING & REVISING THE STATE EDL ......................................................................................... 51<br />
5.4 STRENGTHENING PROCUREMENT AND SUPPLY CHAIN. ........................................................................... 51<br />
ANNEXURE 1 - ITEMISED LIST OF DRUGS WITH TOTAL STATE DEMAND IN NUMBER AND VALUE .. 52<br />
ANNEXURE 2 - ABC ANALYSIS OF ITEMISED LIST OF DRUGS ......................................................... 83<br />
ANNEXURE 3 – PRESCRIPTION SURVEY TOOL ............................................................................ 112<br />
ANNEXURE 4 – STORE DATA COLLECTION TOOL ........................................................................ 113<br />
ANNEXURE 5 – LIST OF CONSUMABLES INCLUDED IN THE AMBIT OF THE STUDY ....................... 114<br />
BIBLIOGRAPHY ......................................................................................................................... 117<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 8
List <strong>of</strong> Tables<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Table 1: Demographic pr<strong>of</strong>ile ............................................................................................................... 11<br />
Table 2: Public <strong>Health</strong> Infrastructure <strong>of</strong> Chhattisgarh .......................................................................... 11<br />
Table 3: Standard populati<strong>on</strong> covered per health facility .................................................................... 12<br />
Table 4: <strong>Health</strong> Infrastructure <strong>of</strong> Chhattisgarh ..................................................................................... 13<br />
Table 5: Bed capacity <strong>of</strong> Medical colleges and DHs .............................................................................. 14<br />
Table 6: Patients footfall in Govt. health facilities ................................................................................ 14<br />
Table 7: Surgeries performed at District Level (2011-12) ..................................................................... 15<br />
Table 8: Chhattisgarh <strong>Health</strong> outcome ................................................................................................. 16<br />
Table 9: <strong>Health</strong> budgets comparis<strong>on</strong> .................................................................................................... 16<br />
Table 10: Sample distributi<strong>on</strong> <strong>of</strong> prescripti<strong>on</strong> surveyed ....................................................................... 25<br />
Table 11: Facilities where prescripti<strong>on</strong> survey was undertaken ........................................................... 26<br />
Table 12: Sample distributi<strong>on</strong> <strong>of</strong> stores data ........................................................................................ 28<br />
Table 13: Oncology Workload ............................................................................................................... 30<br />
Table 14: Number <strong>of</strong> drugs prescribed in the prescripti<strong>on</strong> .................................................................. 32<br />
Table 15: <strong>Drugs</strong> prescribed using their generic name .......................................................................... 32<br />
Table 16: The durati<strong>on</strong> for which the medicine is prescribed .............................................................. 32<br />
Table 17: <strong>Drugs</strong> prescribed listed in the EDL ........................................................................................ 33<br />
Table 18: Cases where drug dosage forms were provided or nor provided ........................................ 33<br />
Table 19: Strengths <strong>of</strong> dosage form provided ...................................................................................... 33<br />
Table 20: Diagnosis menti<strong>on</strong>ed in the prescripti<strong>on</strong> .............................................................................. 33<br />
Table 21:Dosage schedule for MDT Regimen ....................................................................................... 40<br />
Table 22: Drug Demand and budget calculati<strong>on</strong> based <strong>on</strong> nati<strong>on</strong>al prevalence rates ......................... 43<br />
Table 23: Drug demand & cost based <strong>on</strong> local prevalence statistics .................................................... 44<br />
Table 24: Drug demand & cost based <strong>on</strong> local prevalence statistics .................................................... 44<br />
Table 25: Demand assessment for ARV from 3 sources ....................................................................... 45<br />
List <strong>of</strong> Figures<br />
Figure 1 : Illustrati<strong>on</strong> <strong>of</strong> demand calculati<strong>on</strong> ........................................................................................ 34<br />
Figure 2 : Demand estimati<strong>on</strong> for chemotherapeutic drugs ................................................................ 35<br />
Figure 3 : Demand estimati<strong>on</strong> for drugs used in psychiatry ................................................................. 35<br />
Figure 4: Algorithm for Diagnosis and treatment <strong>of</strong> Malaria................................................................ 37<br />
Figure 5: Dosage schedule for treatment <strong>of</strong> Pl Vivax (under NVBDCP) ................................................ 37<br />
Figure 6: Age wise schedule for treatment <strong>of</strong> Plasmodium Falciparum malaria (as per NVBDCP) ...... 38<br />
Figure 7The ABC analysis for the items studied is provided at Annexure – 2 ...................................... 48<br />
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Chhattisgarh 9
1.1 Background:<br />
Chapter 1: Introducti<strong>on</strong><br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The Chhattisgarh Government is c<strong>on</strong>sidering to adopt and announce a policy guaranteeing<br />
access to <strong>free</strong> generic medicines to all at the public health facilities in the State and has asked the<br />
State <strong>Health</strong> Resource Centre, its technical support agency, to make an assessment <strong>of</strong> financial<br />
envelope required to fulfill the commitment. To carry out the assessment exercise, SHRC invited<br />
proposals from agencies having expertise and instituti<strong>on</strong>al capacity to mobilize quick surveys to carry<br />
out the assessment.<br />
For Chhattisgarh, <strong>on</strong>e <strong>of</strong> the key Challenges identified is improving access and reducing out <strong>of</strong> pocket<br />
(OOP) expenditure by ensuring availability <strong>of</strong> <strong>free</strong> medicines from government hospitals (from<br />
Essential Drug List) in the state.<br />
The state is proposing to substantially increase government spending <strong>on</strong> public procurement <strong>of</strong><br />
generic medicines in order to provide them <strong>free</strong>ly to patients through government hospitals and<br />
facilities.<br />
<strong>Drugs</strong> play a very important role in the delivery <strong>of</strong> the health care system. The availability <strong>of</strong> drugs at<br />
the health facility not <strong>on</strong>ly enhances the utilizati<strong>on</strong> <strong>of</strong> the facilities but also increases credibility <strong>of</strong><br />
the public healthcare system to the community. Despite all efforts being made the State & Central<br />
governments, the availability <strong>of</strong> drugs both in quantity and quality is not reached the desired level.<br />
State <strong>of</strong> Chhattisgarh<br />
Chhattisgarh is a land-locked state located in the middle <strong>of</strong> India surrounded by six other<br />
states – Madhya Pradesh, Andhra Pradesh, Orissa, Bihar, Jharkhand and<br />
Uttar Pradesh. This new state was formed <strong>on</strong> 1st November 2000 by<br />
carving out secti<strong>on</strong>s from the southeastern part <strong>of</strong> Madhya Pradesh.<br />
There are 27 districts and 20,715 villages. 1<br />
Unprecedented work is going <strong>on</strong> to improve the health situati<strong>on</strong><br />
and status <strong>of</strong> the vulnerable and unattended populati<strong>on</strong>. The state has<br />
achieved stupendous success in bettering basic health indicators, in<br />
ensuring quality health services and in improving the public health<br />
infrastructure. There are notable efforts to provide affordable care to<br />
the people in match with the needs <strong>of</strong> the diverse populati<strong>on</strong>.<br />
1 (http://health.cg.gov.in)- Chhattisgarh state Govt. <strong>Health</strong> Dept. website<br />
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Chhattisgarh 10
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
A large c<strong>on</strong>centrati<strong>on</strong> <strong>of</strong> tribal populati<strong>on</strong> lives in the hilly areas <strong>of</strong> Chhattisgarh. The state<br />
has 9.41% and 25.88% <strong>of</strong><br />
Scheduled Caste and Scheduled<br />
Tribe populati<strong>on</strong> respectively 3 Indicator Chhattisgarh<br />
.<br />
Al<strong>on</strong>g with the presence <strong>of</strong> huge<br />
tribal populati<strong>on</strong>, the state is also<br />
<strong>on</strong>e <strong>of</strong> those sparsely populated<br />
states with very remote and<br />
difficult to reach terrain with<br />
almost half <strong>of</strong> its land covered<br />
with dense forests. So there is a<br />
c<strong>on</strong>cern <strong>of</strong> inaccessibility <strong>of</strong><br />
medical care and Govt. <strong>of</strong><br />
Chhattisgarh feels that an<br />
accessible and affordable<br />
medical care should be available<br />
to all.<br />
2 India<br />
Total populati<strong>on</strong> (Census 2011) CR 2.55 121.01<br />
Decadal Growth (Census 2011) (%) 22.59 17.64<br />
Crude Birth Rate (SRS 2009) 25.7 22.5<br />
Crude Death Rate (SRS 2009)<br />
Natural Growth Rate (SRS 2009)<br />
Sex Ratio (Census 2011)<br />
8.1<br />
17.6<br />
991<br />
7.3<br />
15.2<br />
940<br />
Child Sex Ratio (Census 2011) 964 914<br />
Schedule Caste populati<strong>on</strong> (in crore) 0.24 16.6<br />
Schedule Tribe populati<strong>on</strong> (in crore) 0.66 8.4<br />
Total Literacy Rate (Census 2011) (%) 71.04 74.04<br />
Male Literacy Rate (Census 2011) (%) 81.45 82.14<br />
Female Literacy Rate (Census 2011) 60.59 65.46<br />
Table 1: Demographic pr<strong>of</strong>ile<br />
Public <strong>Health</strong> delivery infrastructure:<br />
Chhattisgarh state has the 3 tier healthcare delivery system at par with the nati<strong>on</strong>al system.<br />
Primary healthcare is delivered through Primary <strong>Health</strong> Sub centers and Primary <strong>Health</strong> Centers<br />
(PHC). Sec<strong>on</strong>dary healthcare is delivered through CHCs and DHs. Tertiary healthcare through DHs<br />
and Medical College Hospitals.<br />
Rural Populati<strong>on</strong> (In lakhs) Census 2011 196.04<br />
Number <strong>of</strong> Districts (RHS 2010) 18<br />
Number <strong>of</strong> Sub Divisi<strong>on</strong>/ Talukas 96<br />
umber <strong>of</strong> Blocks 146<br />
Number <strong>of</strong> Villages (RHS 2010) 20126<br />
Number <strong>of</strong> District Hospitals 17 + 10*<br />
Number <strong>of</strong> Community <strong>Health</strong> Centres (RHS 2010) 148 CHC+17 H=165<br />
Number <strong>of</strong> Primary <strong>Health</strong> Centres (RHS 2010) 741<br />
Number <strong>of</strong> Sub Centres (RHS 2010) 5076<br />
*10 CHs are under up-gradati<strong>on</strong> to District Hospitals for the newly c<strong>on</strong>structed districts.<br />
Table 2: Public <strong>Health</strong> Infrastructure <strong>of</strong> Chhattisgarh 4<br />
The public health facilities at each level, Primary, Sec<strong>on</strong>dary & Tertiary cater to a populati<strong>on</strong> .Below<br />
given is the standard populati<strong>on</strong> which is to be covered per health facility: 5<br />
2 5 th Comm<strong>on</strong> Review Missi<strong>on</strong>, Chhattisgarh<br />
3 5 th Comm<strong>on</strong> Review Missi<strong>on</strong>, Chhattisgarh<br />
4 5 th Comm<strong>on</strong> Review Missi<strong>on</strong>, Chhattisgarh<br />
5 PHFI Standards<br />
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Chhattisgarh 11
<strong>Health</strong> Facilities Number <strong>of</strong> functi<strong>on</strong>ing<br />
facilities<br />
Sub-centres 5076 3862<br />
PHC 741 26400<br />
CHC level hospitals 148 CHC+17 CH=165 1.54 Lakh<br />
District Hospitals 17+10* 15.02 Lakh<br />
Medical colleges 3 85.13Lakh<br />
*The 10 CHCs in newly created districts are under upgradati<strong>on</strong> to DH.<br />
Table 3: Standard populati<strong>on</strong> covered per health facility<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Populati<strong>on</strong> covered per facility<br />
The state has 27 districts. Originally there were 16 administrative districts in the state. The newly<br />
formed districts are Bijapur and Narayanpur were formed in 2007 and another 9 new districts were<br />
carved out <strong>on</strong> 2012 namely,<br />
♦ Sukma<br />
♦ K<strong>on</strong>daga<strong>on</strong><br />
♦ Balod<br />
♦ Bemetra<br />
♦ Baloda Bazar<br />
♦ Gariaband<br />
♦ Mungeli<br />
♦ Surajpur and<br />
♦ Balrampur<br />
District wise health infrastructures are in the following table:-<br />
SNo. District<br />
Chhattisgarh <strong>Health</strong> Infrastructure 6<br />
No <strong>of</strong> Instituti<strong>on</strong><br />
DH CHC Noti<strong>on</strong>al PHC SHC Total<br />
CHC<br />
Rural Urban Villages<br />
1 BALOD 1 7 0 27 191 226 213 12 726<br />
2 BALODA BAJAR 1 7 0 27 195 230 219 10 955<br />
3 BALRAMPUR 1 6 0 23 191 221 216 0 643<br />
4 BASTAR 0 6 1 40 187 234 232 0 594<br />
5 BEMETRA 1 4 1 21 125 152 145 6 710<br />
6 BIJAPUR 1 3 1 13 90 108 105 1 762<br />
7 BILASPUR 1 7 0 54 272 334 316 9 942<br />
8 DANTEWADA 1 4 0 12 69 86 78 7 266<br />
9 DHAMTARI 1 4 0 22 165 192 190 1 633<br />
10 DURG 1 3 0 23 127 154 120 33 437<br />
11 GARIYABANDH 1 6 0 12 194 213 207 5 703<br />
12 JANJGIR 1 9 0 39 246 295 275 19 1005<br />
6 http://health.cg.gov.in – Chhattisgarh State Govt. <strong>Health</strong> Dept. website<br />
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Chhattisgarh 12
SNo. District<br />
No <strong>of</strong> Instituti<strong>on</strong><br />
DH CHC Noti<strong>on</strong>al PHC SHC Total<br />
Rural Urban Villages<br />
13 JASHPUR 1 8 0 32 256 297 296 0 764<br />
14 KANKER 1 8 0 28 204 241 233 7 1103<br />
15 KAWARDHA 1 5 0 22 144 172 157 14 1049<br />
16 KONDAGAON 1 4 1 16 129 151 150 0 579<br />
17 KORBA 1 5 0 36 212 254 225 28 874<br />
18 KORIA 1 5 0 27 154 187 174 12 671<br />
19 MAHASAMUND 1 4 1 28 219 253 221 6 1135<br />
20 MUNGELI 1 3 0 21 108 133 128 4 668<br />
21 NARAYANPUR 1 2 0 7 59 69 67 1 376<br />
22 RAIGARH 1 8 1 50 311 371 368 2 1473<br />
23 RAIPUR 1 5 0 24 148 178 153 24 518<br />
24 RAJNANDGAON 1 8 1 43 306 359 351 7 1609<br />
25 SARGUJA 1 6 1 25 197 230 225 4 583<br />
26 SUKMA 1 3 0 12 81 97 96 0 384<br />
27 SURAJPUR 1 7 0 30 199 237 233 3 553<br />
Total 26 147 8 714 4779 5674 5393 215 20715<br />
Table 4: <strong>Health</strong> Infrastructure <strong>of</strong> Chhattisgarh<br />
BED AVAILABILITY<br />
The Bed strength <strong>of</strong> operati<strong>on</strong>al District Hospitals and medical colleges is given below. 10 identified<br />
CHCs/ CH will be upgraded for functi<strong>on</strong>ing as District Hospitals. For the purpose <strong>of</strong> study we are<br />
taking into account the existing DH which are 17 in numbers.<br />
Sr. No. District<br />
Numbers <strong>of</strong><br />
beds<br />
1 Raipur 100<br />
2 Durg 430<br />
3 Bilaspur 100<br />
4 Sarguja 300<br />
5 Janjgir Champa 100<br />
6 Rajnandga<strong>on</strong> 300<br />
7 Raigarh 300<br />
8 Kabardha 100<br />
9 Korba 100<br />
10 Mahasamund 100<br />
11 Jashpur 100<br />
12 Dhamtari 100<br />
13 Kanker 100<br />
14 Korea 100<br />
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Chhattisgarh 13
Sr. No. District<br />
Numbers <strong>of</strong><br />
beds<br />
15 Dantewada 100<br />
16 Narayanpur 100<br />
17 Bastar NA<br />
Sr. No. Medical<br />
College<br />
Numbers <strong>of</strong><br />
beds<br />
1 Jagdalpur 500<br />
2 Bilaspur 500<br />
3 Raipur 1000<br />
Table 5: Bed capacity <strong>of</strong> Medical colleges and DHs<br />
1.2 State <strong>Health</strong> statistics<br />
The workload catered by the Public <strong>Health</strong> facilities can be assessed from the following:-<br />
Year<br />
Total Annual OPD<br />
in the State<br />
2005-06 3474275<br />
Total OPD & IPD 7<br />
Percentage increase<br />
<strong>of</strong> OPD over previous<br />
year<br />
Total annual In-<br />
Patient<br />
admissi<strong>on</strong>s in the<br />
State<br />
2006-07 3512450 1.09 380572<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Percentage<br />
increase <strong>of</strong> IPD<br />
over previous<br />
year<br />
2007-08 3540512 0.79 402287 5.71<br />
2008-09 3612219 1.99 426890 6.12<br />
2009-10 3762565 4 443394 3.87<br />
2010-11 4305814 12.62 459036 3.53<br />
2011-12* 4736395 10 504940 10<br />
*Projected values Table 6: Patients footfall in Govt. health facilities<br />
Given below is the illustrati<strong>on</strong> <strong>of</strong> the above table which shows a gradually increasing trend:<br />
6000000<br />
4000000<br />
2000000<br />
0<br />
Total Annual OPD in the State<br />
2005-06<br />
2006-07<br />
2007-08<br />
2008-09<br />
2009-10<br />
2010-11<br />
7 5 th Comm<strong>on</strong> Review Missi<strong>on</strong>, Chhattisgarh<br />
600000<br />
400000<br />
Total Annual 200000<br />
OPD in the State 0<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 14<br />
NA<br />
Total annual In-Patient admissi<strong>on</strong>s in the<br />
State<br />
2005-06<br />
2006-07<br />
2007-08<br />
2008-09<br />
2009-10<br />
2010-11<br />
Total annual<br />
In-Patient<br />
admissi<strong>on</strong>s in<br />
the State
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total number <strong>of</strong> Surgeries in Chhattisgarh being performed at the District Level from 1 st Jan, 2012 to<br />
31 st Dec, 2012 8 .<br />
The illustrati<strong>on</strong> <strong>of</strong> the below table is given in the bar chart<br />
Sr.<br />
No.<br />
Table 7: Surgeries performed at District Level (2011-12)<br />
S. N. Activity / Measurable indicator Target 2011-12 Current status<br />
A Maternal <strong>Health</strong><br />
1 Instituti<strong>on</strong>al Deliveries (%) 65% (4.22 lakh) 52<br />
2<br />
District No. <strong>of</strong> total<br />
surgeries<br />
1 Raipur 320<br />
2 Durg 8937<br />
3 Bilaspur 1886<br />
4 Sarguja 3669<br />
5 Janjgir Champa 392<br />
6 Rajnandga<strong>on</strong> 2122<br />
7 Raigarh 891<br />
8 Kabardha 1368<br />
9 Korba 1974<br />
10 Mahasamund 1292<br />
11 Jashpur 618<br />
12 Dhamtari 2816<br />
13 Kanker 2142<br />
14 Korea 798<br />
15 Dantewada 507<br />
16 Narayanpur 3078<br />
17 K<strong>on</strong>daga<strong>on</strong> NA<br />
18 Bijapur 296<br />
K<strong>on</strong>daga<strong>on</strong><br />
Narayanpur<br />
Dantewada<br />
Dhamtari<br />
Mahasamund<br />
Kabardha<br />
Rajnandga<strong>on</strong><br />
Janjgir Champa<br />
Bilaspur<br />
24x7 Facilities (CHCs+CH) 153 139+14 = 153<br />
24x7 Facilities (PHCs) 100<br />
3 Functi<strong>on</strong>al First Referral Units 75 26<br />
B Populati<strong>on</strong> Stabilizati<strong>on</strong><br />
4 Male Sterilizati<strong>on</strong> 15,000 4,119<br />
5 Female Sterilizati<strong>on</strong> 151,200 39,654<br />
8 Ref: http://cg.nic.in/health/dhrs/<str<strong>on</strong>g>Report</str<strong>on</strong>g>sGraph/jsy_birthASPChart.aspx<br />
Bijapur<br />
Korea<br />
Kanker<br />
Jashpur<br />
Korba<br />
Raigarh<br />
Sarguja<br />
Raipur<br />
0 5000 10000<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 15<br />
Durg<br />
No. <strong>of</strong> total…
S. N. Activity / Measurable indicator Target 2011-12 Current status<br />
6 No. <strong>of</strong> IUD Inserti<strong>on</strong>s 135,000 51,998<br />
C Disease C<strong>on</strong>trol<br />
7 Annualized New Smear Positive<br />
Detecti<strong>on</strong> Rate <strong>of</strong> TB (%)<br />
8 Success Rate <strong>of</strong> New Smear Positive<br />
Treatment initiated <strong>on</strong> DOTS (%)<br />
56% (45/lakh) 54<br />
95% 87<br />
9 ABER for malaria (%) >14% 9.1<br />
10 API for malaria (per 1000 populati<strong>on</strong>) NA 3.8<br />
11 Annual New Case Detecti<strong>on</strong> Rate for<br />
Leprosy (per 1,00,000 populati<strong>on</strong>)<br />
31.7(per lakh<br />
popu)<br />
29.65<br />
12 Cataract Surgeries performed 105,000 50,196<br />
Table 8: Chhattisgarh <strong>Health</strong> outcome 9<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
1.3 State <strong>Health</strong> Finance<br />
The state has kept <strong>Health</strong> as a priority and the budget has been corresp<strong>on</strong>dingly increased over the<br />
years. The fund allocati<strong>on</strong> over the years is tabulated below. (Reference: http://pipnrhmmohfw.nic.in/index_files/high_focus_n<strong>on</strong>_ne/Chhattisgarh/Presentati<strong>on</strong>/NPCC%2006.04.11-final-<br />
%201.35%20pm.pdf. Nati<strong>on</strong>al Rural <strong>Health</strong> Missi<strong>on</strong> Chhattisgarh, NPCC Meeting -6thApril 2011, New<br />
Delhi)<br />
2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12<br />
STATE 37088 42163 56313 67588 83935 95231 109500 130123<br />
NRHM 0 8891 13367 11665 23386 40036 52637 60914<br />
EUSPP 0 0 2376 0 3817 0 0 2500<br />
CARE 600 586 396 298 394 0 0 0<br />
UNICEF 97 77 292 533 345 232 232 232<br />
Total 37786 51717 72745 80083 111878 135499 162368 193656<br />
1.4 <strong>Health</strong> Finance<br />
OOP expense 10<br />
Table 9: <strong>Health</strong> budgets comparis<strong>on</strong><br />
Government <strong>of</strong> India has initiated a provisi<strong>on</strong> <strong>of</strong> Universal <strong>Health</strong> Coverage (UHC) to provide<br />
an easily accessible and affordable health care to all Indians. While financial protecti<strong>on</strong> was the<br />
principal objective <strong>of</strong> this initiative, it was recognised that the delivery <strong>of</strong> UHC also requires the<br />
availability <strong>of</strong> adequate healthcare infrastructure, skilled health workforce and access to affordable<br />
drugs and technologies to ensure the entitled level and quality <strong>of</strong> care is given to every citizen.<br />
9 5 th Comm<strong>on</strong> Review Missi<strong>on</strong>, Chhattisgarh<br />
10 High Level Expert Group <str<strong>on</strong>g>Report</str<strong>on</strong>g> <strong>on</strong> Universal <strong>Health</strong> Coverage for India. Instituted by Planning Commissi<strong>on</strong> <strong>of</strong> India<br />
Submitted to the Planning Commissi<strong>on</strong> <strong>of</strong> India, New Delhi, November, 2011<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 16
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The aim was to ensure that regardless <strong>of</strong> income<br />
level, social status, gender, caste or religi<strong>on</strong> all Indian<br />
citizens should be able to avail affordable,<br />
accountable, appropriate health services <strong>of</strong> assured<br />
quality as well as public health services. 11<br />
Only 76 drugs accounting for around <strong>on</strong>e-fourth <strong>of</strong><br />
the drug market are under price c<strong>on</strong>trol. An<br />
examinati<strong>on</strong> <strong>of</strong> the price trends <strong>of</strong> 152 drugs<br />
(c<strong>on</strong>sisting <strong>of</strong> 360 formulati<strong>on</strong>s) reveals that<br />
antibiotics, anti-tuberculosis and anti-malarial drugs,<br />
and drugs for cardiac disorders, etc. registered price<br />
increases from 1%-15% per annum during 1976-<br />
2000. Indian households spend 50% <strong>of</strong> their total<br />
health expenditures <strong>on</strong> drugs and medicines. Reducing this burden and ensuring access can be<br />
achieved by: (i) bringing all drugs under price c<strong>on</strong>trol to ensure lower prices for the households; (ii)<br />
streamlining and putting in place a system <strong>of</strong> centralized pooled procurement <strong>of</strong> drugs so that the<br />
public health system can save almost 30% to 40% <strong>on</strong> costs; (iii) weeding out irrati<strong>on</strong>al drugs and<br />
irrati<strong>on</strong>al combinati<strong>on</strong> drugs; and (iv) encouraging ISM drugs for treating diseases for which<br />
efficacious and low-cost drugs are available. This will address about 90% <strong>of</strong> the health needs <strong>of</strong> the<br />
community and reduce household spending <strong>on</strong> these services. Price c<strong>on</strong>trol should not be limited to<br />
essential drugs as the industry can then simply switch its producti<strong>on</strong> to the n<strong>on</strong>-c<strong>on</strong>trolled<br />
categories, depriving people <strong>of</strong> access to essential drugs. 12<br />
As UHC comes in there would be a provisi<strong>on</strong> <strong>of</strong> <strong>free</strong> health care and medicines for both in-patient as<br />
well as out-patient care. This would give financial protecti<strong>on</strong> and this in turn can reduce or reverse<br />
the high private out <strong>of</strong> pocket spending.<br />
Enhancing public expenditures <strong>on</strong> health is likely to have a direct impact <strong>on</strong> poverty reducti<strong>on</strong> also.<br />
Provisi<strong>on</strong> <strong>of</strong> <strong>free</strong> drugs to all accessing public health system a means <strong>of</strong> reducing OOP expenditure<br />
and increasing accessibility a model already in place in states <strong>of</strong> TN, Rajasthan, Orissa, Kerala.<br />
The government <strong>of</strong> India is actively pursuing a policy <strong>of</strong> promoting universal access to healthcare<br />
with access to affordable medicines forming an integral part <strong>of</strong> this scheme. This is based <strong>on</strong> the<br />
recommendati<strong>on</strong>s <strong>of</strong> a High Level Expert Group <strong>on</strong> Universal <strong>Health</strong> Coverage (HLEG-UHC)<br />
c<strong>on</strong>stituted by the Planning Commissi<strong>on</strong> <strong>of</strong> India.<br />
The report c<strong>on</strong>tains recommendati<strong>on</strong>s regarding the architecture <strong>of</strong> the Universal <strong>Health</strong> Care<br />
(UHC). A key recommendati<strong>on</strong> is recommendati<strong>on</strong> 3.1.2 to “Ensure availability <strong>of</strong> <strong>free</strong> essential<br />
medicines by increasing public spending <strong>on</strong> drug procurement”. While making this recommendati<strong>on</strong>,<br />
the HLEG report explains that “Low public spending <strong>on</strong> drugs and n<strong>on</strong>-availability <strong>of</strong> <strong>free</strong> medicines<br />
in government healthcare facilities are major factors discouraging people from accessing public<br />
sector health facilities. Addressing this deficiency by ensuring adequate supplies <strong>of</strong> <strong>free</strong> essential<br />
drugs is vital to the success <strong>of</strong> the proposed UHC system.” To this end, the report recommends a<br />
11 High Level Expert Group <str<strong>on</strong>g>Report</str<strong>on</strong>g> <strong>on</strong> Universal <strong>Health</strong> Coverage for India. Instituted by Planning Commissi<strong>on</strong> <strong>of</strong> India<br />
Submitted to the Planning Commissi<strong>on</strong> <strong>of</strong> India, New Delhi, November, 2011<br />
12 <str<strong>on</strong>g>Report</str<strong>on</strong>g> <strong>of</strong> the Nati<strong>on</strong>al Commissi<strong>on</strong> <strong>on</strong> Macroec<strong>on</strong>omics and <strong>Health</strong>,2005<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 17
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
two-pr<strong>on</strong>ged approach: 1) increasing government spending <strong>on</strong> public procurement <strong>of</strong> medicines<br />
from 0.1 per cent <strong>of</strong> the GDP to 0.5 per cent <strong>of</strong> the GDP; and 2) introducing a pooled procurement<br />
system to ensure adequate supplies and rati<strong>on</strong>al prescripti<strong>on</strong> <strong>of</strong> quality generic drugs by the public<br />
health system.<br />
Tamil Nadu and Rajasthan are already distributing <strong>free</strong> drugs. Free drugs are also being given to<br />
pregnant women under the Nati<strong>on</strong>al Rural <strong>Health</strong> Missi<strong>on</strong> (NRHM).<br />
For Chhattisgarh, <strong>on</strong>e <strong>of</strong> the key Challenges identified is improving access and reducing OOP<br />
expenditure by ensuring availability <strong>of</strong> <strong>free</strong> medicines (generic ) from government hospitals (from<br />
EDL) and across the counter availability <strong>of</strong> generic drugs in general in the state.<br />
The state is proposing to substantially increase government spending <strong>on</strong> public procurement <strong>of</strong><br />
generic medicines in order to distribute them <strong>free</strong>ly to patients through government hospitals and<br />
clinics.<br />
The government has set up the Chhattisgarh Medical Services Corporati<strong>on</strong> to improve inventory<br />
management, prevent stock outs and expiry <strong>of</strong> medicines. The organisati<strong>on</strong> has notified the Essential<br />
drug list and operates Jan Aushadhi (Generic Drug) Stores.<br />
1.5 Tamil Nadu model -The first <strong>on</strong>e<br />
The “Tamil Nadu Model”<br />
Under the “Tamil Nadu model”, the procurement, storage and distributi<strong>on</strong> <strong>of</strong> all drugs as<br />
well as surgical and suture items to all government hospitals and public health centres (PHCs) is<br />
c<strong>on</strong>ducted by a government company. In the state <strong>of</strong> Tamil Nadu, procurement has been<br />
undertaken by the Tamil Nadu Medical Services Corporati<strong>on</strong> (TNMSC) since 1994. The TNMSC has<br />
been lauded for following a very clear and transparent tender process. It procures about 268 drugs<br />
in bulk directly from the manufacturers based <strong>on</strong> an Essential <strong>Drugs</strong> List (EDL) which is reviewed and<br />
updated periodically. These drugs are packaged with a special “TG” (Tamil Nadu Government) logo<br />
to prevent unauthorized sale outside hospital dispensaries. Each and every batch <strong>of</strong> drugs supplied<br />
by suppliers is subjected to quality tests by laboratories empanelled through an open bidding<br />
process.<br />
The drugs procured are stored in TNMSC warehouses in each district from where they are<br />
distributed to government hospitals and PHCs in the district. Every government hospital and PHC is<br />
issued a passbook with which it can approach the nearest warehouse to procure a drug. The entry in<br />
the passbook serves as the basis <strong>of</strong> an inventory system which helps to prevent stock outs. The<br />
passbooks are issued based <strong>on</strong> the budget allocati<strong>on</strong> for each hospital or PHC. 90 per cent <strong>of</strong> the<br />
allocated budget amount is deposited in a special account from which the TNMSC purchases the<br />
drugs each time an indent is made from the hospital or PHC. 10 per cent <strong>of</strong> the budget allocati<strong>on</strong> is<br />
provided to the respective hospitals and PHCs for local purchases.<br />
The TNMSC system has been very successful in substantially reducing the cost <strong>of</strong> procurement. It has<br />
also been very successful in ensuring through strict quality c<strong>on</strong>trol mechanisms in the procurement<br />
process that medicines <strong>of</strong> high quality are made available for <strong>free</strong> to patients through the<br />
government hospitals and PHCs. According to a World Bank report, the TNMSC system has been<br />
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highly successful in significantly increasing the number <strong>of</strong> patients using government hospitals and<br />
PHCs.<br />
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Chapter 2: Study Design & Discussi<strong>on</strong><br />
The Chhattisgarh State <strong>Health</strong> and <strong>Family</strong> <strong>Department</strong> has an Essential Drug List (EDL).<br />
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Essential Drug List has been defined as those drugs that satisfy the healthcare needs <strong>of</strong> the majority<br />
<strong>of</strong> the populati<strong>on</strong>. They should therefore be available at all times in adequate amounts and in<br />
appropriate dosage forms at all levels <strong>of</strong> the health care delivery system <strong>of</strong> the state.<br />
The Chhattisgarh EDL comprises a list <strong>of</strong> Essential drugs, surgical products and sutures. A number <strong>of</strong><br />
n<strong>on</strong>-c<strong>on</strong>sumables and support equipment are also included in the EDL. The drug items in the EDL<br />
are categorized as per their usage and applicability. The Chhattisgarh EDL formulated in 2010-11 is<br />
currently under revisi<strong>on</strong>.<br />
The present study is designed based <strong>on</strong> the EDL – 2010-11.<br />
All Survey tools for collecti<strong>on</strong> <strong>of</strong> data were designed as per existing EDL for data collecti<strong>on</strong> from<br />
stores for demand calculati<strong>on</strong> and prescripti<strong>on</strong> data for estimati<strong>on</strong> <strong>of</strong> drugs c<strong>on</strong>sumpti<strong>on</strong> in Medical<br />
Colleges, District Hospitals, CHCs and PHCs. While the list <strong>of</strong> items in the EDL is exhaustive,<br />
prescripti<strong>on</strong> <strong>of</strong> many drugs were out <strong>of</strong> EDL in many cases. Certain drugs which came up in repeated<br />
prescripti<strong>on</strong>s and could not be included in the study as they were not part <strong>of</strong> the current ED for<br />
example Statins.<br />
2.1 Objective <strong>of</strong> the study<br />
The assignment was to provide answer to the following questi<strong>on</strong><br />
“How much m<strong>on</strong>ey will be required by Government <strong>of</strong> Chhattisgarh to achieve the objective <strong>of</strong><br />
providing good quality ‘Free Medicines for All’ as part <strong>of</strong> the goal <strong>of</strong> ‘<strong>Health</strong> Care for All’?”<br />
2.2 Scope <strong>of</strong> the study<br />
The scope <strong>of</strong> the study included<br />
Developing methodology for collecti<strong>on</strong> <strong>of</strong> informati<strong>on</strong> from a sample <strong>of</strong> health facilities in<br />
the state, including instruments for data collecti<strong>on</strong>;<br />
Data collecti<strong>on</strong>, tabulati<strong>on</strong> and analysis were organized;<br />
Data analysis, to make assessment <strong>of</strong> financial envelope under various assumpti<strong>on</strong>s (e.g.<br />
guaranteeing access to State’s current essential drug list or a revised EDL);<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g> generati<strong>on</strong> and mid-course presentati<strong>on</strong> <strong>of</strong> the same to policy making bodies <strong>of</strong> the<br />
State.<br />
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2.3 Study Design<br />
2.3.1 Introducti<strong>on</strong><br />
The quantum <strong>of</strong> financial resources required was calculated <strong>on</strong> the basis <strong>of</strong> demand projecti<strong>on</strong>.<br />
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Demand <strong>of</strong> each drug item was worked out in such a way that in almost all <strong>of</strong> the occasi<strong>on</strong>s it<br />
remains available with the health center if prescribed.<br />
Quantificati<strong>on</strong> is the process used to calculate or estimate the quantities <strong>of</strong> medical supplies, drugs<br />
and equipments required. It is usually d<strong>on</strong>e <strong>on</strong>ce a year or during the planning for a new health<br />
programme or project. Proper quantificati<strong>on</strong> ensures that there is enough stock to meet demands,<br />
and avoids both under stocking and overstocking. It is also a useful tool for preparing budget<br />
estimates, adjusting quantities to match a fixed budget, and m<strong>on</strong>itoring use <strong>of</strong> supplies and<br />
equipment by health facility staff.<br />
The most comm<strong>on</strong>ly used quantificati<strong>on</strong> methods are:<br />
C<strong>on</strong>sumpti<strong>on</strong> method – This uses data about actual use or past c<strong>on</strong>sumpti<strong>on</strong> pattern to calculate<br />
what quantities, will be required in future. The c<strong>on</strong>sumpti<strong>on</strong> method depends <strong>on</strong> reliable<br />
c<strong>on</strong>sumpti<strong>on</strong> data and effective stock c<strong>on</strong>trol, especially accurate record keeping. To use this<br />
method you need a m<strong>on</strong>itoring system that both provides informati<strong>on</strong> about actual rates <strong>of</strong><br />
c<strong>on</strong>sumpti<strong>on</strong> <strong>of</strong> supplies and equipment and highlights higher than expected c<strong>on</strong>sumpti<strong>on</strong> <strong>of</strong><br />
particular items and potential misuse <strong>of</strong> supplies.<br />
Morbidity data method – Which uses data about prevalence and incidence <strong>of</strong> disease and health<br />
problems and the standard treatments for these to estimate future needs.<br />
2.3.2 Study Design<br />
In the current study<br />
4) We have worked out the demand projecti<strong>on</strong> taking into account different data sets as each<br />
<strong>on</strong>e in isolati<strong>on</strong> will have a demerit to influence reliability.<br />
5) The study results are probabilistic keeping in view the short time frame in which the report<br />
was required to be generated otherwise l<strong>on</strong>g term prospective study would have been ideal.<br />
6) The Study design is cross secti<strong>on</strong>al and includes sec<strong>on</strong>dary and primary data collecti<strong>on</strong> and<br />
Prescripti<strong>on</strong>s survey across various categories <strong>of</strong> health facilities (tertiary, sec<strong>on</strong>dary and<br />
primary health care level).<br />
Hybrid method for demand assessment<br />
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A Hybrid method for Demand assessment which is a combinati<strong>on</strong> <strong>of</strong> C<strong>on</strong>sumpti<strong>on</strong>, Morbidity<br />
Method and analytical methods was used.<br />
A. C<strong>on</strong>sumpti<strong>on</strong> Method<br />
For those items for which past c<strong>on</strong>sumpti<strong>on</strong> data is available we have used the c<strong>on</strong>sumpti<strong>on</strong><br />
method.<br />
We obtained the data <strong>of</strong> the past c<strong>on</strong>sumpti<strong>on</strong>s <strong>of</strong> drugs for past 3 years. This data was<br />
useful , however had low reliability as we are not sure in some cases if the amount procured<br />
was sufficient to meet the demand or not. It also did not include complete inventory. Also<br />
there were instances <strong>of</strong> over stocking which provided incorrect data for projecti<strong>on</strong>.<br />
However the data did give an indicati<strong>on</strong> an overall requirement for a secti<strong>on</strong> <strong>of</strong> items.<br />
B. Morbidity Method<br />
Drug demand data was also calculated using morbidity method. This was especially used for<br />
drugs being used for N<strong>on</strong>-Communicable Diseases (NCD) and diseases covered in Nati<strong>on</strong>al<br />
Programmes (NCP).<br />
C. Prescripti<strong>on</strong> survey<br />
Drug demand was assessed through a prescripti<strong>on</strong> survey.<br />
D. Analytical Method<br />
For items not covered by any <strong>of</strong> the above methods and those requiring adjustments and<br />
validati<strong>on</strong> <strong>on</strong> past c<strong>on</strong>sumpti<strong>on</strong> we have used Analytical Estimati<strong>on</strong> Method.<br />
2.4 Prescripti<strong>on</strong> Survey<br />
Good statistically enabled samples <strong>of</strong> prescripti<strong>on</strong>s were studied for frequency and quantity<br />
<strong>of</strong> drugs from EDL. The challenge here was that the preparati<strong>on</strong>s prescribed were <strong>of</strong>ten not generic.<br />
We c<strong>on</strong>verted the prescripti<strong>on</strong>s into generic forms for the purpose <strong>of</strong> recording data. Qualified<br />
pers<strong>on</strong>nel well versed with pharmacy sciences c<strong>on</strong>ducted the survey and data analysis and to assess<br />
prescripti<strong>on</strong> patterns for EDL and Specialist drugs. The survey team was led by program<br />
associates from SHRC who were also the chief investigators.<br />
Primary data was collected from OPD and IPD prescripti<strong>on</strong>s <strong>of</strong> drugs from Medical Colleges, Districts<br />
Hospitals, CHCs and PHCs for estimati<strong>on</strong> <strong>of</strong> drugs c<strong>on</strong>sumpti<strong>on</strong>.<br />
2.4.1 Training <strong>of</strong> Surveyors<br />
A two day orientati<strong>on</strong> training was c<strong>on</strong>ducted for the surveyors by experts in the field. They<br />
were provided the necessary tools and guidance for effective outcome from the survey. The<br />
surveyors were supported centrally from SHSRC, Chhattisgarh for any assistance.<br />
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The team was made c<strong>on</strong>versant with the drugs in the EDL. The Survey team was led by a senior<br />
qualified pharmacist and survey was c<strong>on</strong>ducted by pharmacist teams supported with data entry<br />
assistants.<br />
2.4.2 Survey Tool<br />
A Survey tool was developed <strong>on</strong> the basis <strong>of</strong> existing EDL <strong>of</strong> the state and the tool was<br />
piloted at Raipur Medical College Hospital. Based <strong>on</strong> the feedback from the pilot study necessary<br />
revisi<strong>on</strong>s were made.<br />
The tool also had a secti<strong>on</strong> for collecting data <strong>on</strong> the number <strong>of</strong> drugs prescribed and a secti<strong>on</strong> for<br />
capturing broad prescribing practices.<br />
The final Survey tool used for the study is placed as Annexure-3<br />
Step 2: The state wise OPD for the year was taken as the universe for the purpose.<br />
Step 3: Based <strong>on</strong> the universe, at 95% c<strong>on</strong>fidence level a sample size for prescripti<strong>on</strong>s was<br />
worked out.<br />
Step 4: The state was divided into five divisi<strong>on</strong>s:<br />
♦ Bastar<br />
♦ Durg<br />
♦ Raipur<br />
♦ Bilaspur<br />
♦ Sarguja<br />
One District Hospital (DH), Tertiary <strong>Health</strong>care Centre (THC), Primary <strong>Health</strong> Centre<br />
(PHC) and Community <strong>Health</strong> Centre (CHC) from each divisi<strong>on</strong> will be selected<br />
through randomizati<strong>on</strong>.<br />
Step 5: Depending <strong>on</strong> the percent load <strong>of</strong> various OPDs all 3 medical colleges were covered.<br />
This DH/THC/PHC/CHC, proporti<strong>on</strong> <strong>of</strong> samples from the already calculated sample<br />
size was allocated.<br />
Yardstick for numbers <strong>of</strong> prescripti<strong>on</strong>s per health facility – Numbers <strong>of</strong> prescripti<strong>on</strong>s<br />
were collected prospectively from the various level <strong>of</strong> health facilities over a period <strong>of</strong><br />
time<br />
• Medical college level: 100-300 prescripti<strong>on</strong>s were collected from various<br />
specialities OPD.<br />
• DH/SDH level: Minim. 60-80 prescripti<strong>on</strong>s were selected from various OPDs<br />
• PHC level: Minim. 10 to 15 prescripti<strong>on</strong>s were collected from OPD<br />
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Step 6: The results were statistically studied for annual c<strong>on</strong>sumpti<strong>on</strong> and the results were<br />
compared with historical data <strong>on</strong> c<strong>on</strong>sumpti<strong>on</strong> pattern obtained from central stores<br />
and hospital stores to ensure midcourse correcti<strong>on</strong>.<br />
For IPD data:<br />
Similar audit <strong>of</strong> case sheets <strong>of</strong> IPD <strong>on</strong> sample basis were c<strong>on</strong>ducted for items in EDL.<br />
Guidelines for Survey Team<br />
All facilities included in the sample were communicated about the prescripti<strong>on</strong> survey.<br />
The surveyors were provided a letter authorizing him/her to look into the prescripti<strong>on</strong>s <strong>of</strong><br />
patients at the OPD & IPD.<br />
A nodal pers<strong>on</strong> was identified in each district for the prescripti<strong>on</strong> survey.<br />
Average Percentage distributi<strong>on</strong> <strong>of</strong> various departments OPD & IPD was provided by the<br />
Medical Colleges, DHs & CHCs in sample to calculate the sample allocati<strong>on</strong>.<br />
All surveyors made themselves well c<strong>on</strong>versant with the EDL 2010-2011 <strong>of</strong> Chhattisgarh.<br />
On day <strong>of</strong> Survey –<br />
The prescripti<strong>on</strong> survey was carried out over the period 20 th Feb to 05 th March 2013<br />
c<strong>on</strong>currently across the designated five z<strong>on</strong>es <strong>of</strong> the state.<br />
1. The survey team presented the authorizati<strong>on</strong> letter to the administrati<strong>on</strong> who in<br />
turn informed the doctors and nurses in the facility about the activities.<br />
2. The surveyors covered 50% <strong>of</strong> the daily OPD load at the facility by taking every 2 nd<br />
prescripti<strong>on</strong> generated at a particular OPD. The sample size <strong>of</strong> prescripti<strong>on</strong>s was<br />
drawn as per proporti<strong>on</strong> <strong>of</strong> OPD c<strong>on</strong>tributi<strong>on</strong> from different departments. Based <strong>on</strong><br />
the number <strong>of</strong> surveyors deployed, this number was covered over <strong>on</strong>e or two days.<br />
3. The tool was also filled for the drugs in the Emergency Kit in the Store ( wherever<br />
available )<br />
4. Sample for IPD was worked out in proporti<strong>on</strong> to the IPD load at the facility and the<br />
survey will cover the drugs prescribed in the last case sheet entry.<br />
5. The surveyors did not questi<strong>on</strong> the patients <strong>on</strong> the prescripti<strong>on</strong>.<br />
6. Due care was exercised while dealing with female patients.<br />
7. If a patient refused to show his/her prescripti<strong>on</strong>, his/her wish was h<strong>on</strong>ored.<br />
8. There were n<strong>on</strong>-generic prescripti<strong>on</strong>s also and in that case the trade name was<br />
noted.<br />
9. The survey tool provided was covered for each prescripti<strong>on</strong>.<br />
10. N<strong>on</strong> EDL drugs were not covered. However, in case <strong>of</strong> doubt, the drug was noted<br />
and was checked later if it was included in the EDL or not.<br />
11. Similarly IPD records were studied and drugs were identified from the case sheets<br />
from the last entry.<br />
12. At CHC and PHC department wise survey was not necessary as specialists were not<br />
available.<br />
13. Data entry was d<strong>on</strong>e in the customized excel formats in the afterno<strong>on</strong> <strong>of</strong> the same<br />
day.<br />
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14. The prescripti<strong>on</strong>s were preferably checked at the pharmacy and Red Cross store<br />
windows so that drug availability can also be simultaneously captured. Assistance <strong>of</strong><br />
the pharmacist was taken.<br />
Post Survey<br />
15. Any doubts regarding categorizati<strong>on</strong> / Code <strong>of</strong> drug were cleared with the help <strong>of</strong><br />
the Survey Team leader prior to entering the data into the finalized excel formats.<br />
16. Any additi<strong>on</strong>al inputs / informati<strong>on</strong> gathered by the surveyor during the period <strong>of</strong><br />
survey that is relevant to the study were mailed to the team leader.<br />
17. A survey tracker menti<strong>on</strong>ing the name <strong>of</strong> facility and the number <strong>of</strong> prescripti<strong>on</strong>s<br />
covered were submitted at the end <strong>of</strong> each day.<br />
2.4.3 Sample<br />
Samples for data collecti<strong>on</strong> were dispersed over 5 z<strong>on</strong>es<br />
♦ Bastar<br />
♦ Durg<br />
♦ Raipur<br />
♦ Bilaspur<br />
♦ Sarguja<br />
. A total <strong>of</strong> 858, 787, 440 and 492 samples were collected from Medical Colleges, District<br />
Hospitals, CHCs and PHCs respectively.<br />
Designated Z<strong>on</strong>es<br />
for survey<br />
Number <strong>of</strong><br />
Prescripti<strong>on</strong>s<br />
sampled from<br />
Med College<br />
Number <strong>of</strong><br />
Prescripti<strong>on</strong>s<br />
sampled from DH<br />
Number <strong>of</strong><br />
Prescripti<strong>on</strong>s<br />
sampled from<br />
CHC<br />
Number <strong>of</strong><br />
Prescripti<strong>on</strong>s<br />
sampled from<br />
PHC<br />
Total Number <strong>of</strong><br />
Prescripti<strong>on</strong>s<br />
sampled<br />
from z<strong>on</strong>e<br />
Bastar 266 144 98 119 627<br />
Bilaspur 150 152 46 48 346<br />
Durg - 248 94 215 557<br />
Sarguja - 122 63 24 209<br />
Raipur 442 121 139 86 788<br />
Total 858 787 440 492 2577<br />
Table 10: Sample distributi<strong>on</strong> <strong>of</strong> prescripti<strong>on</strong> surveyed<br />
Details <strong>of</strong> facilities where prescripti<strong>on</strong> survey was undertaken:<br />
Z<strong>on</strong>e Facility Type Locati<strong>on</strong> Name<br />
Bastar<br />
Medical College Jagdalpur<br />
District Hospital Dantewada<br />
CHC<br />
PHC<br />
Geedam<br />
Kuak<strong>on</strong>da<br />
Barsur<br />
Tumnar<br />
Palnar<br />
Potali<br />
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Z<strong>on</strong>e Facility Type Locati<strong>on</strong> Name<br />
Bilaspur<br />
Durg<br />
Raipur<br />
Sarguja<br />
Medical College Bilaspur<br />
District Hospital Raigarh<br />
CHC<br />
PHC<br />
Baramkela<br />
Chable Kharsia<br />
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Saria<br />
Lendhra<br />
Binjkot<br />
S<strong>on</strong>daka<br />
District Hospital Durg<br />
CHC<br />
PHC<br />
Dhamdha<br />
Jheet<br />
Ahiwara<br />
Bori<br />
Bastrel<br />
Bhilai<br />
Medical College Raipur<br />
District Hospital Mahasamund<br />
CHC<br />
PHC<br />
Bagbahra<br />
Basna<br />
Hathibahra<br />
Khallari<br />
Baroli<br />
Bhanwarpur<br />
District Hospital Ambikapur<br />
CHC<br />
PHC<br />
Table 11: Facilities where prescripti<strong>on</strong> survey was undertaken<br />
2.4.4 Data analysis & Statistical Correlati<strong>on</strong><br />
Batauli<br />
Bhafouli<br />
Bataikela<br />
Ghutrapara<br />
Nawanagar<br />
The data collected from CHC, PHC, DH and Medical college was grouped accordingly and<br />
amalgamated <strong>on</strong> an excel sheet. Statistical tools and probability methods were used for data analysis<br />
to arrive to a scientific result for the study. The frequency <strong>of</strong> prescripti<strong>on</strong> as well as quantity was<br />
analysed using mean and standard deviati<strong>on</strong> for each drug. Assuming that prescripti<strong>on</strong> pattern will<br />
follow a normal distributi<strong>on</strong>, probability, model for normal distributi<strong>on</strong> was used to get a projecti<strong>on</strong><br />
for 90% probability. The excel based NORMINV functi<strong>on</strong> for determining probability <strong>of</strong> frequency as<br />
well as quantity was used. The multiplicati<strong>on</strong> <strong>of</strong> the probability <strong>of</strong> frequency <strong>of</strong> prescripti<strong>on</strong> <strong>of</strong> a<br />
drug and the probability <strong>of</strong> a quantity prescribed in each prescripti<strong>on</strong> gave an indicati<strong>on</strong> <strong>of</strong> probable<br />
demand for a CHC/PHC/DH/MC for <strong>on</strong>e day. Based <strong>on</strong> this an annual demand projecti<strong>on</strong> has been<br />
worked out or each level <strong>of</strong> facility. Adding up this data gave the approximate final figure for entire<br />
state for those items which could be adequately picked up in the prescripti<strong>on</strong> survey.
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Analytical estimati<strong>on</strong>: for items not covered by above methods and those requiring adjustments <strong>on</strong><br />
past c<strong>on</strong>sumpti<strong>on</strong> we have used Analytical Estimati<strong>on</strong>.<br />
Basics <strong>of</strong> Analytical Estimating<br />
Analytical estimating is a process used by bid makers, usually in the c<strong>on</strong>structi<strong>on</strong> industry or<br />
skilled trades, to develop an approximati<strong>on</strong> <strong>of</strong> a given project's costs. In analytical estimating, the<br />
project is carefully broken down into the various tasks necessary to complete it, and then these are<br />
estimated for time and cost expectati<strong>on</strong>s based <strong>on</strong> experience. These comp<strong>on</strong>ent costs are then<br />
assembled into an estimate <strong>of</strong> the entire project's cost. Analytical estimating is usually a practical<br />
and reliable method for determining costs. In our study we used this technique by interviewing the<br />
experts i.e. doctors who have been working in the facilities and handling patients in large number for<br />
at least more than three years to indicate the frequency and quantity they come across for some the<br />
drugs. This was more required in Medical College setting where specialist medicines are prescribed.<br />
A comparis<strong>on</strong> <strong>of</strong> at least three analytical estimati<strong>on</strong> and using the mean eliminated bias to come to a<br />
logical figure <strong>of</strong> requirement in a day.<br />
Accuracy and Error Correcti<strong>on</strong><br />
Analytical estimating tends to be relatively accurate because errors made in the estimati<strong>on</strong> <strong>of</strong><br />
a single task's time and resource needs are usually <strong>of</strong>fset by errors in those <strong>of</strong> another task. For<br />
example, if the estimated time for replacing a door frame turns out to be shorter than the actual<br />
work's time demands, this error is <strong>of</strong>ten corrected in the larger estimate when another task takes far<br />
less time than expected. In general, an estimate composed <strong>of</strong> these smaller tasks has incorporated<br />
room for error as a result. 13<br />
2.4.5 Additi<strong>on</strong>al informati<strong>on</strong> collected<br />
Additi<strong>on</strong>al informati<strong>on</strong> was collected during the survey and analysed for better<br />
understanding <strong>of</strong> drugs usage pattern from Medical colleges, District Hospitals, CHCs and PHCs <strong>of</strong><br />
the state. Following informati<strong>on</strong> were obtained:<br />
a) What are the numbers <strong>of</strong> drugs prescribed in the prescripti<strong>on</strong>?<br />
b) Are the drugs prescribed using their generic name?<br />
c) What is the durati<strong>on</strong> <strong>of</strong> prescripti<strong>on</strong>?<br />
d) Are the drugs prescribed listed in the EDL?<br />
e) Is the drug dosage form provided?<br />
f) Are the strengths <strong>of</strong> dosage form provided?<br />
g) Is the diagnosis menti<strong>on</strong>ed in the prescripti<strong>on</strong>?<br />
2.4.6 Limitati<strong>on</strong>s<br />
h) All drugs were not covered from the prescripti<strong>on</strong> survey.<br />
13 iSixSigma; An Analytical Method for Estimating Project Benefits; Chew Jian Chieh; 2011<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 27
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
i) Irrati<strong>on</strong>al prescripti<strong>on</strong>s may lead to skewed demand especially for antibiotics, analgesics<br />
and Vitamin Supplements.<br />
j) <strong>Drugs</strong> such as statins were not a part <strong>of</strong> EDL and came up in many prescripti<strong>on</strong>s.<br />
k) The demand assessed was essentially sample based are probabilistic.<br />
2.5 Historical C<strong>on</strong>sumpti<strong>on</strong> Data<br />
Primary data was collected from stores <strong>of</strong> different z<strong>on</strong>es for demand estimati<strong>on</strong> <strong>of</strong> essential drugs<br />
and c<strong>on</strong>sumables. A tool was developed to capture data <strong>of</strong> c<strong>on</strong>sumpti<strong>on</strong> for durati<strong>on</strong> <strong>of</strong> three years.<br />
It included stock c<strong>on</strong>sumed over 3 years including periods <strong>of</strong> stock outs.<br />
2.5.1 Sample<br />
Samples for data <strong>of</strong> c<strong>on</strong>sumpti<strong>on</strong> were dispersed in 5 z<strong>on</strong>es <strong>of</strong> the state as under<br />
Z<strong>on</strong>e Facility Type<br />
Number <strong>of</strong> stores<br />
from<br />
which c<strong>on</strong>sumpti<strong>on</strong><br />
data was obtained<br />
Bastar Medical College & District Hospital 2<br />
Bilaspur Medical College & District Hospital 2<br />
Durg District Hospital 1<br />
Sarguja District Hospital 1<br />
Raipur Medical College 1<br />
Total 7<br />
Table 12: Sample distributi<strong>on</strong> <strong>of</strong> stores data<br />
2.5.2 Analysis <strong>of</strong> data keeping stock outs in account<br />
Step 1: We selected the time period for calculating c<strong>on</strong>sumpti<strong>on</strong> (3 years)<br />
Step 2: Calculated the c<strong>on</strong>sumpti<strong>on</strong> for each item during the time period<br />
Step 3: Adjusted c<strong>on</strong>sumpti<strong>on</strong> figures for stock outs.<br />
Stock out Adjusted RC = Real c<strong>on</strong>sumpti<strong>on</strong> x Period in calculati<strong>on</strong> (m<strong>on</strong>ths, weeks, days) Period<br />
in stock (m<strong>on</strong>ths, weeks, days)<br />
Step 4: Calculated the m<strong>on</strong>thly maintenance figure and quarterly maintenance figure for each<br />
item<br />
Step 5: Arrived at an annual c<strong>on</strong>sumpti<strong>on</strong> figure<br />
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2.5.3 Limitati<strong>on</strong>s <strong>of</strong> data<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
a) Most <strong>of</strong> the historical store data had wide gaps in that the figures were available for 2<br />
years <strong>on</strong>ly.<br />
b) The supply <strong>of</strong> most drugs was erratic.<br />
c) Periods <strong>of</strong> over stocking and l<strong>on</strong>g stock outs were seen. Data obtained from the store<br />
c<strong>on</strong>sumpti<strong>on</strong> therefore could not be relied up<strong>on</strong> fully. Indirect methods <strong>of</strong> calculating drug<br />
demand using prescripti<strong>on</strong> survey had to be resorted to.<br />
It is our opini<strong>on</strong>, that after <strong>on</strong>e or two cycle <strong>of</strong> procurement and c<strong>on</strong>sumpti<strong>on</strong> <strong>of</strong> the entire<br />
list, other c<strong>on</strong>sumpti<strong>on</strong> data will stabilize and the demand can be assessed to higher precisi<strong>on</strong> levels.<br />
2.6 <str<strong>on</strong>g>Assessment</str<strong>on</strong>g> through Morbidity patterns<br />
Demand assessment for certain drugs was carried out/validated using the morbidity<br />
patterns. This was especially used for drugs used in NCD and in diseases covered in Nati<strong>on</strong>al<br />
Programme.<br />
2.6.1 Applicable for NCD<br />
The global burden and threat <strong>of</strong> n<strong>on</strong>-communicable diseases c<strong>on</strong>stitutes <strong>on</strong>e <strong>of</strong> the major<br />
challenges for development. N<strong>on</strong>-communicable diseases are am<strong>on</strong>g the leading causes <strong>of</strong><br />
preventable morbidity and <strong>of</strong> related disability. The rapidly growing magnitude <strong>of</strong> n<strong>on</strong>communicable<br />
diseases affects people <strong>of</strong> all ages, gender, race and income levels, and further that<br />
poor populati<strong>on</strong>s and those living in vulnerable situati<strong>on</strong>s, in particular in developing countries, bear<br />
a misappropriate burden.<br />
We worked out the demand based <strong>on</strong> the nati<strong>on</strong>al prevalence and also <strong>on</strong> the state level data<br />
wherever available.<br />
<strong>Drugs</strong> used for diseases covered in the Nati<strong>on</strong>al Programmes were also validated against state<br />
statistics.<br />
2.7 Expert input / Analytical assessment<br />
For drugs used in niche areas such as <strong>on</strong>cology, psychiatry and ophthalmology etc. and which did not<br />
get covered in the prescripti<strong>on</strong> survey we ratified the demand by the c<strong>on</strong>cerned specialists.<br />
Discussi<strong>on</strong>s were held with specialists both at Chhattisgarh and at Delhi before arriving at a best<br />
estimate for these items.<br />
At this stage we also worked out the work load <strong>of</strong> the tertiary specialised services to assess the drug<br />
demand.<br />
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Oncology Workload at Government facilities (Chhatisgarh)<br />
Reference Chhattisgarh NPCDCS data<br />
Period – Year 2010 2011 2012<br />
Surgeries 1146 1200 1298<br />
Medical (new for Chemotherapy 18750 19400 19398<br />
Brachytherapy 1050<br />
Table 13: Oncology Workload<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
C<strong>on</strong>sumables which are required for day to day care delivery and are more than <strong>of</strong>ten loaded <strong>on</strong> to<br />
the patients were also taken in the ambit <strong>of</strong> study, as their provisi<strong>on</strong> by the government will reduce<br />
the OOP expense for the public.<br />
The list <strong>of</strong> C<strong>on</strong>sumables included in the Chhattisgarh EDL is exhaustive and includes all c<strong>on</strong>sumables<br />
required for high end and complex multi-speciality services and specialised surgeries and<br />
procedures.<br />
As per the data available from the Chhattisgarh <strong>Department</strong> <strong>of</strong> <strong>Health</strong> & <strong>Family</strong> Welfare e-portal, the<br />
total number <strong>of</strong> major & minor surgeries at district level is as shown -. Given that 70 FRUs are<br />
operati<strong>on</strong>al in the state. This brings us to the c<strong>on</strong>clusi<strong>on</strong> that there are <strong>on</strong> an average 1226 Surgeries<br />
per district per year and 473 surgeries per FRU per year.<br />
As per COPP the average number <strong>of</strong> surgeries in a multi-specialty hospital are 12% <strong>of</strong> all admissi<strong>on</strong>s;<br />
and 22% <strong>of</strong> all beds are catering to the surgical<br />
care.<br />
In view <strong>of</strong> the above, c<strong>on</strong>sumables were<br />
factored into the financial envelope that the<br />
government will require to cater in order to<br />
reduce the OOP expense <strong>on</strong> the patient.<br />
The c<strong>on</strong>sumable items included in the EDL and<br />
catered for in the calculati<strong>on</strong> <strong>of</strong> the final<br />
envelope is appended at Annexure 3<br />
The c<strong>on</strong>sumable demand was worked out for each facility level; i.e. Medical College, District<br />
Hospital, CHC & PHC. We relied up<strong>on</strong> historical c<strong>on</strong>sumpti<strong>on</strong> data and the work load analysis <strong>of</strong><br />
Casualty & Emergency; Intensive Care Units , Dialysis Units and surgeries which account for major<br />
utilisati<strong>on</strong> <strong>of</strong> c<strong>on</strong>sumables.<br />
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<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The cost <strong>of</strong> limited most essential and comm<strong>on</strong>ly used c<strong>on</strong>sumables, which will have an impact <strong>on</strong><br />
the OOP expense, was brought under the ambit <strong>of</strong> this study.<br />
2.8 Price Estimati<strong>on</strong><br />
The two key variables which the study required to work <strong>on</strong> were-<br />
1. Annual demand for each item<br />
2. Price for each item<br />
Given that the Chhattisgarh Government has set up the Chhattisgarh Medicare Services Corporati<strong>on</strong><br />
for centralised procurement <strong>of</strong> drugs, and that such large procurements will result in extremely<br />
competitive rates, we factored that the price per item would be much below the market price <strong>of</strong> the<br />
drugs.<br />
Data <strong>on</strong> rates at which drugs were procured over the past 2/3 years by the DME and DHS in the state<br />
were sought. However, this could cater to <strong>on</strong>ly 30% <strong>of</strong> the items covered.<br />
For the rest <strong>of</strong> the items we relied <strong>on</strong> Tamil Nadu Medical Stores Corporati<strong>on</strong>, Rajasthan Medical<br />
Stores Corporati<strong>on</strong> and Kerala Medical Stores Corporati<strong>on</strong> tender rates. The price under which<br />
TNMSC obtained drugs was found to be much lower <strong>on</strong> account <strong>of</strong> the benefits <strong>of</strong> larger scale and<br />
length <strong>of</strong> operati<strong>on</strong>s. This was addressed by adding a twenty per cent weightage to all TNMSC price<br />
rates utilised.<br />
The item wise price listed does not include tax.<br />
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Chapter 3 Data Analysis & <str<strong>on</strong>g>Report</str<strong>on</strong>g> generati<strong>on</strong><br />
A. Prescripti<strong>on</strong> Survey Data Analysis:<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The prescripti<strong>on</strong> survey besides providing the demand for drugs prescribed at various facilities also<br />
shed light <strong>on</strong> certain key prescribing patterns.<br />
1) Number <strong>of</strong> drugs prescribed per prescripti<strong>on</strong> - More than 60% <strong>of</strong> prescripti<strong>on</strong>s at all levels had<br />
less than three drugs per prescripti<strong>on</strong>.<br />
>3 >5 7 Days<br />
Medical Colleges 34% 42% 24%<br />
District Hospitals 53% 36% 10%<br />
CHCs 77% 12% 11%<br />
PHCs 69% 24% 8%<br />
Table 16: The durati<strong>on</strong> for which the medicine is prescribed<br />
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<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
4) <strong>Drugs</strong> prescribed listed in the EDL -All levels <strong>of</strong> facilities showed that the majority <strong>of</strong> drugs<br />
prescribed (80%) were listed in the EDL.<br />
All Some N<strong>on</strong>e<br />
Medical Colleges 80% 19% 1%<br />
District Hospitals 79% 20% 0%<br />
CHCs 85% 14% 1%<br />
PHCs 85% 14% 1%<br />
Table 17: <strong>Drugs</strong> prescribed listed in the EDL<br />
5) Drug details -It was observed that nearly all prescripti<strong>on</strong>s had the drug dosage entered.<br />
Cases where<br />
drug dosage<br />
forms were<br />
provided<br />
Cases where<br />
drug dosage<br />
forms were<br />
not provided<br />
Medical Colleges 98% 2%<br />
District Hospitals 98% 2%<br />
CHCs 98% 1%<br />
PHCs 98% 1%<br />
Table 18: Cases where drug dosage forms were provided or nor provided<br />
a) The strength <strong>of</strong> the drugs prescribed was however not entered in most prescripti<strong>on</strong>s.<br />
Yes No<br />
Medical Colleges 17% 66%<br />
District Hospitals 9% 75%<br />
CHCs 3% 86%<br />
PHCs 7% 86%<br />
Table 19: Strengths <strong>of</strong> dosage form provided<br />
b) Also, the Diagnosis was not entered in the majority <strong>of</strong> prescripti<strong>on</strong>s at all level <strong>of</strong> facilities<br />
Yes No<br />
Medical Colleges 8% 91%<br />
District Hospitals 7% 92%<br />
CHCs 4% 96%<br />
PHCs 3% 96%<br />
Table 20: Diagnosis menti<strong>on</strong>ed in the prescripti<strong>on</strong><br />
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B. Data Analysis from Stores<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
As brought out below, the store data for each item <strong>on</strong> the EDL was requisiti<strong>on</strong>ed from<br />
District Stores and the stores <strong>of</strong> Medical Colleges.<br />
The m<strong>on</strong>thly maintenance and quarterly c<strong>on</strong>sumpti<strong>on</strong> figures were then calculated, while<br />
taking into account the periods <strong>of</strong> stock out for each store.<br />
Illustrati<strong>on</strong>: In the figure below, the store data from 4 District Hospitals was collated. DH1<br />
had an average annual c<strong>on</strong>sumpti<strong>on</strong> <strong>of</strong> 27700 tablets; however the average period <strong>of</strong> stock<br />
out was 3 m<strong>on</strong>ths per annum. The drug was available for an average <strong>of</strong> 9 m<strong>on</strong>ths. The<br />
average m<strong>on</strong>thly c<strong>on</strong>sumpti<strong>on</strong> was therefore 3078 and the quarterly c<strong>on</strong>sumpti<strong>on</strong> figure<br />
was 9233.<br />
Drug (as per EDL)<br />
Illustrati<strong>on</strong> : Demand Calculati<strong>on</strong> for <strong>Drugs</strong> <strong>on</strong> EDL<br />
F= ( c<strong>on</strong>sumpti<strong>on</strong> Quarterly Average<br />
3 2 0 0<br />
Annual C<strong>on</strong>sumpti<strong>on</strong> (A)<br />
Year 1 Year 2 Year 3 Average<br />
No Stock (B) Number <strong>of</strong> days<br />
Year 1<br />
Diazepam Tablet( scored) 5mg D 165 P<br />
DH 1 42900 12500 27700 0 180 90 9 3078 9233<br />
DH 2 32400 28320 30360 0 120 60 10 3036 9108<br />
DH 3 31900 88400 60150 12 5013 15038<br />
DH 4 48400 5800 27100 12 2258 6775<br />
10038<br />
17 DHs 170654<br />
TNMC Rate 10 x10 Rs 4.68 ( excluding tax) 7987<br />
Formulati<strong>on</strong><br />
Strength<br />
Drug Code<br />
Facility Code (P/S/T )<br />
Figure 1 : Illustrati<strong>on</strong> <strong>of</strong> demand calculati<strong>on</strong><br />
Annual<br />
cost 31946<br />
C. Data Analysis based <strong>on</strong> expert inputs<br />
For items not covered by the prescripti<strong>on</strong> survey and for those under restricted<br />
prescripti<strong>on</strong>s, we arrived at an analytical estimati<strong>on</strong> after discussi<strong>on</strong> with c<strong>on</strong>cerned<br />
specialist.<br />
Illustrati<strong>on</strong>: To arrive at an estimate for anti-metabolites and other drugs used in Oncology,<br />
we understood the prescripti<strong>on</strong> frequency for each medical college.<br />
In the figure below, it is seen that the frequency <strong>of</strong> prescribing Cyclophosphamide Inj per<br />
day is 5 at Medical College Raipur. Given the daily dosage is 2, the m<strong>on</strong>thly requirement <strong>of</strong><br />
the Inj is 300 and the annual c<strong>on</strong>sumpti<strong>on</strong> around 3600. The demand for other medical<br />
colleges was also customized in view <strong>of</strong> their work load.<br />
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Chhattisgarh 34<br />
No stock in m<strong>on</strong>ths (C=B/30)<br />
Year 2 Year 3 Average Drug availability in m<strong>on</strong>ths (D= 12-C)<br />
Average M<strong>on</strong>thly C<strong>on</strong>sumpti<strong>on</strong><br />
(E=A/D)<br />
Ex3)
Drug (as per EDL)<br />
Figure 2 : Demand estimati<strong>on</strong> for chemotherapeutic drugs<br />
Figure 3 : Demand estimati<strong>on</strong> for drugs used in psychiatry<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Estimati<strong>on</strong> <strong>of</strong> demand for Chemotherapeutic drugs (at Medical Colleges)<br />
10%<br />
Annual<br />
20%<br />
Total<br />
Prescripti<strong>on</strong> Drug M<strong>on</strong>thly<br />
Annual Requirement Requirement<br />
Frequency per dosaged Require Annual req MC Req MC Medical for state ( 3<br />
day osages ment Raipur Jagdalpur college MCs)<br />
Busulfan Capsule 2mg 15 2 900 10800 1080 2160 14040<br />
Carboplatin Injecti<strong>on</strong> 50mg/5ml 50 2 3000 36000 3600 7200 46800<br />
Carboprost (PGF2α) as<br />
Tromethamine USP<br />
Injecti<strong>on</strong> 0.25mg/ml<br />
0.1 1 3 36 3.6 7.2 46.8<br />
Chlorambucil Capsule 5mg 15 1 450 5400 540 1080 7020<br />
Cisplatin Injecti<strong>on</strong> 10mg/10ml 25 1 750 9000 900 1800 11700<br />
Cyclophosphamide Tablet 50mg 25 1 750 9000 900 1800 11700<br />
Cyclophosphamide Injecti<strong>on</strong> 200mg 5 2 300 3600 360 720 4680<br />
Cytarabine Injecti<strong>on</strong> 500mg 5 1 150 1800 180 360 2340<br />
D actinomycin Injecti<strong>on</strong> 0.5mg 10 1 300 3600 360 720 4680<br />
Daunorubicin Hydrochloride Powder for Injecti<strong>on</strong> 50mg 5 1 150 1800 180 360 2340<br />
Decarbazine Injecti<strong>on</strong> 100mg 50 1 1500 18000 1800 3600 23400<br />
Doxorubicin Injecti<strong>on</strong> 10mg/5ml 1 1 30 360 36 72 468<br />
Doxylamine Succinate Tablet 100mg 50 1 1500 18000 1800 3600 23400<br />
Etoposide Capsule 100mg 0.2 1 6 72 7.2 14.4 93.6<br />
Etoposide Injecti<strong>on</strong> 100mg/5ml 1 1 30 360 36 72 468<br />
Florouracil Injecti<strong>on</strong> 250mg 2 1 60 720 72 144 936<br />
Hydroxyurea Capsule 500mg 3 1 90 1080 108 216 1404<br />
Lomustine Tablet 40mg 3 1 90 1080 108 216 1404<br />
Melphalan Tablet 2mg 3 1 90 1080 108 216 1404<br />
Mercaptopurine Tablet 50mg 5 1 150 1800 180 360 2340<br />
Methotrexate Injecti<strong>on</strong> 25mg/ ml 5 1 150 1800 180 360 2340<br />
Methotrexate Sodium Tablet 2.5mg 5 1 150 1800 180 360 2340<br />
Mitomycin Capsule 10mg 0.1 1 3 36 3.6 7.2 46.8<br />
Mitoxantr<strong>on</strong>e Injecti<strong>on</strong> 20mg 4 1 120 1440 144 288 1872<br />
Ondansetr<strong>on</strong> Syrup 2mg/5ml 3 1 90 1080 108 216 1404<br />
Procarbazine Capsule 50mg 4 1 120 1440 144 288 1872<br />
Vinblastine Injecti<strong>on</strong> 10mg 12 1 360 4320 432 864 5616<br />
Vincristine Injecti<strong>on</strong> 1 mg 10 1 300 3600 360 720 4680<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
Strength<br />
Demand Calculati<strong>on</strong> for <strong>Drugs</strong> used in Psychiatry ( Medical Colleges <strong>on</strong>ly)<br />
Formulatio<br />
n<br />
Amitriptyline Tablet 25mg 0.5 2 1 900<br />
Clozapine Tablet 100mg 6 2 12 10800<br />
Fluoxetine Hydrochloride (for<br />
use above 8 years <strong>of</strong> age)<br />
Tablet 20mg<br />
5 2 10 9000<br />
Fluphenazine Decanoate or<br />
Enantate<br />
Injecti<strong>on</strong> 25 mg<br />
10 1 10 9000<br />
Haloperidol Tablet 5 mg 5 1 5 4500<br />
Haloperidol Injecti<strong>on</strong> 5 mg 6 1 6 5400<br />
Haloperidol Liquid 2mg/ml 1 1 1 900<br />
Imipramine Hydrochloride Tablet 25 mg 0.5 2 1 900<br />
Lithium Carb<strong>on</strong>ate Tablet 300 mg 5 1 5 4500<br />
Olanzapine Tablet 10 mg 10 1 10 9000<br />
Risperid<strong>on</strong>e Tablet 3mg 10 1 10 9000<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 35<br />
Strength<br />
Frequency<br />
<strong>of</strong> daily<br />
prescriptio<br />
n<br />
Dose / Day<br />
Total daily<br />
demand<br />
per MC<br />
Annual<br />
demand for<br />
state
D. Data Analysis based <strong>on</strong> morbidity statistics<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The demand for drugs for N<strong>on</strong>-communicable diseases and diseases covered under Nati<strong>on</strong>al<br />
and State driven programmes were calculated using the nati<strong>on</strong>al and state level prevalence<br />
rates and other epidemiological statistics.<br />
The Standard Treatment Guidelines available under the various Nati<strong>on</strong>al Programmes and<br />
the STG developed by the Armed Forces Medical College, Pune in collaborati<strong>on</strong> with Ministry<br />
<strong>of</strong> <strong>Health</strong> & <strong>Family</strong> Welfare & WHO Country Office, India were utilized for calculati<strong>on</strong> <strong>of</strong> drug<br />
demand.<br />
Illustrati<strong>on</strong>:<br />
Calculati<strong>on</strong> <strong>of</strong> demand for Antimalarial <strong>Drugs</strong>-<br />
The state <strong>of</strong> Chhattisgarh is endemic for Malaria with a high disease burden as brought out<br />
below<br />
The district level load <strong>of</strong> Malaria is brought out below based <strong>on</strong> the DHS MIS available in the<br />
Chhattisgarh <strong>Department</strong> <strong>of</strong> <strong>Health</strong> & <strong>Family</strong> Welfare portal.<br />
The statistics available in the Directorate <strong>of</strong> NVBDCP and the State <strong>Health</strong> HMIS for the year<br />
2011 reveal-<br />
The state has an average API <strong>of</strong> 6.13 (2011 State NVBDCP data)<br />
The districts <strong>of</strong> Bastar, Dantewada, Jashpur, Korba, Korea, Narayanpur have a high<br />
API (Annual Parasitic Index) > 10<br />
BSE ( Blood Smear examined)– 167656<br />
TPC- 152106<br />
Pf % - 72.15%<br />
The demand for various antimalarial drugs was worked out Based <strong>on</strong> the ‘Guidelines for<br />
Diagnosis & Treatment <strong>of</strong> Malaria in India’ 2011 developed by the Nati<strong>on</strong>al Institute <strong>of</strong><br />
Malaria Research & WHO. The treatment was based <strong>on</strong> the algorithm as provided below-<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 36
Figure 4: Algorithm for Diagnosis and treatment <strong>of</strong> Malaria<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The dosage schedule and the number <strong>of</strong> tablets and injecti<strong>on</strong>s were then calculated using<br />
the STG as developed under the NVBDCP.<br />
Figure 5: Dosage schedule for treatment <strong>of</strong> Pl Vivax (under NVBDCP)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 37
Figure 6: Age wise schedule for treatment <strong>of</strong> Plasmodium Falciparum malaria (as per NVBDCP)<br />
Calculati<strong>on</strong> <strong>of</strong> demand for Injecti<strong>on</strong> Quinine -<br />
Total Pfx 40% x10%x 10<br />
Calculati<strong>on</strong> <strong>of</strong> demand for Injecti<strong>on</strong> Artesunate -<br />
Total Pfx 60% x10%x 3<br />
Demand for Rapid Diagnostic Kit -<br />
(Total Blood slide x 40%x40%) x60%<br />
Calculati<strong>on</strong> for Insulin demand for treatment <strong>of</strong> Diabetes Mellitus<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
In view <strong>of</strong> the essentially rural populati<strong>on</strong> <strong>of</strong> Chhattisgarh, the prevalence <strong>of</strong> Diabetes<br />
Mellitus in the state was taken as 8%.<br />
Prevalence <strong>of</strong> Diabetes in Urban India JAPI, June 2010; Vol 58 A Ramachandran et al ‘Current<br />
status <strong>of</strong> Diabetes in India’<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 38
The Insulin demand was then worked out assuming that 10% <strong>of</strong> the diabetic subset<br />
accessing the public health care system will require Insulin.<br />
The various forms <strong>of</strong> Insulin for which demand was calculated were<br />
<strong>Family</strong> Planning statistics used for calculati<strong>on</strong> <strong>of</strong> demand-<br />
Total Fertility Rate 2.6<br />
C<strong>on</strong>traceptive Prevalence Rate ( Permanent + IUCD ) 63%<br />
Number <strong>of</strong> IUDs inserti<strong>on</strong>s<br />
Period 2010-11 2011-12<br />
Number <strong>of</strong> IUD<br />
inserti<strong>on</strong>s<br />
105245 102000<br />
<strong>Family</strong> Planning Indicators – Based <strong>on</strong> DLHS -2 & DLHS 3<br />
DLHS-2 DLHS-3<br />
Pill % 1.8% 1.7%<br />
IUD % 0.5% 0.6%<br />
C<strong>on</strong>doms % 2% 1.6%<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 39
1<br />
a<br />
b<br />
c<br />
For calculati<strong>on</strong> <strong>of</strong> Demand for Anti Filarials under MDA<br />
The following algorithm was used-<br />
Calculati<strong>on</strong> <strong>of</strong> drug demand for Leprosy treatment -<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Leprosy Prevalence Rate <strong>of</strong> Chhattisgarh - Number <strong>of</strong> patients per 10000 populati<strong>on</strong>s – 1.78<br />
per 10000 with nearly four to five thousand new cases being detected annually.<br />
The districts <strong>of</strong> Mahasamund, Raigarh, Janjgir, Raipur, Bilaspur, Korba, Kawardha, Durg,<br />
Dhamtari, Jagdalpur, Jashpur, Rajnandga<strong>on</strong> have ANCDR more than 10 / 100000 populati<strong>on</strong>.<br />
MB<br />
PB<br />
Dosage schedule for MDT Regimen<br />
Calculati<strong>on</strong><br />
MDT Regimen<br />
Drug Dosage Frequency Durati<strong>on</strong><br />
Rifampicin 600mg <strong>on</strong>ce a m<strong>on</strong>th<br />
demand<br />
per<br />
patient<br />
Daps<strong>on</strong>e 100mg Daily 365<br />
12 m<strong>on</strong>th<br />
Cl<strong>of</strong>azamine 300mg <strong>on</strong>ce a m<strong>on</strong>th 12<br />
Cl<strong>of</strong>azimine 50mg Daily 365<br />
Rifampicin 600mg <strong>on</strong>ce a m<strong>on</strong>th<br />
Daps<strong>on</strong>e 100mg Daily 6 m<strong>on</strong>th 183<br />
Table 21:Dosage schedule for MDT Regimen<br />
Demand calculati<strong>on</strong> for Vaccines -<br />
MDA for Fialria<br />
Single day MDA with DEC and Albendazole<br />
Age group Drug dose<br />
< 2yrs Nil<br />
2 - 5 yrs (100 mg ) 1 tabs<br />
6- 14 yrs (100 mg ) 2 tabs<br />
15 and above 3 tabs<br />
Calculati<strong>on</strong><br />
Yearly requirement calculati<strong>on</strong> DEC 100mg = total populati<strong>on</strong> in area x 2.5<br />
Albendazole 400mg = " x 1<br />
The calculati<strong>on</strong> was based <strong>on</strong> the guidelines provided in the Immunisati<strong>on</strong> Handbook <strong>of</strong><br />
<strong>Department</strong> <strong>of</strong> <strong>Health</strong> & <strong>Family</strong> Welfare, Government <strong>of</strong> India.<br />
The under menti<strong>on</strong>ed tool was used for assessing the vaccine demand.<br />
A wastage rate <strong>of</strong> 25% or a wastage multiplicati<strong>on</strong> <strong>of</strong> 1.33 was applied for all vaccines<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 40<br />
12<br />
6
Total Populati<strong>on</strong><br />
Based <strong>on</strong> Census<br />
Annu<br />
al<br />
Targe<br />
t<br />
Pregnant women<br />
Infants<br />
M<strong>on</strong><br />
thly<br />
Targ<br />
et<br />
Pregnant women<br />
Infants<br />
Benefeciaries per m<strong>on</strong>th Vaccine vials & Vit A per m<strong>on</strong>th<br />
TT<br />
BCG<br />
DPT<br />
OPV<br />
Hepatitis B<br />
Measles<br />
DT<br />
Vitamin A<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
a b c d e f g h i j k l m n o p q r s t u v w<br />
Based <strong>on</strong> census<br />
Based <strong>on</strong> census<br />
a/12<br />
b/12<br />
cx2<br />
dx1<br />
dx4<br />
3.1 Triangulati<strong>on</strong> <strong>of</strong> Data<br />
dx4<br />
dx3<br />
dx1<br />
dx1<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 41<br />
TT<br />
dx9<br />
(ex1.33)/10<br />
In view <strong>of</strong> the short time frame in which a good estimate <strong>of</strong> the financial envelope was to be<br />
ascertained, various data sources were used to get a correct demand estimate for each drug.<br />
From the Store c<strong>on</strong>sumpti<strong>on</strong> data and the prescripti<strong>on</strong> survey, drug demand for each level <strong>of</strong> facility<br />
was worked out. Based <strong>on</strong> the prevalence rates and morbidity patterns, the drug demand was<br />
calculated for the entire state populati<strong>on</strong>.<br />
A triangulati<strong>on</strong> <strong>of</strong> data was d<strong>on</strong>e for each item and the final estimate was chosen.<br />
Triangulati<strong>on</strong> for demand <str<strong>on</strong>g>Assessment</str<strong>on</strong>g> for Anti-Hypertensive <strong>Drugs</strong> is brought out below-<br />
Illustrati<strong>on</strong>:<br />
Demand assessment for Anti-Hypertensive based <strong>on</strong> Morbidity patterns-<br />
Scenario 1:<br />
BCG<br />
(fx1.33)/10<br />
DPT<br />
(gx1.33)/10<br />
OPV<br />
(hx1.33)/10<br />
Hep B<br />
(ix1.33)/10<br />
Measles<br />
(jx1.33)/10<br />
DT<br />
(kx1.33)/10<br />
Vit A<br />
{(dx1ml) +(dx8x2ml)}x1.11<br />
Syringe.1ml<br />
fx1.1<br />
Syringe 0.5ml<br />
(e+g+i+j+k)x1.1<br />
Rec<strong>on</strong>stituti<strong>on</strong><br />
(n+r)x1.1
Assuming -<br />
Prevalence rate <strong>of</strong> Hypertensi<strong>on</strong> 14 to be 10% ( In age group 30 years and above )<br />
Total populati<strong>on</strong> <strong>of</strong> state being 25540196<br />
76 per cent <strong>of</strong> Chhattisgarh populati<strong>on</strong> being rural<br />
35 per cent <strong>of</strong> the state Polpulati<strong>on</strong> being above the age <strong>of</strong> 30 years ( census 2011)<br />
30 per cent <strong>of</strong> state Populati<strong>on</strong> currently accessing public healthcare system<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Standard Treatment Guidelines (STG) for Hypertensi<strong>on</strong> advocates step ladder use <strong>of</strong> combinati<strong>on</strong><br />
drug therapy from the following Drug Groups -<br />
Drug Group<br />
( Anti Hypertensives )<br />
Average Percent <strong>of</strong><br />
prescripti<strong>on</strong>s with drug<br />
group<br />
Diuretics 30%<br />
Beta Blockers 30%<br />
ACE Inhibitors 40%<br />
Calcium Channel Blockers 30%<br />
Aldoster<strong>on</strong>e antag<strong>on</strong>ists 10%<br />
Angiotensin Receptor blockers 30%<br />
Based <strong>on</strong> the above the demand for each anti-hypertensive drug was calculated and the budget<br />
ascertained.<br />
In the above scenario , the annual amount for procurement <strong>of</strong> anti-hypertensive worked out to INR<br />
6.7 Crore.<br />
Drug Group<br />
Dosage<br />
per day<br />
Patient<br />
load<br />
Unit<br />
price<br />
Annual<br />
demand<br />
Annual<br />
Amount<br />
Diuretics<br />
80452<br />
Hydrochlorthiazide (25mg) 1 80452 0.44 29364840 12920530<br />
B Blockers<br />
80452<br />
Atenolol(50mg) 1 40226 0.15 14682420 2202363<br />
Metoprolol (50mg) 1 40226 0.37 14682420 5432495<br />
Calcium Channel Blockers<br />
80452<br />
Ditiazem 1 8045 0.19 2936484 557932<br />
Nifedipine (5mg) 1 24135 0.3 8809452 2642836<br />
14 ICMR – Medical Research Council Workshop <strong>on</strong> Chr<strong>on</strong>ic Diseases 2009 ; The Burden <strong>of</strong><br />
Cardiovascular Disease in India<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 42
Scenario 2:<br />
Drug Group<br />
Dosage<br />
per day<br />
Patient<br />
load<br />
Unit<br />
price<br />
Annual<br />
demand<br />
Annual<br />
Amount<br />
Amlodepin (5mg) 1 0.06 11745936 704756.2<br />
Nifedipine (20mg) 1 8045 0.13 2936484 381742.9<br />
Verapamil Inj 1 4023 5.87 1468242 8618581<br />
Verapamil Tab 1 8045 0.4 2936484 1174594<br />
Aldoster<strong>on</strong>e antag<br />
26817<br />
Spirinolact<strong>on</strong>e (100mg) 1 26817 1.62 9788280 15857014<br />
Angiotensin Receptor<br />
Blockers<br />
80452<br />
Losartan (25mg) 1 80452 0.46 29364840 13507827<br />
ACE I<br />
107269<br />
Enalapril(5mg) 1 107269 0.08 39153120 3132250<br />
Total Amount 67132919<br />
Table 22: Drug Demand and budget calculati<strong>on</strong> based <strong>on</strong> nati<strong>on</strong>al prevalence rates<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Assuming the prevalence rate <strong>of</strong> Hypertensi<strong>on</strong> in Chattisgarh to be 2.7% as brought out from the<br />
screening results covering the 3 designated NCDC .The item wise demand and cost is tabulated<br />
below.<br />
The total cost for anti hypertensives now comes to INR 1.8 Crore<br />
Drug Group<br />
Diuretics<br />
Dosage<br />
per day<br />
Patient<br />
load<br />
21722<br />
Unit<br />
price<br />
Annual<br />
demand<br />
Annual<br />
Amount<br />
Hydrochlorthiazide (25mg) 1 21722 0.44 7928506.9 3488543<br />
B Blockers<br />
21722<br />
Atenolol(50mg) 1 10861 0.15 7928506.9 1189276<br />
Metoprolol (50mg) 1 10861 0.37 3964253.4 1466774<br />
Calcium Channel Blockers<br />
21722<br />
Ditiazem 1 2172 0.19 792850.69 150642<br />
Nifedipine (5mg) 1 6517 0.3 2378552.1 713566<br />
Amlodepin (5mg) 1 8689 3171402.8 190284<br />
Nifedipine (20mg) 1 2172 0.13 792850.69 103071<br />
Verapamil Inj 1 1086 5.87 396425.34 2327017<br />
Verapamil Tab 1 2172 0.4 792850.69 317140<br />
Aldo antag<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 43<br />
7241<br />
Spirinolact<strong>on</strong>e (100mg) 1 7241 1.62 2642835.6 4281394<br />
Angiotensin Receptor<br />
Blockers<br />
21722<br />
Losartan (25mg) 1 21722 0.46 7928506.9 3647113<br />
ACE I<br />
28963
Scenario 3:<br />
Drug Group<br />
Dosage<br />
per day<br />
Patient<br />
load<br />
Unit<br />
price<br />
Annual<br />
demand<br />
Annual<br />
Amount<br />
Enalapril(5mg) 1 28963 0.08 10571343 845707<br />
Total Amount 18720526<br />
Table 23: Drug demand & cost based <strong>on</strong> local prevalence statistics<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The same drug demand when assessed utilizing the data obtained from stores resulted in total cost<br />
coming to <strong>on</strong>ly INR 25 lakhs.<br />
This is attributed to the erratic store supply, l<strong>on</strong>g periods <strong>of</strong> stock outs and the insufficient supply <strong>of</strong><br />
ACE Inhibitors and ARBs.<br />
I Diuretics<br />
Ii B Blockers<br />
Drug Group Dosage<br />
per day<br />
Unit<br />
price<br />
Demand Amt<br />
Hydrochlorthiazide (25mg) 1 0.44 505490 372767<br />
Atenolol(50mg) 1 0.15 1992324 298849<br />
Metoprolol (50mg) 1 0.37 1399571 1077063<br />
Iii Calcium Channel Blockers<br />
Ditiazem 1 0.19 21688 4164<br />
Nifedipine (5mg) 1 0.3 140227 42068<br />
Amlodepin (5mg) 1 0.06 2726157 142969<br />
Nifedipine (20mg) 1 0.13 155808 20567<br />
Verapamil Inj 1 5.87 7056 41405<br />
Verapamil Tab 1 0.4 7056 2794<br />
Iv Aldo antag<br />
Spirinolact<strong>on</strong>e (100mg) 1 1.62 341837 452186<br />
V Angiotensin Receptor Blockers<br />
Vi ACE I<br />
Losartan (25mg) 1 0.46 77904 35836<br />
Enalapril(5mg) 1 0.08 526000 69432<br />
Total Amount 2560100<br />
Table 24: Drug demand & cost based <strong>on</strong> local prevalence statistics<br />
In the current study we utilized the figures based <strong>on</strong> the nati<strong>on</strong>al prevalence rate as brought out in<br />
scenario 1.<br />
3.1.1 Demand for Anti Rabies Vaccine<br />
The c<strong>on</strong>sumpti<strong>on</strong> data from stores shows an average annual state level c<strong>on</strong>sumpti<strong>on</strong> <strong>of</strong> 3056<br />
ARV. The prescripti<strong>on</strong> survey calculated an annual requirement <strong>of</strong> 16,867 ARV.<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 44
However, <strong>on</strong> taking into account the actual incidence <strong>of</strong> Dog Bite in the state from the HMIS we<br />
calculated an annual demand <strong>of</strong> 13282 ARV.<br />
Drug (as per EDL)<br />
Demand from<br />
Store<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Incidence as per Chhattisgarh Govt. HMIS<br />
Demand<br />
from<br />
Prescripti<strong>on</strong><br />
survey 2010-11 2011-12 2012-13<br />
ARV 3056 16867 14827 15018 13282<br />
Table 25: Demand assessment for ARV from 3 sources<br />
The demand for Anti Snake Venom Serum <strong>on</strong> the other hand was 774 based <strong>on</strong> store c<strong>on</strong>sumpti<strong>on</strong>,<br />
424 based <strong>on</strong> the prescripti<strong>on</strong> survey and 575 based <strong>on</strong> actual incidence rates. In this case we kept<br />
the current store c<strong>on</strong>sumpti<strong>on</strong> data.<br />
3.1.2 Demand for Insulin for treatment <strong>of</strong> Diabetes Mellitus<br />
Scenario 1:<br />
Calculati<strong>on</strong> based <strong>on</strong> Morbidity pattern<br />
Assuming –<br />
• Populati<strong>on</strong> <strong>of</strong> Chhattisgarh is 25540196<br />
• Prevalence <strong>of</strong> Diabetes 15 (Nati<strong>on</strong>al) is 8 per cent <strong>of</strong> the populati<strong>on</strong><br />
• 30 Per cent health seeking people access the public health system in the state <strong>of</strong><br />
Chhattisgarh<br />
• Ten Per cent <strong>of</strong> Diabetic patients are <strong>on</strong> Insulin<br />
Calculati<strong>on</strong><br />
15 ICMR – Medical Research Council Workshop <strong>on</strong> Chr<strong>on</strong>ic Diseases 2009 ; The Burden <strong>of</strong> Diabetes<br />
in India<br />
Diabetic subset 612965<br />
Per cent <strong>of</strong> patients <strong>on</strong> Insulin 10%<br />
Number <strong>of</strong> patients <strong>on</strong> Insulin 61296<br />
Number <strong>of</strong> ptients <strong>on</strong> OHAs 551668<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in<br />
Chhattisgarh 45
Dose calculati<strong>on</strong> for Insulin 30IU/day/patient<br />
Total doses 671196350.9<br />
Insulin in EDL Strength Cost/unit per<br />
cent<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Doses cost<br />
1 Insulin Injecti<strong>on</strong> (Soluble) 40IU/ml<br />
30% 201358905 35257944<br />
2 Insulin Injecti<strong>on</strong> (Soluble) 100IU/ml (70.04 per 10ml 30% 201358905 35257944<br />
3 Isophane Insulin 40IU/ml vial) 20% 134239270 23505296<br />
4 Isophane Insulin 100IU/ml 0.18 per IU 20% 134239270 23505296<br />
The Insulin demand for the state is 1677991 IU at a cost <strong>of</strong> INR 11.75 Crore<br />
Scenario 2:<br />
117526481<br />
Calculati<strong>on</strong> <strong>of</strong> Insulin demand based <strong>on</strong> the NCD screening programme prevalence rate <strong>of</strong>- 4.1<br />
per cent<br />
Number <strong>of</strong> patients <strong>on</strong><br />
Insulin<br />
31414<br />
Number <strong>of</strong> patients <strong>on</strong> OHAs 282730<br />
Dose calculati<strong>on</strong> for Insulin 30IU/day/patient<br />
Total doses 343988129.8<br />
Insulin in EDL Strength Cost/unit per cent Doses cost<br />
Insulin Injecti<strong>on</strong> (Soluble) 40IU/ml Rs 70.04 per 30% 103196439 18069696<br />
Insulin Injecti<strong>on</strong> (Soluble) 100IU/ml 10 ml vial 30% 103196439 18069696<br />
Isophane Insulin 40IU/ml Rs 0.18/IU 20% 68797626 12046464<br />
Isophane Insulin 100IU/ml 20% 68797626 12046464<br />
The Insulin demand is 343988130 IU at a cost <strong>of</strong> INR 6 Cr.<br />
In the current study we have based the Insulin demand <strong>on</strong> scenario 1.<br />
60232322<br />
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Chhattisgarh 46
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
3.2 Total financial envelope<br />
The study has worked out the demand assessment for each item based <strong>on</strong> the current levels<br />
<strong>of</strong> work load and service delivery at the various levels <strong>of</strong> facilities i.e Tertiary, Sec<strong>on</strong>dary and<br />
Primary care.<br />
Scenario 1<br />
On current levels <strong>of</strong> utilizati<strong>on</strong> <strong>of</strong> Public <strong>Health</strong> delivery system<br />
Based <strong>on</strong> the current demand , the financial envelope that the Government <strong>of</strong> Chattisgarh<br />
will require to table for providing <strong>free</strong> generic medicines (listed in the EDL) at all level <strong>of</strong><br />
public healthcare delivery facilities ( Medical Colleges; District Hospitals ; CHCs & PHCs ) is<br />
INR 143.92Crores.<br />
The above figure is reached<br />
Scenario 2<br />
1. Taking into account the current load <strong>of</strong> patients.<br />
2. Utilising the item wise price used in procurement by Chhattisgarh and other<br />
State governments<br />
3. The item wise price is excluding tax<br />
4. The item wise demand does not cater for Wastage except for the calculati<strong>on</strong> <strong>of</strong><br />
Vaccine demand.<br />
5. The Reserve / Buffer stock has not been catered to in the assessment <strong>of</strong> the<br />
annual demand<br />
6. The overall demand has been calculated for 3 Medical Colleges, 17 District<br />
Hospitals, 148 CHCs and 741 PHCs.<br />
7. The Nati<strong>on</strong>al Programme for Preventi<strong>on</strong> and c<strong>on</strong>trol <strong>of</strong> Cancer, Diabetes, CVD &<br />
Stroke (NPCDCS) has been rolled out in the state. The burden <strong>of</strong> NCD is also due<br />
to the chr<strong>on</strong>icity <strong>of</strong> the illness and the requirement <strong>of</strong> lifel<strong>on</strong>g medicati<strong>on</strong>.The<br />
estimated Cost <strong>of</strong> providing for medicines for NCD al<strong>on</strong>e in the current study is<br />
INR 25.66 Crores..<br />
8.<br />
On increased levels <strong>of</strong> utilizati<strong>on</strong> <strong>on</strong>ce <strong>free</strong> generic drugs are made available<br />
Around 30 per cent <strong>of</strong> Chhattisgarh’s populati<strong>on</strong> accesses the Government funded public<br />
health care delivery system in the state. We anticipate an increase in patr<strong>on</strong>age <strong>of</strong> public<br />
health care delivery <strong>on</strong>ce the government starts providing assured <strong>free</strong> medicines .<br />
Based <strong>on</strong> the model utilized by the Planning Commissi<strong>on</strong>, it is anticipated that over a period<br />
52% <strong>of</strong> the state’s populati<strong>on</strong> will be serviced by the Public <strong>Health</strong>care facilities and the<br />
outreach programmes.<br />
The budget for provisi<strong>on</strong> <strong>of</strong> <strong>free</strong> generic drugs will then be INR 175.58 Crores (Rupees One<br />
Hundred and Seventy Five Crores)<br />
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Chhattisgarh 47
ABC Analysis<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
ABC analysis is an inventory categorizati<strong>on</strong> method which c<strong>on</strong>sists in dividing items into<br />
three categories, A, B and C: A being the most valuable items, C being the least valuable<br />
<strong>on</strong>es. This method aims to draw attenti<strong>on</strong> <strong>on</strong> the critical few (A-items) and not <strong>on</strong> the trivial<br />
many (C-items).<br />
The Pareto principle states that 80% <strong>of</strong> the overall financial value is based <strong>on</strong> <strong>on</strong>ly 20% <strong>of</strong><br />
total items. In other words, demand is not evenly distributed between items. The ABC<br />
approach states that, to rate items from A to C:<br />
We have d<strong>on</strong>e an ABC analysis to understand the items <strong>of</strong> high total value.<br />
The items rated A numbering <strong>on</strong>ly 48 are c<strong>on</strong>tributing to sixty per cent <strong>of</strong> the total cost. 97<br />
items were categorized B and rest 340 c<strong>on</strong>tributing <strong>on</strong>ly 10 per cent <strong>of</strong> the budget C.<br />
Category<br />
ABC ANALYSIS: OF ITEMISED DRUG LIST<br />
Per cent number<br />
<strong>of</strong> Items<br />
Per cent <strong>of</strong> Budget<br />
A 10% 60%<br />
B 20% 30%<br />
C 70% 10%<br />
Total 100% 100%<br />
ABC ANALYSIS: NUMBER OF DRUG ITEMS IN EACH<br />
CATEGORY<br />
C, 340, 70%<br />
A, 48, 10%<br />
B, 97, 20%<br />
Figure 7The ABC analysis for the items studied is provided at Annexure – 2<br />
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Chhattisgarh 48<br />
A<br />
B<br />
C
3.3 Financial envelope for each level <strong>of</strong> facility<br />
The average financial envelope for provisi<strong>on</strong> <strong>of</strong> <strong>free</strong> generic medicines (under EDL) at the<br />
various levels <strong>of</strong> public healthcare delivery based <strong>on</strong> the current level <strong>of</strong> utilizati<strong>on</strong> is tabulated<br />
below-<br />
Estimated Annual Cost<br />
in INR for providing <strong>free</strong><br />
generic medicines (EDL)<br />
at various facilities<br />
Medical<br />
College<br />
6.9 Cr<br />
3.4 Funding for Outreach Programme<br />
District Hospital CHC PHC<br />
2.8 Cr<br />
0.31 Cr<br />
0.04 Cr<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
In the state <strong>of</strong> Chhattisgarh where the populati<strong>on</strong> density is sparse (150 per sqkm.) and the<br />
habitati<strong>on</strong> is quite disperse dispensing health services is a challenge. In order to provide basic health<br />
services to these underserved area the state has The state has put in place 73 MMUs.<br />
Chhatisgarh has a vast network <strong>of</strong> Mitanins who are present at every 350 populati<strong>on</strong> in the state.<br />
Medicines required to replenish the Mitanin Kit every quarter.<br />
The drug demand for outreach programme has been included in the total state requirement.<br />
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Chhattisgarh 49
4.1 Items not included in study<br />
Chapter 4 Study c<strong>on</strong>straints / limitati<strong>on</strong>s<br />
The study did not include high end c<strong>on</strong>sumable items such as Cardiac Stents, prosthesis,<br />
Dental implants and also l<strong>on</strong>g use c<strong>on</strong>sumables such as Ambu Bags, Laryngoscopes etc.<br />
4.2 Probabilistic study<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
The study has been carried out using sample based data. The seas<strong>on</strong>al trends, n<strong>on</strong>standardizati<strong>on</strong><br />
<strong>of</strong> prescripti<strong>on</strong> patterns, irregular supply data, would c<strong>on</strong>tribute to certain errors in<br />
accuracy. Therefore the study is probabilistic in nature and can be a guided tool for decisi<strong>on</strong> making<br />
as a base case. A follow up in the subsequent years and initiating a systematic m<strong>on</strong>thly maintenance<br />
figures at facility levels would refine the results further.<br />
4.3 Can be refined over years<br />
Given the time c<strong>on</strong>straint, this study has tried to reach the best estimate for demand <strong>of</strong><br />
drugs and the cost that will be incurred by the Government for providing them <strong>free</strong>.<br />
Once cycle <strong>of</strong> procurement and c<strong>on</strong>sumpti<strong>on</strong> <strong>of</strong> the entire list gets stabilized the demand data can<br />
be reached with higher precisi<strong>on</strong> for all levels <strong>of</strong> care.<br />
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Chhattisgarh 50
Chapter 5 Recommendati<strong>on</strong>s<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
5.1 Follow up study<br />
It is recommended that a similar exercise is undertaken by the Government over the next 2<br />
years. This will fine tune the item wise demand assessment and also help in ascertaining the<br />
prescripti<strong>on</strong> patterns at various facilities. This will also help in designing interventi<strong>on</strong>s for promoting<br />
scientific prescripti<strong>on</strong> practices.<br />
5.2 Ongoing prescripti<strong>on</strong> audit<br />
Irrati<strong>on</strong>al prescribing is a comm<strong>on</strong> phenomen<strong>on</strong>. It leads to high expenses, unwanted<br />
adverse effects, and shortages <strong>of</strong> drugs.<br />
The Nati<strong>on</strong>al <strong>Health</strong> Policy 2002 <strong>of</strong> India also gives thrust <strong>on</strong> rati<strong>on</strong>al use <strong>of</strong> drugs. The<br />
deleterious impact <strong>of</strong> poor quality prescripti<strong>on</strong>s, under- and over-dosing, duplicati<strong>on</strong> and multiplicity<br />
<strong>of</strong> drugs <strong>on</strong> the restricted public finances, is a cause <strong>of</strong> c<strong>on</strong>cern.<br />
The Government <strong>of</strong> Chhattisgarh has developed the essential drugs list for the use <strong>of</strong> the<br />
prescribers and had introduced the same. However, it may be menti<strong>on</strong>ed here that, the prescribing<br />
behaviour <strong>of</strong> the doctors through prescripti<strong>on</strong>s audit has not yet been evaluated in the state to<br />
assess the prevailing prescribing practices. Hence, the study will help to know the extent <strong>of</strong> rati<strong>on</strong>al<br />
prescribing practices prevailing in the public sector health facilities, and how it is affecting the<br />
availability and access to essential medicines. This would also help in strengthening the essential<br />
drugs programme in Chhattisgarh by improving availability and access to essential medicines by<br />
carrying out various policy interventi<strong>on</strong>s to improve medicines use in the state like revisi<strong>on</strong> <strong>of</strong> EDL,<br />
STG, establishing drugs formulary for various level <strong>of</strong> health care delivery system, establishment <strong>of</strong><br />
drugs & therapeutic committee, selecti<strong>on</strong> <strong>of</strong> essential drugs for procurement & its rati<strong>on</strong>al use etc.<br />
5.3 Rati<strong>on</strong>alising & Revising the State EDL<br />
The state is already in the process <strong>of</strong> revising EDL. This may change the financial envelop.<br />
5.4 Strengthening Procurement and Supply Chain.<br />
The overall financial envelope is a small comp<strong>on</strong>ent <strong>of</strong> the health budget when <strong>on</strong>ly the<br />
price <strong>of</strong> the item is being factored. However there is a cost <strong>of</strong> procurement, storage, transport and<br />
distributi<strong>on</strong> which also needs to be taken into account. Further the procurement process should be<br />
visited to ensure that there is a procurement cycle for most <strong>of</strong> the items and inventory c<strong>on</strong>trol tools<br />
like fixing re order levels after catering to safety stocks and buffer stock,s using e procurement<br />
system for greater efficiency and transparency and minimizing stock outs will be the key factors for<br />
successful implementati<strong>on</strong> <strong>of</strong> the intent.<br />
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Chhattisgarh 51
S. No.<br />
Annexure 1 - Itemised List <strong>of</strong> <strong>Drugs</strong> with Total state demand in number and value<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
1 Acetazolamide Tablet 250 mg Tablet 1.07 156897 167879<br />
2 Acetyl Salicylic Acid (ASA)<br />
3 Acetyl Salicylic Acid (ASA)<br />
4 Acetyl Salicylic Acid (ASA)<br />
Tablet (Enteric<br />
Coated)<br />
Tablet (Enteric<br />
Coated)<br />
Tablet (Enteric<br />
Coated)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
75 mg Tablet 0.66 1082399 714383<br />
150 mg Tablet 0.15 289931 43490<br />
325 mg Tablet 0.17 4593951 771784<br />
5 Acyclovir Tablet 200 mg Tablet 0.67 181354 121507<br />
6 Acyclovir Oral Soluti<strong>on</strong> 200mg/5ml 60 ml bottle 10.20 709 7232<br />
7 Acyclovir<br />
Ophthalmic<br />
Ointment<br />
3% 5 gms tube 31.20 5832 181958<br />
8 Acyclovir Cream NULL 7.25 2025 14681<br />
9 Acyclovir (as sodium salt)<br />
Powder for<br />
Injecti<strong>on</strong><br />
250 mg 10 ml vial 68.49 1418 97119<br />
10 Adenosine Injecti<strong>on</strong> 3mg/ml 2 ml ampule 69.33 3348 232138<br />
11 Albendazole<br />
Tablet<br />
(Chewable)<br />
400 mg Tablet 0.90 3617246 3255522<br />
12 Albendazole Suspensi<strong>on</strong> 200mg/5ml 10ml bottle 3.60 123469 444488
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
13 Albumin Injecti<strong>on</strong> 20% in 50ml 2050 21168 43394400<br />
14 Allopurinol Tablet 100mg Tablet 0.52 35280 18346<br />
15<br />
16<br />
Aluminium Hydroxide+ Magnesium<br />
Hydroxide + Active<br />
Dimethic<strong>on</strong>/Simethic<strong>on</strong><br />
Aluminium Hydroxide+ Magnesium<br />
Hydroxide + Active<br />
Dimethic<strong>on</strong>/Simethic<strong>on</strong><br />
Chewable Tablet<br />
500mg (250mg+250mg<br />
+50mg)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
Tablet 0.29 7454790 2161889<br />
Gel 250mg+250mg+50mg/5ml 60 ml bottle 13.45 269089 3619244<br />
17 Amikacin Injecti<strong>on</strong> 100mg/2ml Vial 3.72 215337 801053<br />
18 Amikacin Injecti<strong>on</strong> 250mg/2ml Vial 8.04 47012 130248<br />
19 Amikacin Injecti<strong>on</strong> 500mg/2ml Vial 7.09 32211 228376<br />
20 Aminophylline Injecti<strong>on</strong> 25 mg/ml 10 ml ampule 3.28 128026 419927<br />
21 Amiodar<strong>on</strong>e Tablet 200mg Tablet 0.36 35280 12701<br />
22 Amiodar<strong>on</strong>e Injecti<strong>on</strong> (50mg/ml) 3ml Amp 3 ml vial 20.18 7056 142390<br />
23 Amitriptyline Tablet 25mg tablet 0.14 2430 350<br />
24 Amlodipine Tablet 2.5 mg Tablet 0.05 1373358 61801<br />
25 Amlodipine Tablet 5 mg Tablet 0.06 1352798 81168<br />
26 Amoxicillin + Clavulanic acid Suspensi<strong>on</strong><br />
27 Amoxicillin + Clavulanic acid Suspensi<strong>on</strong><br />
125mg + 31.25mg<br />
(156mg)/5ml<br />
250mg + 62.5mg<br />
(312mg)/5ml<br />
30 ml bottle 6.60 637687 4208732<br />
30 ml bottle 9.00 649044 5841398<br />
28 Amoxicillin + Clavulanic acid Injecti<strong>on</strong> 250mg +50mg (300mg) Vial 13.20 889027 11735151
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
29 Amoxicillin + Clavulanic acid Injecti<strong>on</strong> 500mg + 100mg (600mg) Vial 22.20 950352 21097811<br />
30 Amoxicillin + Clavulanic acid Injecti<strong>on</strong> 1gm + 200mg (1.2 gm) Vial 15.00 990478 14857174<br />
31 Amoxicillin + Clavulanic acid Tablet 250mg + 125mg (375mg) Tablet 6.78 859550 5827750<br />
32 Amoxicillin + Clavulanic acid Tablet 500mg + 125mg (625mg) Tablet 4.79 471855 2260185<br />
33 Amoxicillin anhydrous Tablet or Capsule 250 mg Tablet 0.93 1926036 1791213<br />
34 Amoxicillin anhydrous Tablet or Capsule 500 mg Tablet 0.95 4830369 4588851<br />
35 Amoxicillin anhydrous<br />
36 Amphotericin B<br />
Powder for Oral<br />
Suspensi<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
125 mg/5 ml 30ml bottle 9.81 353642 3469226<br />
50 mg Vial 85.90 1418 121801<br />
37 Ampicillin Sodium Tablet 250mg Tablet 0.93 6080053 5654449<br />
38 Ampicillin Sodium Tablet 500mg Tablet 1.63 410101 668465<br />
39 Ampicillin Sodium<br />
40 Anti rabies Vaccine (Verocell)<br />
41 Anti rabies Vaccine (Chickembryo)<br />
42<br />
Anti-D Immunoglobulin Polycl<strong>on</strong>al<br />
(Thiomersal <strong>free</strong>)<br />
Powder for<br />
Injecti<strong>on</strong><br />
Injecti<strong>on</strong> IM<br />
administrati<strong>on</strong><br />
Injecti<strong>on</strong> IM<br />
administrati<strong>on</strong><br />
500 mg Vial 4.41 681704 3006315<br />
200 – 400 IU Vial 243.36 4819 1172782<br />
2.5 IU Vial 129.15 12048 1555967<br />
Injecti<strong>on</strong> 300mcg Vial 1500.00 1453 2178750
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
43<br />
Antitetanus Immunoglobulin<br />
(Human)<br />
Injecti<strong>on</strong> 500 IU Vial 806.40 400 322560<br />
44 Artemether Injecti<strong>on</strong> 80 mg/ml 1ml ampule 7.95 3518 27970<br />
45 Artesunate Tablet 50 mg Tablet 0.13 951041 125537<br />
46 Artesunate Injecti<strong>on</strong> 60mg 2ml ampule 26.90 19753 531356<br />
47 Ascorbic Acid (Vit C) Tablet (Scored) 100 mg Tablet 0.17 4473399 751531<br />
48 Atenolol Tablet 50 mg Tablet 0.15 1926047 288907<br />
49 Atracurium Injecti<strong>on</strong> 10mg/ml 2.5ml ampule 43.99 71064 3126247<br />
50 Atropine Tablet 1mg Tablet 0.05 155360 7457<br />
51 Atropine Sulphate Injecti<strong>on</strong> 0.6 mg/ml 2.5ml ampule 1.60 237342 379747<br />
52 Atropine Sulphate<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
0.50% 5ml 15.67 1944 30466<br />
53 Atropine Sulphate Eye ointment 1% tube 13.20 38880 513216<br />
54 Azithromycin Tablet 250 mg Tablet 3.62 834478 3020811<br />
55 Azithromycin Tablet 500 mg Tablet 5.67 122959 697177<br />
56 Azithromycin Syrup 100 mg/5ml 15ml bottle 7.74 176172 1363569<br />
57 BCG Vaccine Injecti<strong>on</strong> Vial 18.00 73849 1329282<br />
58 Benzathine benzyl penicillin<br />
59<br />
60<br />
Benzyl penicillin (sodium or<br />
potassium salt)<br />
Benzoic acid compound (Benzoic<br />
acid + Salicylic acid)<br />
Powder for<br />
Injecti<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
1.44 g benzylpenicillin<br />
(=2.4 milli<strong>on</strong> IU)<br />
5ml vial 8.40 15016 126134<br />
600 mg (= 1 milli<strong>on</strong> IU) Vial 3.74 25521 95552<br />
Ointment (6%+ 3% ) tube 3.77 16850 63491
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
61 Benzoyl Peroxide Loti<strong>on</strong> 5% 20gms 7.74 115872 896849<br />
62 Benzyl Benzoate 25% Loti<strong>on</strong> or Cream 25% 100ml bottle 17.09 558486 9544532<br />
63<br />
Benzyl penicillin (sodium or<br />
potassium salt)<br />
Powder for<br />
Injecti<strong>on</strong><br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
600 mg (= 1 milli<strong>on</strong> IU) Vial 20.94 34070 713421<br />
64 Betamethas<strong>on</strong>e Ointment/Cream 0.1% (as vale rate) 15g tube 6.72 436175 2931098<br />
65 Betamethas<strong>on</strong>e Dipropi<strong>on</strong>ate Injecti<strong>on</strong> 4mg/ml 1ml ampule 1.20 1418 1702<br />
66<br />
Betamethas<strong>on</strong>e Dipropi<strong>on</strong>ate +<br />
Phenylephrine + Lignocaine<br />
67 Betaxolol Hydrochloride<br />
Ointment 0.025%+0.1%+2.5% 20gms tube 7.88 3150 24835<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
0.50% 5ml 6.96 3888 27060<br />
68 Bisacodyl Tablet 5mg Tablet 0.26 1471422 382570<br />
69 Bleomycin Injecti<strong>on</strong> 15mg Vial 384 1418 544512<br />
70 Bromhexine Hydrochloride Syrup 4mg/5ml 60ml 7.92 2148857 17018948<br />
71 Bupivacaine hydrochloride Injecti<strong>on</strong> 0.25% in vial 20ml vial 12.65 5156 65227<br />
72 Bupivacaine hydrochloride<br />
Injecti<strong>on</strong> for<br />
Spinal<br />
Anaesthesia<br />
0.5% in 4-ml ampoule to<br />
be mixed with 7.5%<br />
glucose soluti<strong>on</strong><br />
20ml vial 5.78 28200 162996<br />
73 Busulfan Capsule 2mg Capsule 1.12 14040 15725<br />
74 Calcium Gluc<strong>on</strong>ate Injecti<strong>on</strong><br />
75 Calcium Salts Tablet<br />
100 mg/ml in 10-ml<br />
ampoule<br />
(as elemental<br />
calcium)(300mg)<br />
10 ml ampule 3.28 1636033 5366188<br />
Tablet 0.28 15454997 4327399
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 57<br />
Strength<br />
76 Carbamazepine Syrup 20 mg/ml 100ml bottle 2.29 38957 89289<br />
77 Carbamazepine<br />
78 Carbamazepine<br />
Tablet (C<strong>on</strong>trol<br />
Release)<br />
Tablet (C<strong>on</strong>trol<br />
Release)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
(200mg) Tablet 0.44 531282 235889<br />
400 mg Tablet 0.74 1150564 851417<br />
79 Carboplatin (15ml)<br />
Carboprost (PGF2α) as<br />
Injecti<strong>on</strong> (15ml) 50mg/5ml Vial 462 10780 4980312<br />
80 Tromethamine USP (Preservative<br />
Free)<br />
Injecti<strong>on</strong> 0.25mg/ml 1ml ampule 36.72 48 1763<br />
81 Cefadroxyl Tablet 250mg Tablet 1.03 1698983 1753350<br />
82 Cefadroxyl Tablet 500mg Tablet 2.74 779940 2137037<br />
83 Cefadroxyl Syrup 125mg/5ml 30ml bottle 7.68 395980 3041123<br />
84 Cefalexin Tablet or Capsule 500mg Tablet 2.71 430635 1167021<br />
85 Cefalexin Tablet or Capsule 250mg Tablet 0.98 5429906 5343027<br />
86<br />
87<br />
Cefalexin (Powder for<br />
rec<strong>on</strong>stituti<strong>on</strong> with water)<br />
Cefalexin (Powder for<br />
rec<strong>on</strong>stituti<strong>on</strong> with water)<br />
Oral Soluti<strong>on</strong> 125mg/5ml 30ml bottle 9.07 1574204 14278028<br />
Oral Soluti<strong>on</strong> 250mg/5ml 30ml bottle 11.07 628200 6954174<br />
88 Cefixime Capsule 100mg Capsule 1.73 99396 171956<br />
89 Cefixime Capsule 200mg Capsule 3.26 458256 1493914<br />
90 Cefixime Dry Syrup 50mg/5ml 30ml bottle 19.23 12567 241663<br />
91 Ceftazidime Injecti<strong>on</strong> 250mg Vial 18.84 42008 791439<br />
92 Ceftazidime Injecti<strong>on</strong> 1gm Vial 33.36 47657 1589849
S. No.<br />
Drug (as per<br />
EDL)<br />
93 Ceftriax<strong>on</strong>e Sodium<br />
94 Ceftriax<strong>on</strong>e Sodium<br />
Formulati<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 58<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
250mg Vial 5.51 6323 34829<br />
1gm (Vial) 30ml vial 13.23 99700 1319034<br />
95 Cetirizine Dihydrochloride Tablet 10mg Tablet 0.12 5598504 671820<br />
96 Chlorambucil Capsule 5mg Capsule 10.00 3593 35919<br />
97 Chloramphenicol Capsule 250 mg Capsule 0.87 3215986 2797908<br />
98 Chloramphenicol Palmitate Oral Suspensi<strong>on</strong> 150 mg/5 ml 60ml bottle 6.13 41305 253201<br />
99 Chloramphenicol Sodium Succinate<br />
Powder for<br />
Injecti<strong>on</strong><br />
1 gm vial 22.05 4882 107643<br />
100 Chlorhexidine 5% for diluti<strong>on</strong> 500ml 500 ml bottle 20.40 27154 553942<br />
101<br />
102<br />
103<br />
Chloroquine (as hydrochloride,<br />
phosphate or sulphate)<br />
Chloroquine (as phosphate or<br />
sulphate)<br />
Chloroquine (as phosphate or<br />
sulphate)<br />
Injecti<strong>on</strong> 40 mg/ml 5ml ampule 11.28 418855 4724683<br />
Tablet 150 mg base Tablet 0.36 15908658 5727117<br />
Syrup 50 mg /5ml (60ml bottle) 60ml bottle 5.98 354798 2120273<br />
104 Chlorpheniramine Injecti<strong>on</strong> 10 mg/ml 1ml ampule 0.92 169715 156817<br />
105<br />
Chlorpheniramine (hydrogen<br />
maleate)<br />
Tablet 4 mg Tablet 0.60 9335426 5601256<br />
106<br />
Chlorpheniramine (hydrogen<br />
maleate)<br />
Oral Soluti<strong>on</strong><br />
Syrup<br />
2mg/5ml 50ml bottle 4.00 1518599 6068321<br />
107 Chlorpromazine Hydrochloride Tablet 100 mg Tablet 0.44 1418 630<br />
108 Chlorpromazine Hydrochloride Syrup 25 mg/5ml 7.56 14112 106687
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 59<br />
Strength<br />
109 Chlorpromazine Hydrochloride Injecti<strong>on</strong> 25 mg/ml 2ml ampule 3.05 14112 43042<br />
110 Chloramphenacol Eye ointment 5 gm tube tube 4.54 52600 238594<br />
111 Cinnarizine Tablet 25mg Tablet 0.14 2127 306<br />
112 Cipr<strong>of</strong>loxacin Hydrochloride Tablet 250 mg Tablet 0.60 5018281 3010968<br />
113 Cipr<strong>of</strong>loxacin Hydrochloride Tablet 500 mg Tablet 1.38 5072183 6999613<br />
114 Cipr<strong>of</strong>loxacin Hydrochloride Infusi<strong>on</strong> 2mg/ml 100ml bottle 9.98 255267 2547568<br />
115 Cipr<strong>of</strong>loxacin Hydrochoride<br />
116 Cipr<strong>of</strong>loxacin Hydrochoride<br />
Soluti<strong>on</strong> (Eye/Ear<br />
Drop)<br />
Ointment<br />
(Eye/Ear)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
0.3% w/v sterile aqueous 5ml 2.98 348840 1039542<br />
0.30% 5gm tube 3.56 122939 437664<br />
117 Cisplatin Injecti<strong>on</strong> 10mg/10ml Vial 36.00 11700 421200<br />
118 Cl<strong>of</strong>azimine Capsule 50 mg Capsule 1.17 1457482 1705254<br />
119 Clotrimazole Ear Drops 1% W/V 10ml 6.38 25862 164998<br />
120 Clotrimazole Mouth Paint 1% W/V 0.97 1441 1400<br />
121 Clotrimazole Cream 2% W/W (15gm tube) 15 gms tube 2.79 717485 2001784<br />
122 Cloxacillin Sodium Capsule 500 mg Capsule 0.86 283500 244944<br />
123 Cloxacillin Sodium<br />
124 Cloxacillin Sodium<br />
Powder for Oral<br />
Soluti<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
125 mg/5 ml 30ml bottle 6.96 751906 5233262<br />
500 mg in vial Vial 22.00 1811226 39839725<br />
125 Clozapine Tablet 100mg Tablet 1.09 29160 31843
S. No.<br />
126<br />
Drug (as per<br />
EDL)<br />
C<strong>on</strong>doms with or without<br />
Spermicide (N<strong>on</strong>oxinol)<br />
Formulati<strong>on</strong><br />
As per NACO/<br />
RCH supply<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 60<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
NULL 0.89 3880638 3446007<br />
127 C<strong>on</strong>jugated Equine Oestrogen Tablet 0.625mg Tablet 14.40 18571 267429<br />
128 Copper-c<strong>on</strong>taining device<br />
As per RCH<br />
Supply<br />
NULL 18.05 175000 3158750<br />
129 Cyclophosphamide Tablet 50mg Tablet 1.06 11700 12355<br />
130 Cyclophosphamide Injecti<strong>on</strong> 200mg 30ml vial 13.63 4680 63798<br />
131 Cytarabine Injecti<strong>on</strong> 1 g 5ml vial 93.60 2340 219024<br />
132 D actinomycin Injecti<strong>on</strong> 0.5mg Vial 98.64 4680 461635<br />
133 Daps<strong>on</strong>e Tablet 50 mg Tablet 0.31 2148025 670184<br />
134 Daunorubicin Hydrochloride<br />
Powder for<br />
Injecti<strong>on</strong><br />
20mg Vial 78.20 2340 182988<br />
135 DDT Powder As per NVBDCP Supply 900MT 5600000<br />
136 Decarbazine Injecti<strong>on</strong> 200mg 97.64 23400 2284870<br />
137 Deltamethrin Soluti<strong>on</strong> As per NVBDCP Supply 190MT 5000000<br />
138 Dexamethas<strong>on</strong>e Tablet 4 mg Tablet 0.12 3192596 383112<br />
139 Dexamethas<strong>on</strong>e Tablet 1mg Tablet 0.96 17672 16965<br />
140 Dexamethas<strong>on</strong>e Tablet 500 micrograms Tablet 0.16 182200 28423<br />
141<br />
Dexamethas<strong>on</strong>e Phosphate<br />
Disodium<br />
Injecti<strong>on</strong> 4 mg/ml 2ml ampule 3.73 1611221 6009854
S. No.<br />
142 Dextrose<br />
143 Dextrose<br />
144 Dextrose<br />
Drug (as per<br />
EDL)<br />
145 Dextrose with Sodium Chloride<br />
146 Dextrose with Sodium Chloride<br />
Formulati<strong>on</strong><br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid) 5%<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid) 25%<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 61<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
500ml 500ml 20.25 330758 6697853<br />
10% Isot<strong>on</strong>ic 500 ml 500ml 21.08 307495 6481989<br />
50% Hypert<strong>on</strong>ic 100ml 500ml 12.50 48532 606649<br />
5% Dextrose, 0.18%<br />
Sodium chloride<br />
(equivalent to Na+ 30<br />
mmol/l, Cl- 30 mmol/l)<br />
5% Dextrose, 0.9%<br />
Sodium chloride<br />
250/500ml 10.54 1335658 14072496<br />
250/500ml 8.76 454856 3984540<br />
147 Diazepam Tablet (Scored) 5 mg Tablet 0.18 754017 135723<br />
148 Diazepam Suspensi<strong>on</strong> 2mg/5ml 60ml bottle 8.40 33775 283709
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 62<br />
Strength<br />
149 Diazepam Injecti<strong>on</strong> 5 mg/ml 2ml ampule 2.63 280779 738448<br />
150 Dicl<strong>of</strong>enac sodium Tablet 50mg Tablet 0.27 6600140 1782038<br />
151 Dicl<strong>of</strong>enac sodium Tablet 100 mg Tablet 0.31 407653 126372<br />
152 Dicl<strong>of</strong>enac sodium Injecti<strong>on</strong><br />
25mg/ml PG surfactant<br />
<strong>free</strong> (3ml)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
3ml ampule 1.93 1197312 2310811<br />
153 Dicl<strong>of</strong>enac sodium Gel 1% w/v 25 gms tube 4.98 1306516 6506448<br />
154 Dicyclomine Hydrochloride Tablet 10mg Tablet 0.07 1775554 124289<br />
155 Dicyclomine Hydrochloride Injecti<strong>on</strong> 10mg/ml (2ml) 2 ml ampule 1.67 656610 1096538<br />
156 Diethyl carbamazine citrate Tablet 100mg Tablet 0.13 63850490 8428265<br />
157 Diethyltoluamide<br />
Cutaneous<br />
Soluti<strong>on</strong><br />
NULL 24.00 150000 3600000<br />
158 Digoxin Tablet 250 mcg Tablet 0.30 1855175 556553<br />
159 Digoxin Oral Soluti<strong>on</strong> 50 mcg/ml 30ml 26.40 634137 16741215<br />
160 Digoxin Injecti<strong>on</strong> 250 mcg/ml 2ml ampule 5.16 25550 131838<br />
161 Diltiazem Tablet 30mg Tablet 0.19 21688 4164<br />
162 Diltiazem Injecti<strong>on</strong> 30mg Vial 25.76 46353 1194246<br />
163 Dinoprost<strong>on</strong>e Injecti<strong>on</strong> 0.5mg 24.00 363 8712<br />
164 Diphtheria Antitoxin Injecti<strong>on</strong> 10 000 IU Vial 3.60 2583 9299<br />
165 Diphtheria Antitoxin Injecti<strong>on</strong> 20 000 IU Vial 3.60 2929 10544<br />
166<br />
Diphtheria,Pertussis and Tetanus<br />
combined (DPT) vaccine<br />
Injecti<strong>on</strong> NULL Vial 15.00 314158 4712370<br />
167 Dobutamine Injecti<strong>on</strong> 50 mg /ml 5ml ampule 26.12 16707 436387
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 63<br />
Strength<br />
168 Domperid<strong>on</strong>e Tablet 10mg Tablet 0.17 1768500 300645<br />
169 Domperid<strong>on</strong>e Syrup 1mg/ml 30ml 4.74 44374 210333<br />
170 Dopamine Hydrochloride Injecti<strong>on</strong> 40 mg 5ml vial 7.72 61606 475598<br />
171 Doxorubicin Injecti<strong>on</strong> 10mg/5ml 5ml vial 69.60 468 32573<br />
172 Doxycycline Hydrochloride Capsule 100 mg Capsule 0.82 849926 696940<br />
173 Doxylamine Succinate Tablet 100mg Tablet 18.00 23400 421200<br />
174<br />
175<br />
Electrolyte G (Multi-Electrolyte with<br />
5% Dextrose IV Injecti<strong>on</strong> Type III<br />
USP)<br />
Electrolyte M (Multi-Electrolyte<br />
with 5% Dextrose IV Injecti<strong>on</strong> Type<br />
III IP)<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
Each 100ml C<strong>on</strong>tains:<br />
Anhydrous Dextrose 5gm;<br />
Sodium Chloride 0.37gm;<br />
Potassium Chloride<br />
0.13gm; Amm<strong>on</strong>ium<br />
Chloride 0.37gm; Sodium<br />
Sulphite 15mg<br />
Each 100ml C<strong>on</strong>tains:<br />
Anhydrous Dextrose 5 g;<br />
Sodium Acetate<br />
Trihydrate 0.28 g<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
100ml 28.45 223201 6350079<br />
500ml 25.73 224373 5773108
S. No.<br />
176<br />
Drug (as per<br />
EDL)<br />
Electrolyte P (Multi-Electrolyte with<br />
5% Dextrose IV Injecti<strong>on</strong> Type I IP)<br />
Formulati<strong>on</strong><br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 64<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
Each 100ml c<strong>on</strong>tains: 500ml 25.73 241361 6210214<br />
177 Enalapril Tablet (Scored) 2.5mg Tablet 0.18 263000 47340<br />
178 Enalapril Tablet (Scored) 5 mg Tablet 0.08 263000 22092<br />
179<br />
Epinephrine Hydrochloride<br />
(Adrenaline)<br />
Injecti<strong>on</strong> 1 mg/ml 1ml ampule 1.52 30871 46924<br />
180 Ergometrine Hydrogen Maleate Tablet 125 micrograms Tablet 0.46 197902 91035<br />
181 Ergometrine Hydrogen Maleate Injecti<strong>on</strong> 200 micrograms 1ml ampule 1.52 145851 221694<br />
182 Erythromycin Stearate Tablet or Capsule 250 mg Tablet 1.06 1747203 1845046<br />
183 Erythromycin Stearate Tablet or Capsule 500mg Tablet 1.97 764635 1504802<br />
184 Erythromycin Stearate<br />
Powder for Oral<br />
Suspensi<strong>on</strong><br />
125 mg/5ml 60ml bottle 8.70 216278 1881614<br />
185 Ethambutol Hydrochloride Tablet 800 mg Tablet 2.69 1386180 3726052<br />
186 Ethanol (Spirit)<br />
Cutaneous<br />
Soluti<strong>on</strong><br />
70% (denatured) 500 ml 500ml 40.86 15300 625158<br />
187 Ethinylestradiol Tablet 50 micrograms Tablet 0.58 5638048 3270068<br />
188 Ethinylestradiol + Lev<strong>on</strong>orgestrel Tablet<br />
189 Ethinylestradiol + Lev<strong>on</strong>orgestrel Tablet<br />
50 micrograms + 250<br />
micrograms<br />
30 micrograms + 150<br />
micrograms<br />
Tablet 1.08 11265118 12166327<br />
Tablet 0.81 10908 8836<br />
190 Ethinylestradiol + Norethister<strong>on</strong>e Tablet 35 micrograms + 1.0 mg Tablet 1.18 8457072 9945517
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 65<br />
Strength<br />
191 Etiophylline + Theophylline Tablet 77mg + 23mg (100mg) Tablet 0.18 856455 154162<br />
192 Etiophylline + Theophylline Injecti<strong>on</strong> 1.80 80375 144675<br />
193 Etoposide Capsule 100mg Capsule 21.88 96 2100<br />
194 Etoposide Injecti<strong>on</strong> 100mg/5ml 5ml vial 52.80 468 24710<br />
195<br />
Factor IX Complex (Coagulati<strong>on</strong><br />
factors II,VII,IX X)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
Injecti<strong>on</strong> Dried 13200.00 1080 14256000<br />
196 Factor VIII C<strong>on</strong>centrate Injecti<strong>on</strong> Dried 3450.00 3528 12171600<br />
197 Fentanyl Citrate Injecti<strong>on</strong> 0.05mg/ml 2ml ampule 10.38 10584 109862<br />
198 Ferrous Fumarate Drop 5mg/ml 9.32 8050 75058<br />
199 Ferrous Sulphate Tablet<br />
200 Ferrous Sulphate + Folic Acid Tablet<br />
201 Ferrous Sulphate + Folic Acid Tablet<br />
202 Ferrous Sulphate + Folic Acid Syrup<br />
200mg equivalent to 60<br />
mg elemental ir<strong>on</strong><br />
200mg equivalent to 60<br />
mg ir<strong>on</strong> + 400 micrograms<br />
folic acid<br />
equivalent to 20 mg ir<strong>on</strong> +<br />
0.1mg folic acid<br />
equivalent to 20 mg Ir<strong>on</strong> +<br />
0.1mg Folic acid per 1ml<br />
in bottle<br />
Tablet 0.16 19687501 3071250<br />
Tablet 0.05 1545489 70474<br />
Tablet 0.08 30309782 2364163<br />
60 ml bottle 8.80 2515208 22123774
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 66<br />
Strength<br />
203 Florouracil Injecti<strong>on</strong> 250mg/5ml 5ml ampule 6.12 936 5728<br />
204 Fluc<strong>on</strong>azole Capsule 150 mg Capsule 1.18 377929 445956<br />
205 Fluc<strong>on</strong>azole Capsule 200 mg Capsule 1.56 420558 656071<br />
206 Fluc<strong>on</strong>azole Injecti<strong>on</strong> 2 mg/ml Vial 15.12 21168 320060<br />
207 Fluc<strong>on</strong>azole Oral Suspensi<strong>on</strong> 50 mg/5-ml 47.52 35280 1676506<br />
208 Fluorescein Sodium Strip NULL 0.97 9720 9448<br />
209<br />
Fluoxetine Hydrochloride (for use<br />
above 8 years <strong>of</strong> age)<br />
Tablet 20mg Tablet 0.23 24000 5472<br />
210<br />
Fluphenazine Decanoate or<br />
Enantate<br />
Injecti<strong>on</strong> 25 mg 1ml ampule 7.20 19000 136800<br />
211 Folic Acid Tablet 1mg Tablet 0.07 231025 16634<br />
212 Folic Acid Tablet 5mg Tablet 0.12 3386401 406368<br />
213 Folic Acid (Sodium salt) Injecti<strong>on</strong> 15 mg/2ml 1ml ampule 9.80 3341 32758<br />
214 Framycetin Sulphate Cream NULL 5.58 153000 853740<br />
215 Furazolid<strong>on</strong>e<br />
Tablet<br />
(Dispersible)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
100 mg Tablet 0.19 5813332 1104533<br />
216 Furazolid<strong>on</strong>e Suspensi<strong>on</strong> 100 mg/5ml 5 gms 5.16 7056 36409<br />
217 Furosemide Tablet 40mg Tablet 0.16 263724 42196<br />
218 Furosemide Tablet 20mg Tablet 0.62 737726 460341<br />
219 Furosemide Oral Soluti<strong>on</strong> 20mg/5ml 0.64 46996 29890<br />
220 Furosemide Injecti<strong>on</strong> 10 mg/ml 2ml ampule 1.34 89821 120361<br />
221 Gentamicin Sulphate Injecti<strong>on</strong> 10 mg/ml 2ml vial 2.62 124344 325285<br />
222 Gentamicin Sulphate Injecti<strong>on</strong> 40 mg/ml 2ml vial 2.95 1125070 3318958
S. No.<br />
Drug (as per<br />
EDL)<br />
223 Gentamicin Sulphate<br />
Formulati<strong>on</strong><br />
Soluti<strong>on</strong> (Eye/ Ear<br />
Drop)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 67<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
NULL 5ml 2.98 215044 640832<br />
224 Glibenclamide Tablet 2.5 mg Tablet 0.28 20639288 5696443<br />
225 Glibenclamide Tablet 5 mg Tablet 0.04 30958932 1114522<br />
226 Glimipride Tablet 1mg Tablet 0.24 20639288 4953429<br />
227 Glimipride Tablet 2mg Tablet 0.26 10319644 2683107<br />
228 Glipizide Tablet 5mg Tablet 0.10 61917863 5944115<br />
229 Glutaraldehyde Aqueous Soluti<strong>on</strong> NULL 5 lit can 173.25 26 4505<br />
230 Glycopyrrolate USP Injecti<strong>on</strong> 0.2mg/ml 1ml ampule 1.65 5000 8250<br />
231 Haloperidol Tablet 5 mg Tablet 0.15 9000 1350<br />
232 Haloperidol Injecti<strong>on</strong> 5 mg 1ml ampule 4.00 10800 43200<br />
233 Haloperidol Liquid 2mg/ml 30ml 6.77 1800 12182<br />
234 Halothane Inhalati<strong>on</strong> 500 ml 250ml bottle 1095.15 5560 6089034<br />
235 Heparin Sodium Injecti<strong>on</strong> 5000 IU/ml 1ml ampule 80.32 3096 248671<br />
236 Hepatitis B Vaccine Injecti<strong>on</strong> 20mcg 10ml Vial 96.60 221546 21401344<br />
237 Homatropine<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
NULL 5ml vial 12.24 20376 249402<br />
238 Hydrochlorothiazide Tablet (Scored) 25 mg Tablet 0.44 193874 86080<br />
239 Hydrochlorothiazide Tablet 25mg Tablet 0.92 311616 286687<br />
240 Hydrocortis<strong>on</strong>e Acetate<br />
241 Hydrocortis<strong>on</strong>e Acetate<br />
Ointment or<br />
Cream<br />
Suppository;<br />
Retenti<strong>on</strong> Enema<br />
1% (as vale rate) 15 gms tube 9.60 55460 532416<br />
25 mg 12.00 5560 66720
S. No.<br />
Drug (as per<br />
EDL)<br />
242 Hydrocortis<strong>on</strong>e Sodium Succinate<br />
Formulati<strong>on</strong><br />
powder for<br />
Injecti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 68<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
100 mg Vial 20.79 91615 1904666<br />
243 Hydrogen Peroxide Soluti<strong>on</strong> NULL 1 Lit 35.16 35837 1260024<br />
244 Hydroxocobalamin Injecti<strong>on</strong> 1 mg 1ml ampule 18.00 120586 2170541<br />
245 Hydroxyethyl Starch Injecti<strong>on</strong> NULL 500ml 150.91 5270 795241<br />
246 Hydroxyurea Capsule 500mg Capsule 2.15 11567 24845<br />
247 Hyosine Butyl Bromide Tablet 10mg Tablet 1.51 208 314<br />
248 Hyosine Butyl Bromide Injecti<strong>on</strong> 20mg/ml 4.73 208 984<br />
249 Ibupr<strong>of</strong>en Tablet 200 mg Tablet 0.47 5957600 2800072<br />
250 Ibupr<strong>of</strong>en Tablet 400 mg Tablet 0.67 3791322 2540186<br />
251 Ibupr<strong>of</strong>en Suspensi<strong>on</strong> 100mg/5ml 60ml bottle 6.96 771957 5372819<br />
252<br />
Imipenem M<strong>on</strong>ohydrate +<br />
Cilastatin Sodium<br />
Powder for<br />
Injecti<strong>on</strong><br />
250mg + 250mg Vial 382.58 8100 3098930<br />
253 Imipramine Hydrochloride Tablet 25 mg Tablet 0.75 900 675<br />
254 Insulin Injecti<strong>on</strong> (Soluble) Injecti<strong>on</strong> 40 IU/ml 10ml Vial 70.04 503397 35257926<br />
255 Insulin Injecti<strong>on</strong> (Soluble) Injecti<strong>on</strong> 100 IU/ml 10ml Vial 70.04 201359 14103184<br />
256<br />
257<br />
Intermediate-Acting Insulin (as<br />
Compound Insulin Zinc suspensi<strong>on</strong><br />
or Isophane Insulin)<br />
Intermediate-acting Insulin (as<br />
compound Insulin Zinc suspensi<strong>on</strong><br />
or Isophane Insulin)<br />
Injecti<strong>on</strong> 40 IU/ml 10ml Vial 95.40 335598 32016049<br />
Injecti<strong>on</strong> 100 IU/ml 10ml Vial 116.64 134239 15657637<br />
258 Iodine D361 Soluti<strong>on</strong> 8mg/5ml 19.20 6246 119929
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 69<br />
Strength<br />
259 Iohexol 350 mg Iodine/ml 50 ml 278.43 2600 723918<br />
260 Ir<strong>on</strong> Sucrose Injecti<strong>on</strong> 50mg<br />
33.10 5332 176477<br />
261 Ir<strong>on</strong> Sucrose Injecti<strong>on</strong> 100mg 43.68 10584 462309<br />
262 Is<strong>of</strong>lurane<br />
Inhalati<strong>on</strong><br />
(Vaporiser)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
NULL 100ml bottle 430 7240 3113200<br />
263 Is<strong>on</strong>iazid Tablet 300mg Tablet 0.37 827496 307829<br />
264 Isosorbide Dinitrate<br />
265 Isosorbide Dinitrate<br />
266 Isosorbide M<strong>on</strong>oinitrate<br />
Tablet<br />
(Sublingual)<br />
Tablet<br />
(Sublingual)<br />
Tablet<br />
(Sublingual)<br />
5 mg Tablet 1.75 1860373 3255653<br />
10 mg Tablet 1.56 292459 456236<br />
5 mg Tablet 0.30 701136 210341<br />
267 Isoxsuprine Injecti<strong>on</strong> 5mg/ml 2ml ampule 6.00 18850 113100<br />
268 Isoxsuprine Hydrochloride Tablet 40 mg Tablet 7.43 183155 1360839<br />
269 Ivermectin Tablet (Scored) 6mg Tablet 3.90 57101 222695<br />
270 Ketamine hydrochloride Injecti<strong>on</strong> 50 mg /ml in 2ml Vial 2ml Vial 6.74 23772 160223<br />
271 Labetalol Tablet 100mg Tablet 2.64 7056 18628<br />
272 Labetalol Injecti<strong>on</strong> 10mg/ml 20ml vial 146.67 7056 1034904<br />
273 Lactulose Syrup 667mg/ml 60ml bottle 47.40 151796 7195122<br />
274 Levodopa + Carbidopa Tablet 100 mg + 10 mg Tablet 0.96 77904 74788<br />
275 Lev<strong>on</strong>orgesterel Tablet 750mcg Tablet 4.20 7723 32437<br />
276 Levothyroxine Sodium Tablet 100 microgram Tablet 0.23 5577930 1271768
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 70<br />
Strength<br />
277 Lidocaine hydrochloride Injecti<strong>on</strong> NULL 30ml vial 5.60 47544 266246<br />
278 Lidocaine hydrochloride<br />
Injecti<strong>on</strong> for<br />
Spinal<br />
Anaesthesia<br />
5% to be mixed with 7.5%<br />
glucose soluti<strong>on</strong><br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
2ml ampule 7.08 142632 1009835<br />
279 Lidocaine hydrochloride Jelly (Topical) NULL 30 gms tube 10.49 4050 42476<br />
280 Lidocaine hydrochloride<br />
281<br />
Lidocaine hydrochloride +<br />
Epinephrine (adrenaline)<br />
Viscous Soluti<strong>on</strong><br />
(Topical)<br />
Injecti<strong>on</strong><br />
NULL 30 ml 7.08 3396 24044<br />
1%+ epinephrine 1:200<br />
000<br />
30 ml vial 5.99 72442 433925<br />
282 Liquid Paraffin Liquid NULL 500ml 500 ml bottle 93.45 6971 651440<br />
283 Lithium Carb<strong>on</strong>ate Tablet 300 mg Tablet 0.36 9000 3240<br />
284 Lomustine Tablet 40mg Tablet 26.40 1404 37066<br />
285 Lorazepam Tablet 2mg Tablet 0.18 17640 3175<br />
286 Lorazepam Injecti<strong>on</strong> 4mg 7.66 17640 135052<br />
287 Losartan Tablet 25mg Tablet 0.46 77904 35836<br />
288 Magnesium Sulphate Injecti<strong>on</strong> 500 mg/ml (2ml) 2ml ampule 1.94 45445 88163<br />
289 Mannitol<br />
Intravenous<br />
Injecti<strong>on</strong><br />
NULL 100ml bottle 15.10 36685 553798<br />
290 Measles Vaccine Injecti<strong>on</strong> NULL Vial 15.50 73849 1144660<br />
291 Mebendazole Tablet 100mg Tablet 0.96 130058 124855<br />
292 Mebendazole Suspensi<strong>on</strong> 100mg/5ml 30ml bottle 5.76 16518 95143<br />
293 Medroxy Progester<strong>on</strong>e Acetate Tablet 5 mg Tablet 0.67 207439 139399<br />
294 Melphalan Tablet 2mg Tablet 3.65 1404 5122
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
295 Mephenteramine Tablet 10mg Tablet 0.38 10584 4064<br />
296 Mephenteramine Injecti<strong>on</strong> 30 mg/ml 10ml Vial 7.20 10584 76205<br />
297 Mercaptopurine Tablet 50mg Tablet 3.41 2340 7975<br />
298 Metformin Hydrochloride Tablet 500 mg Tablet 0.33 61917863 20432895<br />
299 Methotrexate Injecti<strong>on</strong> 25mg/ ml 2ml vial 23.40 2340 54756<br />
300 Methotrexate Sodium Tablet 2.5mg Tablet 0.90 2340 2106<br />
301 Methyl Prednisol<strong>on</strong>e Injecti<strong>on</strong> 40mg/ml 500mg vial 56.00 29773 1667313<br />
302 Methyldopa<br />
303<br />
Methylrosanilinium Chloride<br />
(Gentian Violet)<br />
Tablet (Film<br />
Coated)<br />
Cutaneous<br />
Soluti<strong>on</strong><br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
250 mg Tablet 1.12 38952 43470<br />
NULL 100ml bottle 5.20 69080 359218<br />
304 Metoclopramide Hydrochloride Tablet 10 mg Tablet 0.08 1597715 127817<br />
305 Metoclopramide Hydrochloride Injecti<strong>on</strong> 5 mg/ml 2ml ampule 1.60 198960 318336<br />
306 Metoprolol Tablet 25mg Tablet 0.80 1288015 1035564<br />
307 Metoprolol Tablet 50 mg Tablet 0.37 111556 41499<br />
308 Metoprolol Injecti<strong>on</strong> 1mg/ml 5ml ampule 13.33 18860 251408<br />
309 Metr<strong>on</strong>idazole Tablet 200mg Tablet 0.19 1045549 200745<br />
310 Metr<strong>on</strong>idazole Tablet 400mg Tablet 0.55 6522985 3587642<br />
311 Metr<strong>on</strong>idazole<br />
Infusi<strong>on</strong>/<br />
Injecti<strong>on</strong><br />
500 mg 100ml bottle 4.49 452334 2030075<br />
312 Metr<strong>on</strong>idazole Benzoate Oral Suspensi<strong>on</strong> 200 mg/5 ml 60ml bottle 5.87 436472 2561216<br />
313 Mic<strong>on</strong>azole<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
1% 10ml 4.38 13955 61122
S. No.<br />
Drug (as per<br />
EDL)<br />
314 Mic<strong>on</strong>azole Nitrate<br />
Formulati<strong>on</strong><br />
Ointment or<br />
Cream<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 72<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
2% 15gms tube 4.78 666417 3185473<br />
315 Midazolam Injecti<strong>on</strong> (1mg/ml. ) 5ml vial 8.87 2300 20396<br />
316 Misoprostol Tablet 100mcg Tablet 2.34 792680 1854870<br />
317 Misoprostol Tablet 200mcg Tablet 4.18 234813 981516<br />
318 Mitomycin Capsule 10mg Capsule 75.96 60 4558<br />
319 Mitoxantr<strong>on</strong>e Injecti<strong>on</strong> 20mg 10ml Vial 317.65 1872 594645<br />
320 MMR (Live Vaccine) Injecti<strong>on</strong> NULL<br />
18.00 73849 1329282<br />
321<br />
Morphine (Sulphate or<br />
hydrochloride)<br />
Injecti<strong>on</strong> 10 mg/ml 1ml ampule 8.40 363 3049<br />
322<br />
Multivitamin (B1,B2,B6,<br />
Niacinamide, Pantothenate, Folic<br />
Acid, Ascorbic Acid, Biotin)<br />
Tablet/ Capsule<br />
10mg + 10mg + 3mg +<br />
100mg + 50mg + 1.5mg +<br />
150mg + 100mcg<br />
Tablet 1.32 16984659 22419750<br />
323 Nalox<strong>on</strong>e hydrochloride Injecti<strong>on</strong> 400 micrograms/ml 1ml ampule 11.60 1764 20462<br />
324<br />
Neomycin Sulphate + Bacitracin<br />
Zinc<br />
Ointment 5 mg + 500 IU/gm 15gms tube 13.87 954700 13241682<br />
325 Neostigmine Metilsulfate Injecti<strong>on</strong> 500 micrograms 1ml ampule 2.67 31514 84141<br />
326 Neostigmine Metilsulfate Injecti<strong>on</strong> 2.5 mg 5ml ampule 2.05 44148 90592<br />
327 Nevirapine Tablet 200mg Tablet 4.69 1109800 5207182<br />
328 Nevirapine Oral Suspensi<strong>on</strong> 50mg/5ml 100ml A 29.15 100000 2914800<br />
329 Niacinamide Tablet 50mg Tablet 0.03 21168 593<br />
330 Nifedipine Capsule 5 mg Capsule 0.30 140227 42068
S. No.<br />
331 Nifedipine<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
Tablet (Sustained<br />
Released)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 73<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
(10mg) Tablet 0.13 155808 20567<br />
332 Nitro Glycerine Injecti<strong>on</strong> 25mg (5ml Amp) 12.60 2249 28343<br />
333 Nitr<strong>of</strong>urantoin Tablet 100 mg Tablet 0.38 155808 59207<br />
334 Nitr<strong>of</strong>urantoin Syrup 100mg/5ml 60ml bottle 6.34 233712 1481734<br />
335 Nor adrenaline Injecti<strong>on</strong> 4mg/2ml 2ml ampule 15.56 92966 1446543<br />
336 Norethister<strong>on</strong>e Tablet 5mg Tablet 0.65 237175 154164<br />
337 Norfloxacine Tablet 400mg Tablet 1.24 3595114 4457941<br />
338 Nystatin Oral Soluti<strong>on</strong> 50mg/5ml (100000 IU/ml) 78.00 1072 83616<br />
339 Nystatin Tablet 10000 IU Tablet 3.25 2600 8455<br />
340 Ofloxacin Tablet 200mg Tablet 0.88 2040333 1795493<br />
341 Ofloxacin Tablet 400mg Tablet 1.71 1364785 2333783<br />
342 Ofloxacin<br />
Eye drops<br />
soluti<strong>on</strong><br />
NULL 5 ml 2.98 298845 890559<br />
343 Olanzapine Tablet 5mg Tablet 0.60 12000 7200<br />
344 Olanzapine Tablet 10 mg Tablet 1.68 7187 12073<br />
345 Omeprazole Tablet 20mg Tablet 0.34 4179376 1420988<br />
346 Omeprazole Tablet 40mg Tablet 1.19 2393254 2843186<br />
347 Ondansetr<strong>on</strong> Injecti<strong>on</strong> 2mg/ml 2ml ampule 2.00 25242 50483<br />
348 Ondansetr<strong>on</strong> Syrup 2mg/5ml 30ml 4.55 15523 70632<br />
349 Ondansetr<strong>on</strong> Tablet 4mg Tablet 0.44 4050 1782
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
350 Oral Rehydrati<strong>on</strong> Salts Powder Sachet<br />
351<br />
Oral Rehydrati<strong>on</strong> Salts (for Glucoseelectrolyte<br />
soluti<strong>on</strong>)<br />
Powder Sachet<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 74<br />
Strength<br />
(Low osmolarity<br />
245mmol/l) 4.1 g/200ml;<br />
Comp<strong>on</strong>ents to<br />
rec<strong>on</strong>stitute 200 ml <strong>of</strong><br />
Glucose-electrolyte<br />
soluti<strong>on</strong>: Glucose: 2.7 g;<br />
Sodium Chloride: 0.52 g;<br />
Potassium Chloride: 0.3g;<br />
Trisodium Citrate<br />
Dehydrate*: 0.58 g<br />
20.5 g/l; Comp<strong>on</strong>ents to<br />
rec<strong>on</strong>stitute 1 litre <strong>of</strong><br />
Glucose-electrolyte<br />
soluti<strong>on</strong>: Glucose: 13.5<br />
g/L; Sodium Chloride: 2.6<br />
g/L; Potassium Chloride:<br />
1.5 g/L; Trisodium Citrate<br />
dehydrate*: 2.9 g/L<br />
Unit<br />
1<br />
sachet(200ml)<br />
1 sachet(1<br />
litre)<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
1.90 2922136 5540370<br />
1.94 421393 817502<br />
352 Oseltamivir Capsule 45 mg Capsule 10.78 3500 2873708<br />
353 Oseltamivir Oral Powder 12 mg/ml 25ml bottle 48.00 90 4320<br />
354 Oxygen Inhalati<strong>on</strong> Cylinder cylinder 117.60 98459 11578778<br />
355 Oxytocin Injecti<strong>on</strong> 10 IU 1ml ampule 2.10 117246 246216<br />
356 Pancur<strong>on</strong>ium Injecti<strong>on</strong> 2mg/ml 10ml Vial 0.24 142040 34090
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 75<br />
Strength<br />
357 Paracetamol Tablet 500 mg Tablet 0.26 19113754 4969576<br />
358 Paracetamol Syrup 125 mg/5ml 60ml bottle 5.69 605357 3444480<br />
359 Paracetamol Suppository 250mg 4.00 2000 7992<br />
360 Pentazocine Injecti<strong>on</strong> 30mg/ml 3.05 115428 352056<br />
361 Pentazocine Tablet 25mg Tablet 0.65 82355 53366<br />
362 Pentoprozole Injecti<strong>on</strong> 40mg 1ml ampule 12.24 454184 5559215<br />
363 Pentoprozole Tablet 40mg Tablet 0.63 4215133 2655534<br />
364 Pethidine Injecti<strong>on</strong> 50mg/ml 1ml ampule 4.32 9702 41912<br />
365 Phenobarbit<strong>on</strong>e Tablet 60mg Tablet 0.07 156096 11239<br />
366 Phenobarbit<strong>on</strong>e Syrup 20mg/5ml 60ml bottle 11.88 7056 83825<br />
367 Phenobarbit<strong>on</strong>e Injecti<strong>on</strong> 200mg/ml 1ml ampule 6.12 3401 20816<br />
368 Phenol Liquid 5 lt can 23.52 5541 130328<br />
369 Phenylephrine Injecti<strong>on</strong> 35.00 5260 184100<br />
370 Phenylephrine<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
4 PC 5 ml 24.50 4075 99859<br />
371 Phenytoin Sodium Tablet 100 mg Tablet 0.31 1164100 360871<br />
372 Phenytoin Sodium Injecti<strong>on</strong> 50 mg/ml 5ml vial 3.89 12672 49296<br />
373 Phytomenadi<strong>on</strong>e Injecti<strong>on</strong> 10 mg/ml 5ml ampule 2.22 35280 78322<br />
374 Phytomenadi<strong>on</strong>e Tablet 10 mg Tablet 3.43 15833 54340<br />
375<br />
Pilocarpine Hydrochloride or<br />
Nitrate<br />
376 Piperacillin + Tazobactum<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
Powder for<br />
Injecti<strong>on</strong><br />
2 PC 5ml 27.30 6041 164927<br />
4gm+500mg Vial 72.91 89278 6509292
S. No.<br />
Drug (as per<br />
EDL)<br />
377 Podophyllum Resin<br />
Formulati<strong>on</strong><br />
Cutaneous<br />
Soluti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 76<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
10 –2% 250.00 100 25000<br />
378 Poliomyelitis Vaccine Oral Drop NULL 15.57 314158 4891440<br />
379 Polyvalent Snake Antivenom Serum Injecti<strong>on</strong> 10ml Vial 190.00 13811 2624057<br />
380 Potassium Chloride Injecti<strong>on</strong><br />
11.2% (equivalent to K+<br />
1.5 mmol/ml, Cl- 1.5<br />
mmol/ml)<br />
20ML AMPULE 5.33 10040 53513<br />
381 Potassium Iodide Tablet 60 mg Tablet 4.80 2000 9600<br />
382 Povid<strong>on</strong>e Iodine Ointment/ Drop NULL 5.58 35130 196028<br />
383 Povid<strong>on</strong>e Iodine Soluti<strong>on</strong> NULL 500ML 30.43 17949 546187<br />
384 Povid<strong>on</strong>e Iodine Ointment NULL 10gm tube 6.71 469595 3150982<br />
385 Povid<strong>on</strong>e Iodine Vaginal Passaries 200mg 0.62 1500 930<br />
386 Pralidoxime Injecti<strong>on</strong> 25mg/ml 20ml vial 47.25 17640 833490<br />
387 Prednisol<strong>on</strong>e Tablet 10mg Tablet 0.48 894649 429432<br />
388 Prednisol<strong>on</strong>e Tablet 20mg Tablet 0.70 42336 29466<br />
389 Prednisol<strong>on</strong>e Liquid 5mg/5ml 120ml bottle 8.52 7056 60117<br />
390 Prednisol<strong>on</strong>e Sodium Phosphate<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
NULL 5ml 21.90 38880 851472<br />
391 Primaquine Diphosphate Tablet 7.5 mg Tablet 0.26 2224057 587151<br />
392 Primaquine Diphosphate Tablet 15 mg Tablet 0.60 382690 229614<br />
393 Procarbazine Capsule 50mg Capsule 17.64 1872 33022<br />
394 Prochlorperazine Tablet 25 mg Tablet 1.40 11500 16100<br />
395 Promethazine Hydrochloride Injecti<strong>on</strong> 25 mg/ml 2ml ampule 1.94 11084 21502
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
396 Promethazine Hydrochloride Syrup 5 mg/5 ml 60ml bottle 6.77 164190 1111566<br />
397 Prop<strong>of</strong>ol Injecti<strong>on</strong> NULL 10ml vial 31.25 22680 708750<br />
398 Propranolol Tablet 10 mg Tablet 0.20 1432759 280821<br />
399 Propranolol Tablet 40 mg Tablet 0.14 155808 21813<br />
400 Propyl Thiouracil Tablet 100 mg Tablet 1.44 35280 50803<br />
401 Protamine Sulphate Injecti<strong>on</strong> 10 mg/ml 5ml ampule 28.08 35280 990662<br />
402 Pyrazinamide Tablet 500 mg Tablet 0.73 59409 43488<br />
403 Pyrazinamide Tablet 750 mg Tablet 1.10 41305 45601<br />
404 Pyridoxine Hydrochloride (Vit B6) Tablet 25 mg Tablet 0.02 84900 1698<br />
405 Quinine (bisulphate or sulphate) Tablet 300 mg Tablet 2.70 79420 214434<br />
406 Quinine (bisulphate or sulphate) Oral Soluti<strong>on</strong> 150mg/5ml 60ml bottle 48.54 59741 2899850<br />
407 Quinine Dihydrochloride Injecti<strong>on</strong> 300 mg/ml 2ml ampule 11.50 43895 504793<br />
408 Rabies Immunoglobulin Human Injecti<strong>on</strong> 300 /1500 IU vial 208.80 23504 4907622<br />
409 Ranitidine Tablet 150 mg Tablet 0.32 7736326 2475624<br />
410 Ranitidine Injecti<strong>on</strong> 50mg/ 2ml 2ml ampule 1.60 1147198 1835517<br />
411 Rapid Diagnostic Kit NVBDCP Supply NULL 6.77 115600 782612<br />
412 Rib<strong>of</strong>lavin (Vit B2) Tablet 5mg Tablet 0.96 159000 152640<br />
413 Rifampicin Tablet or Capsule 600 mg Tablet 2.53 2842980 7198425<br />
414 Risperid<strong>on</strong>e Tablet 3mg Tablet 0.50 9000 4500<br />
415 Salbutamol Sulphate Tablet 4 mg Tablet 0.15 671221 100683<br />
416 Salbutamol Sulphate Tablet 2 mg Tablet 0.90 172870 155583<br />
417 Salbutamol Sulphate Syrup 2 mg/5 ml 100ml 6.94 789495 5479098<br />
418 Salbutamol Sulphate Injecti<strong>on</strong> 50 micrograms/ml 5ml ampule 0.72 40676 29287<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items
S. No.<br />
Drug (as per<br />
EDL)<br />
419 Salbutamol Sulphate<br />
Formulati<strong>on</strong><br />
Respirator<br />
Soluti<strong>on</strong> for use<br />
in Nebulizers<br />
420 Salbutamol Sulphate MDI (CFC <strong>free</strong>)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 78<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
5 mg/ml 15ml 7.61 737597 5613117<br />
100mcg/dose in 200<br />
doses<br />
200mdi 64.20 581162 37310601<br />
421 Salbutamol Sulphate Capsule (Rotacap) 200mcg capsule 0.08 872488 73289<br />
422 Salbutamol Sulphate<br />
Respirator<br />
Soluti<strong>on</strong> for use<br />
in Nebulizers<br />
5 mg/ml 10ml vial 8.12 727037 5906445<br />
423 Salicylic Acid Topical Soluti<strong>on</strong> NULL 10.80 5750 62100<br />
424 Salmeterol + Fluiticas<strong>on</strong>e Inhaler 25mcg + 125mcg/ dose 120 dose 254.40 8100 2060640<br />
425 Sertraline Tablet 50mg Tablet 0.38 24300 9331<br />
426 Sev<strong>of</strong>lurane<br />
427 Silver Nitrate<br />
Inhalati<strong>on</strong><br />
(Vaporiser)<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
250 ml bottle 250 ml bottle 3500.00 5574 19509000<br />
NULL 5ml 24.96 208 5192<br />
428 Silver Nitrate Loti<strong>on</strong> NULL 15gms tube 13.20 100 1320<br />
429 Silver Sulfadiazine Cream 1% w/w 5gm tube 20.69 61719 1276966<br />
430 Sodium bi Carb<strong>on</strong>ate<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
1.4% Isot<strong>on</strong>ic (equivalent<br />
to Na+ 167 mmol/l, HCO3-<br />
167 mmol/l) 10ml<br />
10ml ampule 3.28 49661 162888
S. No.<br />
431<br />
Drug (as per<br />
EDL)<br />
Sodium bi Carb<strong>on</strong>ate Glycerine<br />
(Soda Bocarb Glycerine)<br />
432 Sodium Chloride<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 79<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
Ear Drop NULL 5ml 6.00 77616 465696<br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
0.9% Isot<strong>on</strong>ic (equivalent<br />
to Na+ 154 mmol/l, Cl-<br />
154 mmol/l (500ml)<br />
500ml 7.49 222936 1669343<br />
433 Sodium Chloride + Dextrose 500 ml 500ml 6.87 129360 888703<br />
434 Sodium Hypochlorite<br />
435<br />
Sodium Lactate, Compound<br />
Soluti<strong>on</strong> (Ringer Lactate Soluti<strong>on</strong>)<br />
Powder for<br />
Soluti<strong>on</strong><br />
Injectable<br />
Soluti<strong>on</strong><br />
(Intravenous<br />
Fluid)<br />
NULL<br />
9.00 103488 931392<br />
Each 100ml c<strong>on</strong>tains 500ml 9.24 571352 5279289<br />
436 Spir<strong>on</strong>olact<strong>on</strong>e Tablet 25 mg Tablet 0.60 99598 59759<br />
437 Spir<strong>on</strong>olact<strong>on</strong>e Tablet 100mg Tablet 1.62 242239 392428<br />
438 Streptokinase Injecti<strong>on</strong> 15,00,000 IU vial 450.00 2150 967500<br />
439 Streptomycin Sulphate<br />
Powder for<br />
Injecti<strong>on</strong><br />
1 g vial 6.72 5260 35347<br />
440 Sulfadoxine + Pyrimethamine Tablet 500mg+ 25mg Tablet 2.12 23200 49277<br />
441 Sulfasalazine Tablet 500 mg Tablet 2.16 31162 67309<br />
442 Sulphacetamide Sodium<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
NULL 10ml 6.68 364140 2433911<br />
443 Sulphamethoxazole + Trimethoprim Tablet 200 mg + 40 mg Tablet 0.32 2434041 778893<br />
444 Sulphamethoxazole + Trimethoprim Tablet 400 mg + 80 mg Tablet 0.74 5038037 3728148
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
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Strength<br />
445 Sulphamethoxazole + Trimethoprim Oral Suspensi<strong>on</strong> 200 mg + 40 mg/5 ml 60ml bottle 14.40 596766 8593429<br />
446 Surgical Spirit Soluti<strong>on</strong> NULL 500ml 41.47 35677 1479607<br />
447<br />
Suxameth<strong>on</strong>ium Chloride<br />
(Succinylchloline)<br />
Powder for<br />
Injecti<strong>on</strong><br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
50 mg/ml vial 9.96 41400 412344<br />
448 Synthetic pyrethroid (MT) Soluti<strong>on</strong> As per NVBDCP Supply 0.00 574 578000<br />
449 Terbutaline Tablet 2.5mg Tablet 0.20 72468 14783<br />
450 Terbutaline Injecti<strong>on</strong> 0.5mg/ml 1ml ampule 11.33 3528 39972<br />
451 Tetanus Vaccine (Tetanus Toxoid) Injecti<strong>on</strong> NULL 5ml ampule 17.10 1037400 17739540<br />
452 Tetracaine Hydrochloride Soluti<strong>on</strong> NULL 10.92 1944 21228<br />
453 Tetracycline Hydrochloride Ointment (Eye) NULL 5gms tube 14.40 886 12758<br />
454 Thiamine Hydrochloride (Vit B1) Injecti<strong>on</strong> 50mg 10ml 1.31 5000 6540<br />
455 Thiopent<strong>on</strong>e sodium Injecti<strong>on</strong> 0.5 g ampule 17.56 64800 1137629<br />
456 Thiopent<strong>on</strong>e sodium Injecti<strong>on</strong> 1.0 g ampule 22.89 77720 1779011<br />
457 Timolol Maleate<br />
Soluti<strong>on</strong> (Eye<br />
Drop)<br />
NULL 5ml 5.16 29160 150466<br />
458 Tinidazole Tablet 500mg Tablet 0.60 700353 420212<br />
459 Tinidazole Tablet 1gm Tablet 2.76 101275 279519<br />
460 Tobramycine<br />
Eye drops<br />
soluti<strong>on</strong><br />
NULL 5ml 4.59 38880 178459<br />
461 Tranexamic Acid Tablet 500mg Tablet 2.01 12150 24422<br />
462 Tranexamic Acid Injecti<strong>on</strong> 500mg/5ml ampule 32.40 12039 390051<br />
463 Trihexyphenidyl Hydrochloride Tablet 2 mg Tablet 0.19 3493 671
S. No.<br />
464 Tropicamide<br />
465<br />
Drug (as per<br />
EDL)<br />
Tuberculin, Purified Protein<br />
Derivative (PPD)<br />
466 Valproic Acid (Sodium Salt)<br />
467 Valproic acid (Sodium salt)<br />
468 Vancomycin Hydrochloride<br />
469 Vecur<strong>on</strong>ium<br />
Formulati<strong>on</strong><br />
Eye Drops<br />
Soluti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 81<br />
Strength<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
NULL 5ml 27.60 40752 1124755<br />
Injecti<strong>on</strong> NULL vial 66.00 8490 560340<br />
Tablet (C<strong>on</strong>trol<br />
Release)<br />
Liquid Oral<br />
Soluti<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
Powder for<br />
Injecti<strong>on</strong><br />
200mg Tablet 0.15 54336 8150<br />
200mg/5ml vial 8.40 35712 299981<br />
500mg vial 61.58 363 22354<br />
20mg vial 36.96 8400 310464<br />
470 Verapamil Hydrochloride Tablet 40 mg Tablet 0.40 7056 2794<br />
471 Verapamil Hydrochloride Injecti<strong>on</strong> 2.5 mg/ml 2ml ampule 5.87 7056 41405<br />
472 Vinblastine Injecti<strong>on</strong> 10mg vial 154.80 5616 869357<br />
473 Vincristine Injecti<strong>on</strong> 1 mg vial 27.41 4680 128269<br />
474 Vitamin A Palmitate Capsule 25000 IU Capsule 1.35 2387940 3223718<br />
475<br />
Vitamin A Palmitate (as per NRHM<br />
supply)<br />
Oral Oily Soluti<strong>on</strong><br />
(100ml)<br />
100 000 IU/ml<br />
multidose<br />
dispenser<br />
56.00 104776 5867456<br />
476 Vitamin B12 (Cyanocobalamin) Injecti<strong>on</strong> 500mcg/ml ampule 1.10 73060 80658<br />
477 Vitamin D3 Granules 1gm sachet 3.87 1510830 5846913<br />
478 Vitamin K Injecti<strong>on</strong> 1mg/ml ampule 13.33 25337 337743<br />
479 Warfarin Sodium Tablet (Score) 5 mg Tablet 0.96 36792 35320<br />
480 Water for injecti<strong>on</strong> Injecti<strong>on</strong> NULL (10ml) ampule 0.82 131500 107830
S. No.<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
481 Xylometazoline Nasal Drop<br />
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Strength<br />
0.05% Not in children less<br />
than 3 m<strong>on</strong>th<br />
Unit<br />
Unit Price<br />
Total Demand<br />
<strong>of</strong> State<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Total Amount<br />
per Items<br />
10ml 11.21 998607 11192391<br />
482 Zidovudine Capsule 300 mg Capsule 10.80 1131500 12220200<br />
483 Zidovudine Oral Liquid 50 mg/5 ml 100ml bottle 21.60 10000 216000<br />
484 Zidovudine<br />
485 Zinc Sulphate<br />
IV or Infusi<strong>on</strong><br />
Injecti<strong>on</strong><br />
Dispersible Tablet<br />
(Scored)<br />
10mg/ml 20ml vial 24.00 9000 216000<br />
20mg Tablet 0.11 606583 66724
Sl #<br />
Drug (as per<br />
EDL)<br />
Annexure 2 - ABC Analysis <strong>of</strong> Itemised List <strong>of</strong> <strong>Drugs</strong><br />
Formulati<strong>on</strong><br />
1 Albumin Injecti<strong>on</strong> 20% in 50ml 43394400 3.9 0.2 A<br />
2 Cloxacillin Sodium Powder for Injecti<strong>on</strong> 500 mg in vial 83234125 7.4 0.4 A<br />
3 Salbutamol Sulphate MDI (CFC <strong>free</strong>) 100mcg/dose in 200 doses 120544726 10.8 0.6 A<br />
4 Insulin Injecti<strong>on</strong> (Soluble) Injecti<strong>on</strong> 40 IU/ml 155802652 13.9 0.8 A<br />
5<br />
6<br />
Intermediate-Acting Insulin (as<br />
Compound Insulin Zinc suspensi<strong>on</strong> or<br />
Isophane Insulin)<br />
Multivitamin (B1,B2,B6, Niacinamide,<br />
Pantothenate, Folic Acid, Ascorbic<br />
Acid, Biotin)<br />
7 Ferrous Sulphate + Folic Acid Syrup<br />
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Strength<br />
Injecti<strong>on</strong> 40 IU/ml 187818701 16.8 1.0 A<br />
Tablet/ Capsule<br />
10mg + 10mg + 3mg + 100mg<br />
+ 50mg + 1.5mg + 150mg +<br />
100mcg<br />
equivalent to 20 mg Ir<strong>on</strong> +<br />
0.1mg Folic acid per 1ml in<br />
bottle<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
210238451 18.8 1.2 A<br />
232362225 20.7 1.4 A<br />
8 Hepatitis B Vaccine Injecti<strong>on</strong> 20mcg 253763569 22.6 1.6 A<br />
9 Amoxicillin + Clavulanic acid Injecti<strong>on</strong> 500mg + 100mg (600mg) 274861380 24.5 1.9 A<br />
10 Metformin Hydrochloride Tablet 500 mg 295294274 26.3 2.1 A
Sl #<br />
11 Sev<strong>of</strong>lurane<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
Inhalati<strong>on</strong><br />
(Vaporiser)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 84<br />
Strength<br />
Cum A<br />
250 ml bottle 314803274 28.1 2.3 A<br />
12 Tetanus Vaccine (Tetanus Toxoid) Injecti<strong>on</strong> NULL 332542814 29.7 2.5 A<br />
13 Bromhexine Hydrochloride Syrup 4mg/5ml 349561763 31.2 2.7 A<br />
14 Digoxin Oral Soluti<strong>on</strong> 50 mcg/ml 366302978 32.7 2.9 A<br />
15<br />
Intermediate-acting Insulin (as<br />
compound Insulin Zinc suspensi<strong>on</strong> or<br />
Isophane Insulin)<br />
Injecti<strong>on</strong> 100 IU/ml 381960615 34.1 3.1 A<br />
16 Amoxicillin + Clavulanic acid Injecti<strong>on</strong> 1gm + 200mg (1.2 gm) 396817789 35.4 3.3 A<br />
17<br />
18<br />
Cefalexin (Powder for rec<strong>on</strong>stituti<strong>on</strong><br />
with water)<br />
Factor IX Complex (Coagulati<strong>on</strong><br />
factors II,VII,IX X)<br />
Oral Soluti<strong>on</strong> 125mg/5ml 411095817 36.7 3.5 A<br />
Injecti<strong>on</strong> Dried 425351817 37.9 3.7 A<br />
19 Insulin Injecti<strong>on</strong> (Soluble) Injecti<strong>on</strong> 100 IU/ml 439455002 39.2 3.9 A<br />
20 Dextrose with Sodium Chloride<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
5% Dextrose, 0.18% Sodium<br />
chloride (equivalent to Na+ 30<br />
mmol/l, Cl- 30 mmol/l)<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
453527498 40.5 4.1 A<br />
21 Neomycin Sulphate + Bacitracin Zinc Ointment 5 mg + 500 IU/gm 466769180 41.6 4.3 A<br />
22 Zidovudine Capsule 300 mg 478989380 42.7 4.5 A<br />
23 Factor VIII C<strong>on</strong>centrate Injecti<strong>on</strong> Dried 491160980 43.8 4.7 A
Sl #<br />
Drug (as per<br />
EDL)<br />
24 Ethinylestradiol + Lev<strong>on</strong>orgestrel Tablet<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 85<br />
Strength<br />
50 micrograms + 250<br />
micrograms<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
503327308 44.9 4.9 A<br />
25 Amoxicillin + Clavulanic acid Injecti<strong>on</strong> 250mg +50mg (300mg) 515062458 46.0 5.2 A<br />
26 Oxygen Inhalati<strong>on</strong> Cylinder 526641237 47.0 5.4 A<br />
27 Xylometazoline Nasal Drop<br />
0.05% Not in children less<br />
than 3 m<strong>on</strong>th<br />
537833627 48.0 5.6 A<br />
28 Ethinylestradiol + Norethister<strong>on</strong>e Tablet 35 micrograms + 1.0 mg 547779144 48.9 5.8 A<br />
29 Benzyl Benzoate 25% Loti<strong>on</strong> or Cream 25% 557323676 49.7 6.0 A<br />
30 Sulphamethoxazole + Trimethoprim Oral Suspensi<strong>on</strong> 200 mg + 40 mg/5 ml 565917105 50.5 6.2 A<br />
31 Diethyl carbamazine citrate Tablet 100mg 574345369 51.2 6.4 A<br />
32 Rifampicin Tablet or Capsule 600 mg 581543795 51.9 6.6 A<br />
33 Lactulose Syrup 667mg/ml 588738917 52.5 6.8 A<br />
34 Cipr<strong>of</strong>loxacin Hydrochloride Tablet 500 mg 595738529 53.2 7.0 A<br />
35<br />
Cefalexin (Powder for rec<strong>on</strong>stituti<strong>on</strong><br />
with water)<br />
36 Dextrose<br />
Oral Soluti<strong>on</strong> 250mg/5ml 602692703 53.8 7.2 A<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
5%<br />
500ml 609390556 54.4 7.4 A
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
37 Piperacillin + Tazobactum Powder for Injecti<strong>on</strong> 4gm+500mg 615899849 54.9 7.6 A<br />
38 Dicl<strong>of</strong>enac sodium Gel 1% w/v 622406296 55.5 7.8 A<br />
39 Dextrose<br />
40<br />
41<br />
Electrolyte G (Multi-Electrolyte with<br />
5% Dextrose IV Injecti<strong>on</strong> Type III USP)<br />
Electrolyte P (Multi-Electrolyte with<br />
5% Dextrose IV Injecti<strong>on</strong> Type I IP)<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 86<br />
Strength<br />
Cum A<br />
10% Isot<strong>on</strong>ic 500 ml 628888285 56.1 8.0 A<br />
Each 100ml C<strong>on</strong>tains:<br />
Anhydrous Dextrose 5gm;<br />
Sodium Chloride 0.37gm;<br />
Potassium Chloride 0.13gm;<br />
Amm<strong>on</strong>ium Chloride 0.37gm;<br />
Sodium Sulphite 15mg<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
635238365 56.7 8.2 A<br />
Each 100ml c<strong>on</strong>tains: 641448579 57.2 8.5 A<br />
42 Halothane Inhalati<strong>on</strong> 500 ml 647537613 57.8 8.7 A<br />
43 Chlorpheniramine (hydrogen maleate) Oral Soluti<strong>on</strong> Syrup 2mg/5ml 653605933 58.3 8.9 A<br />
44 Dexamethas<strong>on</strong>e Phosphate Disodium Injecti<strong>on</strong> 4 mg/ml 659615788 58.8 9.1 A<br />
45 Glipizide Tablet 5mg 665559903 59.4 9.3 A
Sl #<br />
Drug (as per<br />
EDL)<br />
46 Salbutamol Sulphate<br />
47<br />
Vitamin A Palmitate (as per NRHM<br />
supply)<br />
Formulati<strong>on</strong><br />
Respirator Soluti<strong>on</strong><br />
for use in Nebulizers<br />
Oral Oily Soluti<strong>on</strong><br />
(100ml)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 87<br />
Strength<br />
Cum A<br />
5 mg/ml 671466347 59.9 9.5 A<br />
100 000 IU/ml 677333803 60.4 9.7 A<br />
48 Vitamin D3 Granules 1gm 683180716 61.0 9.9 A<br />
49 Amoxicillin + Clavulanic acid Suspensi<strong>on</strong><br />
250mg + 62.5mg<br />
(312mg)/5ml<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
689022115 61.5 10.1 B<br />
50 Amoxicillin + Clavulanic acid Tablet 250mg + 125mg (375mg) 694849864 62.0 10.3 B<br />
51<br />
52<br />
Electrolyte M (Multi-Electrolyte with<br />
5% Dextrose IV Injecti<strong>on</strong> Type III IP)<br />
Chloroquine (as phosphate or<br />
sulphate)<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
Each 100ml C<strong>on</strong>tains:<br />
Anhydrous Dextrose 5 g;<br />
Sodium Acetate Trihydrate<br />
0.28 g<br />
700622973 62.5 10.5 B<br />
Tablet 150 mg base 706350090 63.0 10.7 B<br />
53 Glibenclamide Tablet 2.5 mg 712046533 63.5 10.9 B<br />
54 Ampicillin Sodium Tablet 250mg 717700982 64.0 11.1 B<br />
55 Salbutamol Sulphate<br />
Respirator Soluti<strong>on</strong><br />
for use in Nebulizers<br />
5 mg/ml 723314099 64.5 11.3 B<br />
56 Chlorpheniramine (hydrogen maleate) Tablet 4 mg 728915355 65.0 11.5 B
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
57 DDT Powder As per NVBDCP Supply 734515355 65.5 11.8 B<br />
58 Pentoprozole Injecti<strong>on</strong> 40mg 740074570 66.0 12.0 B<br />
59 Oral Rehydrati<strong>on</strong> Salts Powder Sachet<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 88<br />
Strength<br />
(Low osmolarity 245mmol/l)<br />
4.1 g/200ml; Comp<strong>on</strong>ents to<br />
rec<strong>on</strong>stitute 200 ml <strong>of</strong><br />
Glucose-electrolyte soluti<strong>on</strong>:<br />
Glucose: 2.7 g; Sodium<br />
Chloride: 0.52 g; Potassium<br />
Chloride: 0.3g; Trisodium<br />
Citrate Dehydrate*: 0.58 g<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
745614940 66.5 12.2 B<br />
60 Salbutamol Sulphate Syrup 2 mg/5 ml 751094038 67.0 12.4 B<br />
61 Ibupr<strong>of</strong>en Suspensi<strong>on</strong> 100mg/5ml 756466856 67.5 12.6 B<br />
62 Calcium Gluc<strong>on</strong>ate Injecti<strong>on</strong> 100 mg/ml in 10-ml ampoule 761833044 68.0 12.8 B<br />
63 Cefalexin Tablet or Capsule 250mg 767176072 68.4 13.0 B<br />
64<br />
Sodium Lactate, Compound Soluti<strong>on</strong><br />
(Ringer Lactate Soluti<strong>on</strong>)<br />
65 Cloxacillin Sodium<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
Powder for Oral<br />
Soluti<strong>on</strong><br />
Each 100ml c<strong>on</strong>tains 772455360 68.9 13.2 B<br />
125 mg/5 ml 777688623 69.4 13.4 B<br />
66 Nevirapine Tablet 200mg 782895804 69.8 13.6 B
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
67 Deltamethrin Soluti<strong>on</strong> As per NVBDCP Supply 787895804 70.3 13.8 B<br />
68 Carboplatin (15ml) Injecti<strong>on</strong> (15ml) 50mg/5ml 792876117 70.7 14.0 B<br />
69 Paracetamol Tablet 500 mg 797845693 71.2 14.2 B<br />
70 Glimipride Tablet 1mg 802799122 71.6 14.4 B<br />
71 Rabies Immunoglobulin Human Injecti<strong>on</strong> 300 /1500 IU 807706744 72.1 14.6 B<br />
72 Poliomyelitis Vaccine Oral Drop NULL 812598184 72.5 14.8 B<br />
73<br />
74<br />
Chloroquine (as hydrochloride,<br />
phosphate or sulphate)<br />
Diphtheria,Pertussis and Tetanus<br />
combined (DPT) vaccine<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 89<br />
Strength<br />
Injecti<strong>on</strong> 40 mg/ml 817322867 72.9 15.1 B<br />
Injecti<strong>on</strong> NULL 822035237 73.3 15.3 B<br />
75 Amoxicillin anhydrous Tablet or Capsule 500 mg 826624088 73.7 15.5 B<br />
76 Norfloxacine Tablet 400mg 831082029 74.1 15.7 B<br />
77 Calcium Salts Tablet<br />
78 Amoxicillin + Clavulanic acid Suspensi<strong>on</strong><br />
79 Dextrose with Sodium Chloride<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
(as elemental<br />
calcium)(300mg)<br />
125mg + 31.25mg<br />
(156mg)/5ml<br />
5% Dextrose, 0.9% Sodium<br />
chloride<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
835409428 74.5 15.9 B<br />
839618161 74.9 16.1 B<br />
843602701 75.3 16.3 B<br />
80 Sulphamethoxazole + Trimethoprim Tablet 400 mg + 80 mg 847330849 75.6 16.5 B<br />
81 Ethambutol Hydrochloride Tablet 800 mg 851056901 75.9 16.7 B
Sl #<br />
82<br />
Drug (as per<br />
EDL)<br />
Aluminium Hydroxide+ Magnesium<br />
Hydroxide + Active<br />
Dimethic<strong>on</strong>/Simethic<strong>on</strong><br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 90<br />
Strength<br />
Gel 250mg+250mg+50mg/5ml 854676144 76.3 16.9 B<br />
83 Diethyltoluamide Cutaneous Soluti<strong>on</strong> NULL 858276144 76.6 17.1 B<br />
84 Metr<strong>on</strong>idazole Tablet 400mg 861863786 76.9 17.3 B<br />
85 Amoxicillin anhydrous<br />
86<br />
C<strong>on</strong>doms with or without Spermicide<br />
(N<strong>on</strong>oxinol)<br />
Powder for Oral<br />
Suspensi<strong>on</strong><br />
As per NACO/ RCH<br />
supply<br />
Cum A<br />
125 mg/5 ml 865333012 77.2 17.5 B<br />
NULL 868779019 77.5 17.7 B<br />
87 Paracetamol Syrup 125 mg/5ml 872223499 77.8 17.9 B<br />
88 Gentamicin Sulphate Injecti<strong>on</strong> 40 mg/ml 875542456 78.1 18.1 B<br />
89 Ethinylestradiol Tablet 50 micrograms 878812524 78.4 18.4 B<br />
90 Isosorbide Dinitrate Tablet (Sublingual) 5 mg 882068177 78.7 18.6 B<br />
91 Albendazole Tablet (Chewable) 400 mg 885323699 79.0 18.8 B<br />
92 Vitamin A Palmitate Capsule 25000 IU 888547417 79.3 19.0 B<br />
93 Mic<strong>on</strong>azole Nitrate Ointment or Cream 2% 891732890 79.6 19.2 B<br />
94 Copper-c<strong>on</strong>taining device As per RCH Supply NULL 894891640 79.8 19.4 B<br />
95 Povid<strong>on</strong>e Iodine Ointment NULL 898042622 80.1 19.6 B<br />
96 Atracurium Injecti<strong>on</strong> 10mg/ml 901168869 80.4 19.8 B<br />
97 Is<strong>of</strong>lurane<br />
Inhalati<strong>on</strong><br />
(Vaporiser)<br />
NULL 904282069 80.7 20.0 B<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
98<br />
Drug (as per<br />
EDL)<br />
Imipenem M<strong>on</strong>ohydrate + Cilastatin<br />
Sodium<br />
99 Ferrous Sulphate Tablet<br />
Formulati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 91<br />
Strength<br />
Powder for Injecti<strong>on</strong> 250mg + 250mg 907381000 81.0 20.2 B<br />
200mg equivalent to 60 mg<br />
elemental ir<strong>on</strong><br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
910452250 81.2 20.4 B<br />
100 Cefadroxyl Syrup 125mg/5ml 913493373 81.5 20.6 B<br />
101 Azithromycin Tablet 250 mg 916514185 81.8 20.8 B<br />
102 Cipr<strong>of</strong>loxacin Hydrochloride Tablet 250 mg 919525153 82.0 21.0 B<br />
103 Ampicillin Sodium Powder for Injecti<strong>on</strong> 500 mg 922531468 82.3 21.2 B<br />
104 Betamethas<strong>on</strong>e Ointment/Cream 0.1% (as vale rate) 925462566 82.6 21.4 B<br />
105 Nevirapine Oral Suspensi<strong>on</strong> 50mg/5ml 928377366 82.8 21.6 B<br />
106 Quinine (bisulphate or sulphate) Oral Soluti<strong>on</strong> 150mg/5ml 931277216 83.1 21.9 B<br />
107 Oseltamivir Capsule 45 mg 934150925 83.3 22.1 B<br />
108 Omeprazole Tablet 40mg 936994111 83.6 22.3 B<br />
109 Ibupr<strong>of</strong>en Tablet 200 mg 939794183 83.8 22.5 B<br />
110 Chloramphenicol Capsule 250 mg 942592091 84.1 22.7 B<br />
111 Glimipride Tablet 2mg 945275198 84.3 22.9 B<br />
112 Pentoprozole Tablet 40mg 947930732 84.6 23.1 B<br />
113 Polyvalent Snake Antivenom Serum Injecti<strong>on</strong> 10ml 950554788 84.8 23.3 B<br />
114 Metr<strong>on</strong>idazole Benzoate Oral Suspensi<strong>on</strong> 200 mg/5 ml 953116004 85.0 23.5 B<br />
115 Cipr<strong>of</strong>loxacin Hydrochloride Infusi<strong>on</strong> 2mg/ml 955663573 85.3 23.7 B<br />
116 Ibupr<strong>of</strong>en Tablet 400 mg 958203758 85.5 23.9 B
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
117 Ranitidine Tablet 150 mg 960679382 85.7 24.1 B<br />
118 Sulphacetamide Sodium Soluti<strong>on</strong> (Eye Drop) NULL 963113294 85.9 24.3 B<br />
119 Ferrous Sulphate + Folic Acid Tablet<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 92<br />
Strength<br />
equivalent to 20 mg ir<strong>on</strong> +<br />
0.1mg folic acid<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
965477457 86.1 24.5 B<br />
120 Ofloxacin Tablet 400mg 967811239 86.3 24.7 B<br />
121 Dicl<strong>of</strong>enac sodium Injecti<strong>on</strong><br />
25mg/ml PG surfactant <strong>free</strong><br />
(3ml)<br />
970122051 86.6 24.9 B<br />
122 Decarbazine Injecti<strong>on</strong> 200mg 972406920 86.8 25.2 B<br />
123 Amoxicillin + Clavulanic acid Tablet 500mg + 125mg (625mg) 974667105 87.0 25.4 B<br />
124<br />
Anti-D Immunoglobulin Polycl<strong>on</strong>al<br />
(Thiomersal <strong>free</strong>)<br />
Injecti<strong>on</strong> 300mcg 976845855 87.2 25.6 B<br />
125 Hydroxocobalamin Injecti<strong>on</strong> 1 mg 979016396 87.3 25.8 B<br />
126<br />
Aluminium Hydroxide+ Magnesium<br />
Hydroxide + Active<br />
Dimethic<strong>on</strong>/Simethic<strong>on</strong><br />
Chewable Tablet<br />
500mg (250mg+250mg<br />
+50mg)<br />
981178285 87.5 26.0 B<br />
127 Cefadroxyl Tablet 500mg 983315322 87.7 26.2 B<br />
128<br />
Chloroquine (as phosphate or<br />
sulphate)<br />
Syrup 50 mg /5ml (60ml bottle) 985435595 87.9 26.4 B<br />
129 Salmeterol + Fluiticas<strong>on</strong>e Inhaler 25mcg + 125mcg/ dose 987496235 88.1 26.6 B
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
130 Metr<strong>on</strong>idazole Infusi<strong>on</strong>/ Injecti<strong>on</strong> 500 mg 989526310 88.3 26.8 B<br />
131 Clotrimazole Cream 2% W/W (15gm tube) 991528094 88.5 27.0 B<br />
132 Hydrocortis<strong>on</strong>e Sodium Succinate powder for Injecti<strong>on</strong> 100 mg 993432760 88.6 27.2 B<br />
133 Erythromycin Stearate<br />
Powder for Oral<br />
Suspensi<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 93<br />
Strength<br />
Cum A<br />
125 mg/5ml 995314374 88.8 27.4 B<br />
134 Misoprostol Tablet 100mcg 997169245 89.0 27.6 B<br />
135 Erythromycin Stearate Tablet or Capsule 250 mg 999014291 89.1 27.8 B<br />
136 Ranitidine Injecti<strong>on</strong> 50mg/ 2ml 1000849808 89.3 28.0 B<br />
137 Ofloxacin Tablet 200mg 1002645301 89.5 28.2 B<br />
138 Amoxicillin anhydrous Tablet or Capsule 250 mg 1004436514 89.6 28.5 B<br />
139 Dicl<strong>of</strong>enac sodium Tablet 50mg 1006218551 89.8 28.7 B<br />
140 Thiopent<strong>on</strong>e sodium Injecti<strong>on</strong> 1.0 g 1007997562 89.9 28.9 B<br />
141 Cefadroxyl Tablet 250mg 1009750913 90.1 29.1 B<br />
142 Cl<strong>of</strong>azimine Capsule 50 mg 1011456167 90.2 29.3 B<br />
143 Fluc<strong>on</strong>azole Oral Suspensi<strong>on</strong> 50 mg/5-ml 1013132672 90.4 29.5 B<br />
144 Sodium Chloride<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
0.9% Isot<strong>on</strong>ic (equivalent to<br />
Na+ 154 mmol/l, Cl- 154<br />
mmol/l (500ml)<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1014802015 90.5 29.7 B<br />
145 Methyl Prednisol<strong>on</strong>e Injecti<strong>on</strong> 40mg/ml 1016469328 90.7 29.9 B<br />
146 Ceftazidime Injecti<strong>on</strong> 1gm 1018059177 90.8 30.1 C
Sl #<br />
Drug (as per<br />
EDL)<br />
147 Anti rabies Vaccine (Chickembryo)<br />
Formulati<strong>on</strong><br />
Injecti<strong>on</strong> IM<br />
administrati<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 94<br />
Strength<br />
Cum A<br />
2.5 IU 1019615144 91.0 30.3 C<br />
148 Erythromycin Stearate Tablet or Capsule 500mg 1021119945 91.1 30.5 C<br />
149 Cefixime Capsule 200mg 1022613859 91.2 30.7 C<br />
150 Nitr<strong>of</strong>urantoin Syrup 100mg/5ml 1024095593 91.4 30.9 C<br />
151 Surgical Spirit Soluti<strong>on</strong> NULL 1025575200 91.5 31.1 C<br />
152 Nor adrenaline Injecti<strong>on</strong> 4mg/2ml 1027021743 91.6 31.3 C<br />
153 Omeprazole Tablet 20mg 1028442731 91.8 31.5 C<br />
154 Azithromycin Syrup 100 mg/5ml 1029806300 91.9 31.8 C<br />
155 Isoxsuprine Hydrochloride Tablet 40 mg 1031167140 92.0 32.0 C<br />
156 BCG Vaccine Injecti<strong>on</strong> 1032496422 92.1 32.2 C<br />
157 MMR (Live Vaccine) Injecti<strong>on</strong> NULL 1033825704 92.2 32.4 C<br />
158 Ceftriax<strong>on</strong>e Sodium Powder for Injecti<strong>on</strong> 1gm (Vial) 1035144738 92.4 32.6 C<br />
159 Silver Sulfadiazine Cream 1% w/w 1036421704 92.5 32.8 C<br />
160 Levothyroxine Sodium Tablet 100 microgram 1037693472 92.6 33.0 C<br />
161 Hydrogen Peroxide Soluti<strong>on</strong> NULL 1038953496 92.7 33.2 C<br />
162 Diltiazem Injecti<strong>on</strong> 30mg 1040147743 92.8 33.4 C<br />
163 Anti rabies Vaccine (Verocell)<br />
Injecti<strong>on</strong> IM<br />
administrati<strong>on</strong><br />
200 – 400 IU 1041320525 92.9 33.6 C<br />
164 Cefalexin Tablet or Capsule 500mg 1042487546 93.0 33.8 C<br />
165 Measles Vaccine Injecti<strong>on</strong> NULL 1043632205 93.1 34.0 C<br />
166 Thiopent<strong>on</strong>e sodium Injecti<strong>on</strong> 0.5 g 1044769834 93.2 34.2 C<br />
167 Tropicamide Eye Drops Soluti<strong>on</strong> NULL 1045894589 93.3 34.4 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
168 Glibenclamide Tablet 5 mg 1047009111 93.4 34.6 C<br />
169 Promethazine Hydrochloride Syrup 5 mg/5 ml 1048120677 93.5 34.8 C<br />
170 Furazolid<strong>on</strong>e Tablet (Dispersible) 100 mg 1049225210 93.6 35.1 C<br />
171 Dicyclomine Hydrochloride Injecti<strong>on</strong> 10mg/ml (2ml) 1050321748 93.7 35.3 C<br />
172 Cipr<strong>of</strong>loxacin Hydrochoride<br />
Soluti<strong>on</strong> (Eye/Ear<br />
Drop)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 95<br />
Strength<br />
Cum A<br />
0.3% w/v sterile aqueous 1051361290 93.8 35.5 C<br />
173 Metoprolol Tablet 25mg 1052396854 93.9 35.7 C<br />
174 Labetalol Injecti<strong>on</strong> 10mg/ml 1053431757 94.0 35.9 C<br />
175 Lidocaine hydrochloride<br />
Injecti<strong>on</strong> for Spinal<br />
Anaesthesia<br />
5% to be mixed with 7.5%<br />
glucose soluti<strong>on</strong><br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1054441592 94.1 36.1 C<br />
176 Protamine Sulphate Injecti<strong>on</strong> 10 mg/ml 1055432254 94.2 36.3 C<br />
177 Misoprostol Tablet 200mcg 1056413770 94.3 36.5 C<br />
178 Streptokinase Injecti<strong>on</strong> 15,00,000 IU 1057381270 94.3 36.7 C<br />
179 Sodium Hypochlorite Powder for Soluti<strong>on</strong> NULL 1058312662 94.4 36.9 C<br />
180 Benzoyl Peroxide Loti<strong>on</strong> 5% 1059209511 94.5 37.1 C<br />
181 Ofloxacin Eye drops soluti<strong>on</strong> NULL 1060100069 94.6 37.3 C<br />
182 Sodium Chloride + Dextrose 500 ml 1060988773 94.7 37.5 C<br />
183 Vinblastine Injecti<strong>on</strong> 10mg 1061858129 94.7 37.7 C<br />
184 Framycetin Sulphate Cream NULL 1062711869 94.8 37.9 C<br />
185 Prednisol<strong>on</strong>e Sodium Phosphate Soluti<strong>on</strong> (Eye Drop) NULL 1063563341 94.9 38.1 C
Sl #<br />
186 Carbamazepine<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
Tablet (C<strong>on</strong>trol<br />
Release)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 96<br />
Strength<br />
Cum A<br />
400 mg 1064414759 95.0 38.4 C<br />
187 Pralidoxime Injecti<strong>on</strong> 25mg/ml 1065248249 95.0 38.6 C<br />
188<br />
Oral Rehydrati<strong>on</strong> Salts (for Glucoseelectrolyte<br />
soluti<strong>on</strong>)<br />
Powder Sachet<br />
20.5 g/l; Comp<strong>on</strong>ents to<br />
rec<strong>on</strong>stitute 1 litre <strong>of</strong><br />
Glucose-electrolyte soluti<strong>on</strong>:<br />
Glucose: 13.5 g/L; Sodium<br />
Chloride: 2.6 g/L; Potassium<br />
Chloride: 1.5 g/L; Trisodium<br />
Citrate dehydrate*: 2.9 g/L<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1066065751 95.1 38.8 C<br />
189 Amikacin Injecti<strong>on</strong> 100mg/2ml 1066866804 95.2 39.0 C<br />
190 Hydroxyethyl Starch Injecti<strong>on</strong> NULL 1067662045 95.3 39.2 C<br />
191 Ceftazidime Injecti<strong>on</strong> 250mg 1068453484 95.3 39.4 C<br />
192 Rapid Diagnostic Kit NVBDCP Supply NULL 1069236096 95.4 39.6 C<br />
193 Sulphamethoxazole + Trimethoprim Tablet 200 mg + 40 mg 1070014989 95.5 39.8 C<br />
194 Acetyl Salicylic Acid (ASA)<br />
Tablet (Enteric<br />
Coated)<br />
325 mg 1070786773 95.5 40.0 C<br />
195 Ascorbic Acid (Vit C) Tablet (Scored) 100 mg 1071538304 95.6 40.2 C<br />
196 Diazepam Injecti<strong>on</strong> 5 mg/ml 1072276752 95.7 40.4 C<br />
197 Iohexol 350 mg Iodine/ml 1073000670 95.7 40.6 C<br />
198 Acetyl Salicylic Acid (ASA)<br />
199<br />
Benzyl penicillin (sodium or potassium<br />
salt)<br />
Tablet (Enteric<br />
Coated)<br />
75 mg 1073715053 95.8 40.8 C<br />
Powder for Injecti<strong>on</strong> 600 mg (= 1 milli<strong>on</strong> IU) 1074428473 95.9 41.0 C
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
200 Prop<strong>of</strong>ol Injecti<strong>on</strong> NULL 1075137223 95.9 41.2 C<br />
201 Azithromycin Tablet 500 mg 1075834401 96.0 41.4 C<br />
202 Doxycycline Hydrochloride Capsule 100 mg 1076531340 96.0 41.6 C<br />
203 Cetirizine Dihydrochloride Tablet 10mg 1077203161 96.1 41.9 C<br />
204 Daps<strong>on</strong>e Tablet 50 mg 1077873344 96.2 42.1 C<br />
205 Ampicillin Sodium Tablet 500mg 1078541810 96.2 42.3 C<br />
206 Fluc<strong>on</strong>azole Capsule 200 mg 1079197881 96.3 42.5 C<br />
207 Liquid Paraffin Liquid NULL 500ml 1079849321 96.3 42.7 C<br />
208 Gentamicin Sulphate<br />
Soluti<strong>on</strong> (Eye/ Ear<br />
Drop)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 97<br />
Strength<br />
Cum A<br />
NULL 1080490153 96.4 42.9 C<br />
209 Ethanol (Spirit) Cutaneous Soluti<strong>on</strong> 70% (denatured) 500 ml 1081115311 96.5 43.1 C<br />
210 Dextrose<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
25%<br />
50% Hypert<strong>on</strong>ic 100ml 1081721959 96.5 43.3 C<br />
211 Mitoxantr<strong>on</strong>e Injecti<strong>on</strong> 20mg 1082316604 96.6 43.5 C<br />
212 Primaquine Diphosphate Tablet 7.5 mg 1082903755 96.6 43.7 C<br />
213 Synthetic pyrethroid (MT) Soluti<strong>on</strong> As per NVBDCP Supply 1083481755 96.7 43.9 C<br />
214<br />
Tuberculin, Purified Protein Derivative<br />
(PPD)<br />
Injecti<strong>on</strong> NULL 1084042095 96.7 44.1 C<br />
215 Digoxin Tablet 250 mcg 1084598647 96.8 44.3 C<br />
216 Chlorhexidine 5% for diluti<strong>on</strong> 500ml 1085152589 96.8 44.5 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
217 Mannitol<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
Intravenous<br />
Injecti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 98<br />
Strength<br />
Cum A<br />
NULL 1085706387 96.9 44.7 C<br />
218 Povid<strong>on</strong>e Iodine Soluti<strong>on</strong> NULL 1086252573 96.9 44.9 C<br />
219 Bleomycin Injecti<strong>on</strong> 15mg 1086797085 97.0 45.2 C<br />
220 Hydrocortis<strong>on</strong>e Acetate Ointment or Cream 1% (as vale rate) 1087329501 97.0 45.4 C<br />
221 Artesunate Injecti<strong>on</strong> 60mg 1087860857 97.1 45.6 C<br />
222 Atropine Sulphate Eye ointment 1% 1088374073 97.1 45.8 C<br />
223 Quinine Dihydrochloride Injecti<strong>on</strong> 300 mg/ml 1088878865 97.1 46.0 C<br />
224 Dopamine Hydrochloride Injecti<strong>on</strong> 40 mg 1089354464 97.2 46.2 C<br />
225<br />
Sodium bi Carb<strong>on</strong>ate Glycerine (Soda<br />
Bocarb Glycerine)<br />
Ear Drop NULL 1089820160 97.2 46.4 C<br />
226 Ir<strong>on</strong> Sucrose Injecti<strong>on</strong> 100mg 1090282469 97.3 46.6 C<br />
227 D actinomycin Injecti<strong>on</strong> 0.5mg 1090744104 97.3 46.8 C<br />
228 Furosemide Tablet 20mg 1091204445 97.4 47.0 C<br />
229 Isosorbide Dinitrate Tablet (Sublingual) 10 mg 1091660682 97.4 47.2 C<br />
230 Fluc<strong>on</strong>azole Capsule 150 mg 1092106637 97.4 47.4 C<br />
231 Albendazole Suspensi<strong>on</strong> 200mg/5ml 1092551125 97.5 47.6 C<br />
232 Cipr<strong>of</strong>loxacin Hydrochoride Ointment (Eye/Ear) 0.30% 1092988789 97.5 47.8 C<br />
233 Dobutamine Injecti<strong>on</strong> 50 mg /ml 1093425176 97.6 48.0 C<br />
234<br />
Lidocaine hydrochloride + Epinephrine<br />
(adrenaline)<br />
Injecti<strong>on</strong> 1%+ epinephrine 1:200 000 1093859101 97.6 48.2 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
235 Prednisol<strong>on</strong>e Tablet 10mg 1094288533 97.6 48.5 C<br />
236 Cisplatin Injecti<strong>on</strong> 10mg/10ml 1094709733 97.7 48.7 C<br />
237 Doxylamine Succinate Tablet 100mg 1095130933 97.7 48.9 C<br />
238 Tinidazole Tablet 500mg 1095551145 97.7 49.1 C<br />
239 Aminophylline Injecti<strong>on</strong> 25 mg/ml 1095971071 97.8 49.3 C<br />
240<br />
Suxameth<strong>on</strong>ium Chloride<br />
(Succinylchloline)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 99<br />
Strength<br />
Powder for Injecti<strong>on</strong> 50 mg/ml 1096383415 97.8 49.5 C<br />
241 Folic Acid Tablet 5mg 1096789783 97.9 49.7 C<br />
242 Spir<strong>on</strong>olact<strong>on</strong>e Tablet 100mg 1097182211 97.9 49.9 C<br />
243 Tranexamic Acid Injecti<strong>on</strong> 500mg/5ml 1097572262 97.9 50.1 C<br />
244 Dexamethas<strong>on</strong>e Tablet 4 mg 1097955374 98.0 50.3 C<br />
245 Bisacodyl Tablet 5mg 1098337944 98.0 50.5 C<br />
246 Atropine Sulphate Injecti<strong>on</strong> 0.6 mg/ml 1098717691 98.0 50.7 C<br />
247 Phenytoin Sodium Tablet 100 mg 1099078562 98.1 50.9 C<br />
248<br />
Methylrosanilinium Chloride (Gentian<br />
Violet)<br />
Cutaneous Soluti<strong>on</strong> NULL 1099437780 98.1 51.1 C<br />
249 Pentazocine Injecti<strong>on</strong> 30mg/ml 1099789837 98.1 51.3 C<br />
250 Vitamin K Injecti<strong>on</strong> 1mg/ml 1100127580 98.2 51.5 C<br />
251 Gentamicin Sulphate Injecti<strong>on</strong> 10 mg/ml 1100452865 98.2 51.8 C<br />
252 Antitetanus Immunoglobulin (Human) Injecti<strong>on</strong> 500 IU 1100775425 98.2 52.0 C<br />
253 Fluc<strong>on</strong>azole Injecti<strong>on</strong> 2 mg/ml 1101095485 98.2 52.2 C<br />
254 Metoclopramide Hydrochloride Injecti<strong>on</strong> 5 mg/ml 1101413821 98.3 52.4 C<br />
255 Vecur<strong>on</strong>ium Powder for Injecti<strong>on</strong> 20mg 1101724285 98.3 52.6 C<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
256 Is<strong>on</strong>iazid Tablet 300mg 1102032114 98.3 52.8 C<br />
257 Domperid<strong>on</strong>e Tablet 10mg 1102332759 98.3 53.0 C<br />
258 Valproic acid (Sodium salt) Liquid Oral Soluti<strong>on</strong> 200mg/5ml 1102632740 98.4 53.2 C<br />
259 Atenolol Tablet 50 mg 1102921647 98.4 53.4 C<br />
260 Hydrochlorothiazide Tablet 25mg 1103208334 98.4 53.6 C<br />
261 Diazepam Suspensi<strong>on</strong> 2mg/5ml 1103492043 98.5 53.8 C<br />
262 Propranolol Tablet 10 mg 1103772864 98.5 54.0 C<br />
263 Tinidazole Tablet 1gm 1104052383 98.5 54.2 C<br />
264 C<strong>on</strong>jugated Equine Oestrogen Tablet 0.625mg 1104319811 98.5 54.4 C<br />
265 Lidocaine hydrochloride Injecti<strong>on</strong> NULL 1104586058 98.5 54.6 C<br />
266 Chloramphenicol Palmitate Oral Suspensi<strong>on</strong> 150 mg/5 ml 1104839259 98.6 54.8 C<br />
267 Metoprolol Injecti<strong>on</strong> 1mg/ml 1105090666 98.6 55.1 C<br />
268 Homatropine Soluti<strong>on</strong> (Eye Drop) NULL 1105340069 98.6 55.3 C<br />
269 Heparin Sodium Injecti<strong>on</strong> 5000 IU/ml 1105588739 98.6 55.5 C<br />
270 Oxytocin Injecti<strong>on</strong> 10 IU 1105834955 98.7 55.7 C<br />
271 Cloxacillin Sodium Capsule 500 mg 1106079899 98.7 55.9 C<br />
272 Cefixime Dry Syrup 50mg/5ml 1106321562 98.7 56.1 C<br />
273 Chloramphenacol Eye ointment 5 gm tube 1106560156 98.7 56.3 C<br />
274 Carbamazepine<br />
Tablet (C<strong>on</strong>trol<br />
Release)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 100<br />
Strength<br />
Cum A<br />
(200mg) 1106796045 98.7 56.5 C<br />
275 Adenosine Injecti<strong>on</strong> 3mg/ml 1107028183 98.8 56.7 C<br />
276 Primaquine Diphosphate Tablet 15 mg 1107257797 98.8 56.9 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
277 Amikacin Injecti<strong>on</strong> 500mg/2ml 1107486173 98.8 57.1 C<br />
278 Ivermectin Tablet (Scored) 6mg 1107708868 98.8 57.3 C<br />
279 Ergometrine Hydrogen Maleate Injecti<strong>on</strong> 200 micrograms 1107930562 98.8 57.5 C<br />
280 Cytarabine Injecti<strong>on</strong> 1 g 1108149586 98.9 57.7 C<br />
281 Zidovudine Oral Liquid 50 mg/5 ml 1108365586 98.9 57.9 C<br />
282 Zidovudine<br />
IV or Infusi<strong>on</strong><br />
Injecti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 101<br />
Strength<br />
Cum A<br />
10mg/ml 1108581586 98.9 58.1 C<br />
283 Quinine (bisulphate or sulphate) Tablet 300 mg 1108796020 98.9 58.4 C<br />
284 Isosorbide M<strong>on</strong>oinitrate Tablet (Sublingual) 5 mg 1109006360 98.9 58.6 C<br />
285 Domperid<strong>on</strong>e Syrup 1mg/ml 1109216694 99.0 58.8 C<br />
286 Metr<strong>on</strong>idazole Tablet 200mg 1109417439 99.0 59.0 C<br />
287 Povid<strong>on</strong>e Iodine Ointment/ Drop NULL 1109613467 99.0 59.2 C<br />
288 Phenylephrine Injecti<strong>on</strong> 1109797567 99.0 59.4 C<br />
289 Daunorubicin Hydrochloride Powder for Injecti<strong>on</strong> 20mg 1109980555 99.0 59.6 C<br />
290 Acyclovir<br />
Ophthalmic<br />
Ointment<br />
3% 1110162513 99.0 59.8 C<br />
291 Tobramycine Eye drops soluti<strong>on</strong> NULL 1110340972 99.1 60.0 C<br />
292 Ir<strong>on</strong> Sucrose Injecti<strong>on</strong> 50mg 1110517449 99.1 60.2 C<br />
293 Cefixime Capsule 100mg 1110689405 99.1 60.4 C<br />
294 Acetazolamide Tablet 250 mg 1110857285 99.1 60.6 C<br />
295 Clotrimazole Ear Drops 1% W/V 1111022283 99.1 60.8 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
296 Pilocarpine Hydrochloride or Nitrate Soluti<strong>on</strong> (Eye Drop) 2 PC 1111187211 99.1 61.0 C<br />
297 Bupivacaine hydrochloride<br />
298 Sodium bi Carb<strong>on</strong>ate<br />
Injecti<strong>on</strong> for Spinal<br />
Anaesthesia<br />
Injectable Soluti<strong>on</strong><br />
(Intravenous Fluid)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 102<br />
Strength<br />
0.5% in 4-ml ampoule to be<br />
mixed with 7.5% glucose<br />
soluti<strong>on</strong><br />
1.4% Isot<strong>on</strong>ic (equivalent to<br />
Na+ 167 mmol/l, HCO3- 167<br />
mmol/l) 10ml<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1111350207 99.2 61.2 C<br />
1111513095 99.2 61.4 C<br />
299 Ketamine hydrochloride Injecti<strong>on</strong> 50 mg /ml in 2ml Vial 1111673318 99.2 61.6 C<br />
300 Chlorpheniramine Injecti<strong>on</strong> 10 mg/ml 1111830135 99.2 61.9 C<br />
301 Salbutamol Sulphate Tablet 2 mg 1111985718 99.2 62.1 C<br />
302 Norethister<strong>on</strong>e Tablet 5mg 1112139882 99.2 62.3 C<br />
303 Etiophylline + Theophylline Tablet 77mg + 23mg (100mg) 1112294044 99.2 62.5 C<br />
304 Rib<strong>of</strong>lavin (Vit B2) Tablet 5mg 1112446684 99.2 62.7 C<br />
305 Timolol Maleate Soluti<strong>on</strong> (Eye Drop) NULL 1112597149 99.3 62.9 C<br />
306 Etiophylline + Theophylline Injecti<strong>on</strong> 1112741824 99.3 63.1 C<br />
307 Amiodar<strong>on</strong>e Injecti<strong>on</strong> (50mg/ml) 3ml Amp 1112884214 99.3 63.3 C
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
308 Medroxy Progester<strong>on</strong>e Acetate Tablet 5 mg 1113023613 99.3 63.5 C<br />
309 Fluphenazine Decanoate or Enantate Injecti<strong>on</strong> 25 mg 1113160413 99.3 63.7 C<br />
310 Diazepam Tablet (Scored) 5 mg 1113296136 99.3 63.9 C<br />
311 Lorazepam Injecti<strong>on</strong> 4mg 1113431188 99.3 64.1 C<br />
312 Digoxin Injecti<strong>on</strong> 250 mcg/ml 1113563026 99.3 64.3 C<br />
313 Phenol Liquid 1113693353 99.4 64.5 C<br />
314 Amikacin Injecti<strong>on</strong> 250mg/2ml 1113823601 99.4 64.7 C<br />
315 Vincristine Injecti<strong>on</strong> 1 mg 1113951871 99.4 64.9 C<br />
316 Metoclopramide Hydrochloride Tablet 10 mg 1114079688 99.4 65.2 C<br />
317 Dicl<strong>of</strong>enac sodium Tablet 100 mg 1114206060 99.4 65.4 C<br />
318 Benzathine benzyl penicillin Powder for Injecti<strong>on</strong><br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 103<br />
Strength<br />
1.44 g benzylpenicillin (=2.4<br />
milli<strong>on</strong> IU)<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1114332195 99.4 65.6 C<br />
319 Artesunate Tablet 50 mg 1114457732 99.4 65.8 C<br />
320 Mebendazole Tablet 100mg 1114582587 99.4 66.0 C<br />
321 Dicyclomine Hydrochloride Tablet 10mg 1114706876 99.5 66.2 C<br />
322 Amphotericin B Powder for Injecti<strong>on</strong> 50 mg 1114828677 99.5 66.4 C<br />
323 Acyclovir Tablet 200 mg 1114950184 99.5 66.6 C<br />
324 Furosemide Injecti<strong>on</strong> 10 mg/ml 1115070544 99.5 66.8 C<br />
325 Iodine D361 Soluti<strong>on</strong> 8mg/5ml 1115190473 99.5 67.0 C<br />
326 Isoxsuprine Injecti<strong>on</strong> 5mg/ml 1115303573 99.5 67.2 C<br />
327 Fentanyl Citrate Injecti<strong>on</strong> 0.05mg/ml 1115413435 99.5 67.4 C<br />
328 Water for injecti<strong>on</strong> Injecti<strong>on</strong> NULL (10ml) 1115521265 99.5 67.6 C
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
329 Chloramphenicol Sodium Succinate Powder for Injecti<strong>on</strong> 1 gm 1115628908 99.5 67.8 C<br />
330 Chlorpromazine Hydrochloride Syrup 25 mg/5ml 1115735595 99.5 68.0 C<br />
331 Salbutamol Sulphate Tablet 4 mg 1115836278 99.6 68.2 C<br />
332 Phenylephrine Soluti<strong>on</strong> (Eye Drop) 4 PC 1115936136 99.6 68.5 C<br />
333 Acyclovir (as sodium salt) Powder for Injecti<strong>on</strong> 250 mg 1116033255 99.6 68.7 C<br />
334<br />
Benzyl penicillin (sodium or potassium<br />
salt)<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 104<br />
Strength<br />
Powder for Injecti<strong>on</strong> 600 mg (= 1 milli<strong>on</strong> IU) 1116128807 99.6 68.9 C<br />
335 Mebendazole Suspensi<strong>on</strong> 100mg/5ml 1116223950 99.6 69.1 C<br />
336 Ergometrine Hydrogen Maleate Tablet 125 micrograms 1116314985 99.6 69.3 C<br />
337 Neostigmine Metilsulfate Injecti<strong>on</strong> 2.5 mg 1116405576 99.6 69.5 C<br />
338 Carbamazepine Syrup 20 mg/ml 1116494866 99.6 69.7 C<br />
339 Magnesium Sulphate Injecti<strong>on</strong> 500 mg/ml (2ml) 1116583028 99.6 69.9 C<br />
340 Hydrochlorothiazide Tablet (Scored) 25 mg 1116669108 99.6 70.1 C<br />
341 Neostigmine Metilsulfate Injecti<strong>on</strong> 500 micrograms 1116753250 99.6 70.3 C<br />
342 Phenobarbit<strong>on</strong>e Syrup 20mg/5ml 1116837075 99.6 70.5 C<br />
343 Nystatin Oral Soluti<strong>on</strong> 50mg/5ml (100000 IU/ml) 1116920691 99.6 70.7 C<br />
344 Amlodipine Tablet 5 mg 1117001859 99.7 70.9 C<br />
345 Vitamin B12 (Cyanocobalamin) Injecti<strong>on</strong> 500mcg/ml 1117082517 99.7 71.1 C<br />
346 Phytomenadi<strong>on</strong>e Injecti<strong>on</strong> 10 mg/ml 1117160839 99.7 71.3 C<br />
347 Mephenteramine Injecti<strong>on</strong> 30 mg/ml 1117237044 99.7 71.5 C<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
348 Ferrous Fumarate Drop 5mg/ml 1117312102 99.7 71.8 C<br />
349 Levodopa + Carbidopa Tablet 100 mg + 10 mg 1117386890 99.7 72.0 C<br />
350 Salbutamol Sulphate Capsule (Rotacap) 200mcg 1117460179 99.7 72.2 C<br />
351 Ondansetr<strong>on</strong> Syrup 2mg/5ml 1117530811 99.7 72.4 C<br />
352 Ferrous Sulphate + Folic Acid Tablet<br />
<str<strong>on</strong>g>Assessment</str<strong>on</strong>g> <strong>of</strong> financial resources for guaranteeing access to <strong>free</strong> generic medicines at public health facilities in Chhattisgarh 105<br />
Strength<br />
200mg equivalent to 60 mg<br />
ir<strong>on</strong> + 400 micrograms folic<br />
acid<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1117601285 99.7 72.6 C<br />
353 Sulfasalazine Tablet 500 mg 1117668594 99.7 72.8 C<br />
354 Zinc Sulphate<br />
355 Hydrocortis<strong>on</strong>e Acetate<br />
Dispersible Tablet<br />
(Scored)<br />
Suppository;<br />
Retenti<strong>on</strong> Enema<br />
20mg 1117735318 99.7 73.0 C<br />
25 mg 1117802038 99.7 73.2 C<br />
356 Bupivacaine hydrochloride Injecti<strong>on</strong> 0.25% in vial 1117867265 99.7 73.4 C<br />
357 Cyclophosphamide Injecti<strong>on</strong> 200mg 1117931062 99.7 73.6 C<br />
358<br />
Benzoic acid compound (Benzoic acid<br />
+ Salicylic acid)<br />
Ointment (6%+ 3% ) 1117994553 99.7 73.8 C<br />
359 Salicylic Acid Topical Soluti<strong>on</strong> NULL 1118056653 99.7 74.0 C<br />
360 Amlodipine Tablet 2.5 mg 1118118454 99.8 74.2 C<br />
361 Mic<strong>on</strong>azole Soluti<strong>on</strong> (Eye Drop) 1% 1118179576 99.8 74.4 C<br />
362 Prednisol<strong>on</strong>e Liquid 5mg/5ml 1118239693 99.8 74.6 C<br />
363 Spir<strong>on</strong>olact<strong>on</strong>e Tablet 25 mg 1118299452 99.8 74.8 C<br />
364 Nitr<strong>of</strong>urantoin Tablet 100 mg 1118358659 99.8 75.1 C
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
365 Methotrexate Injecti<strong>on</strong> 25mg/ ml 1118413415 99.8 75.3 C<br />
366 Phytomenadi<strong>on</strong>e Tablet 10 mg 1118467755 99.8 75.5 C<br />
367 Potassium Chloride Injecti<strong>on</strong><br />
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Strength<br />
11.2% (equivalent to K+ 1.5<br />
mmol/ml, Cl- 1.5 mmol/ml)<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1118521268 99.8 75.7 C<br />
368 Pentazocine Tablet 25mg 1118574634 99.8 75.9 C<br />
369 Propyl Thiouracil Tablet 100 mg 1118625437 99.8 76.1 C<br />
370 Ondansetr<strong>on</strong> Injecti<strong>on</strong> 2mg/ml 1118675921 99.8 76.3 C<br />
371 Phenytoin Sodium Injecti<strong>on</strong> 50 mg/ml 1118725216 99.8 76.5 C<br />
372 Sulfadoxine + Pyrimethamine Tablet 500mg+ 25mg 1118774493 99.8 76.7 C<br />
373 Enalapril Tablet (Scored) 2.5mg 1118821833 99.8 76.9 C<br />
374<br />
Epinephrine Hydrochloride<br />
(Adrenaline)<br />
Injecti<strong>on</strong> 1 mg/ml 1118868757 99.8 77.1 C<br />
375 Pyrazinamide Tablet 750 mg 1118914358 99.8 77.3 C<br />
376 Acetyl Salicylic Acid (ASA)<br />
Tablet (Enteric<br />
Coated)<br />
150 mg 1118957847 99.8 77.5 C<br />
377 Pyrazinamide Tablet 500 mg 1119001335 99.8 77.7 C<br />
378 Methyldopa Tablet (Film Coated) 250 mg 1119044805 99.8 77.9 C<br />
379 Haloperidol Injecti<strong>on</strong> 5 mg 1119088005 99.8 78.1 C<br />
380 Chlorpromazine Hydrochloride Injecti<strong>on</strong> 25 mg/ml 1119131047 99.8 78.4 C<br />
381 Lidocaine hydrochloride Jelly (Topical) NULL 1119173523 99.8 78.6 C<br />
382 Furosemide Tablet 40mg 1119215719 99.9 78.8 C
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
383 Nifedipine Capsule 5 mg 1119257787 99.9 79.0 C<br />
384 Pethidine Injecti<strong>on</strong> 50mg/ml 1119299699 99.9 79.2 C<br />
385 Metoprolol Tablet 50 mg 1119341198 99.9 79.4 C<br />
386 Verapamil Hydrochloride Injecti<strong>on</strong> 2.5 mg/ml 1119382603 99.9 79.6 C<br />
387 Terbutaline Injecti<strong>on</strong> 0.5mg/ml 1119422575 99.9 79.8 C<br />
388 Lomustine Tablet 40mg 1119459641 99.9 80.0 C<br />
389 Furazolid<strong>on</strong>e Suspensi<strong>on</strong> 100 mg/5ml 1119496050 99.9 80.2 C<br />
390 Chlorambucil Capsule 5mg 1119531968 99.9 80.4 C<br />
391 Losartan Tablet 25mg 1119567804 99.9 80.6 C<br />
392 Streptomycin Sulphate Powder for Injecti<strong>on</strong> 1 g 1119603151 99.9 80.8 C<br />
393 Warfarin Sodium Tablet (Score) 5 mg 1119638472 99.9 81.0 C<br />
394 Ceftriax<strong>on</strong>e Sodium Powder for Injecti<strong>on</strong> 250mg 1119673300 99.9 81.2 C<br />
395 Pancur<strong>on</strong>ium Injecti<strong>on</strong> 2mg/ml 1119707390 99.9 81.4 C<br />
396 Procarbazine Capsule 50mg 1119740412 99.9 81.6 C<br />
397 Folic Acid (Sodium salt) Injecti<strong>on</strong> 15 mg/2ml 1119773170 99.9 81.9 C<br />
398 Doxorubicin Injecti<strong>on</strong> 10mg/5ml 1119805743 99.9 82.1 C<br />
399 Lev<strong>on</strong>orgesterel Tablet 750mcg 1119838179 99.9 82.3 C<br />
400 Clozapine Tablet 100mg 1119870022 99.9 82.5 C<br />
401 Atropine Sulphate Soluti<strong>on</strong> (Eye Drop) 0.50% 1119900488 99.9 82.7 C<br />
402 Furosemide Oral Soluti<strong>on</strong> 20mg/5ml 1119930378 99.9 82.9 C<br />
403 Prednisol<strong>on</strong>e Tablet 20mg 1119959844 99.9 83.1 C<br />
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Strength<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
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CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
404 Salbutamol Sulphate Injecti<strong>on</strong> 50 micrograms/ml 1119989131 99.9 83.3 C<br />
405 Dexamethas<strong>on</strong>e Tablet 500 micrograms 1120017554 99.9 83.5 C<br />
406 Nitro Glycerine Injecti<strong>on</strong> 25mg 1120045897 99.9 83.7 C<br />
407 Artemether Injecti<strong>on</strong> 80 mg/ml 1120073867 99.9 83.9 C<br />
408 Betaxolol Hydrochloride Soluti<strong>on</strong> (Eye Drop) 0.50% 1120100928 99.9 84.1 C<br />
409 Podophyllum Resin Cutaneous Soluti<strong>on</strong> 10 –2% 1120125928 99.9 84.3 C<br />
410 Hydroxyurea Capsule 500mg 1120150773 99.9 84.5 C<br />
411<br />
Betamethas<strong>on</strong>e Dipropi<strong>on</strong>ate +<br />
Phenylephrine + Lignocaine<br />
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Strength<br />
Ointment 0.025%+0.1%+2.5% 1120175607 99.9 84.7 C<br />
412 Etoposide Injecti<strong>on</strong> 100mg/5ml 1120200318 99.9 84.9 C<br />
413 Tranexamic Acid Tablet 500mg 1120224739 99.9 85.2 C<br />
414 Lidocaine hydrochloride<br />
Viscous Soluti<strong>on</strong><br />
(Topical)<br />
Cum A<br />
NULL 1120248783 99.9 85.4 C<br />
415 Vancomycin Hydrochloride Powder for Injecti<strong>on</strong> 500mg 1120271137 99.9 85.6 C<br />
416 Enalapril Tablet (Scored) 5 mg 1120293229 99.9 85.8 C<br />
417 Propranolol Tablet 40 mg 1120315042 100.0 86.0 C<br />
418 Promethazine Hydrochloride Injecti<strong>on</strong> 25 mg/ml 1120336544 100.0 86.2 C<br />
419 Tetracaine Hydrochloride Soluti<strong>on</strong> NULL 1120357773 100.0 86.4 C<br />
420 Phenobarbit<strong>on</strong>e Injecti<strong>on</strong> 200mg/ml 1120378588 100.0 86.6 C<br />
421 Nifedipine<br />
Tablet (Sustained<br />
Released)<br />
(10mg) 1120399155 100.0 86.8 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
422 Nalox<strong>on</strong>e hydrochloride Injecti<strong>on</strong> 400 micrograms/ml 1120419617 100.0 87.0 C<br />
423 Midazolam Injecti<strong>on</strong> (1mg/ml. ) 1120440014 100.0 87.2 C<br />
424 Labetalol Tablet 100mg 1120458642 100.0 87.4 C<br />
425 Allopurinol Tablet 100mg 1120476987 100.0 87.6 C<br />
426 Dexamethas<strong>on</strong>e Tablet 1mg 1120493953 100.0 87.8 C<br />
427 Folic Acid Tablet 1mg 1120510586 100.0 88.0 C<br />
428 Prochlorperazine Tablet 25 mg 1120526686 100.0 88.2 C<br />
429 Busulfan Capsule 2mg 1120542411 100.0 88.5 C<br />
430 Terbutaline Tablet 2.5mg 1120557195 100.0 88.7 C<br />
431 Acyclovir Cream NULL 1120571876 100.0 88.9 C<br />
432 Tetracycline Hydrochloride Ointment (Eye) NULL 1120584634 100.0 89.1 C<br />
433 Amiodar<strong>on</strong>e Tablet 200mg 1120597335 100.0 89.3 C<br />
434 Cyclophosphamide Tablet 50mg 1120609690 100.0 89.5 C<br />
435 Haloperidol Liquid 2mg/ml 1120621873 100.0 89.7 C<br />
436 Olanzapine Tablet 10 mg 1120633946 100.0 89.9 C<br />
437 Phenobarbit<strong>on</strong>e Tablet 60mg 1120645185 100.0 90.1 C<br />
438 Diphtheria Antitoxin Injecti<strong>on</strong> 20 000 IU 1120655729 100.0 90.3 C<br />
439 Potassium Iodide Tablet 60 mg 1120665329 100.0 90.5 C<br />
440 Fluorescein Sodium Strip NULL 1120674777 100.0 90.7 C<br />
441 Sertraline Tablet 50mg 1120684108 100.0 90.9 C<br />
442 Diphtheria Antitoxin Injecti<strong>on</strong> 10 000 IU 1120693407 100.0 91.1 C<br />
443 Ethinylestradiol + Lev<strong>on</strong>orgestrel Tablet<br />
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Strength<br />
30 micrograms + 150<br />
micrograms<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS<br />
1120702243 100.0 91.3 C
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
444 Dinoprost<strong>on</strong>e Injecti<strong>on</strong> 0.5mg 1120710955 100.0 91.5 C<br />
445 Nystatin Tablet 10000 IU 1120719410 100.0 91.8 C<br />
446 Glycopyrrolate USP Injecti<strong>on</strong> 0.2mg/ml 1120727660 100.0 92.0 C<br />
447 Valproic Acid (Sodium Salt)<br />
Tablet (C<strong>on</strong>trol<br />
Release)<br />
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Strength<br />
Cum A<br />
200mg 1120735811 100.0 92.2 C<br />
448 Paracetamol Suppository 250mg 1120743803 100.0 92.4 C<br />
449 Mercaptopurine Tablet 50mg 1120751777 100.0 92.6 C<br />
450 Atropine Tablet 1mg 1120759235 100.0 92.8 C<br />
451 Acyclovir Oral Soluti<strong>on</strong> 200mg/5ml 1120766466 100.0 93.0 C<br />
452 Olanzapine Tablet 5mg 1120773666 100.0 93.2 C<br />
453 Thiamine Hydrochloride (Vit B1) Injecti<strong>on</strong> 50mg 1120780206 100.0 93.4 C<br />
454 Florouracil Injecti<strong>on</strong> 250mg/5ml 1120785935 100.0 93.6 C<br />
455<br />
Fluoxetine Hydrochloride (for use<br />
above 8 years <strong>of</strong> age)<br />
Tablet 20mg 1120791407 100.0 93.8 C<br />
456 Silver Nitrate Soluti<strong>on</strong> (Eye Drop) NULL 1120796598 100.0 94.0 C<br />
457 Melphalan Tablet 2mg 1120801720 100.0 94.2 C<br />
458 Mitomycin Capsule 10mg 1120806278 100.0 94.4 C<br />
459 Glutaraldehyde Aqueous Soluti<strong>on</strong> NULL 1120810782 100.0 94.6 C<br />
460 Risperid<strong>on</strong>e Tablet 3mg 1120815282 100.0 94.8 C<br />
461 Oseltamivir Oral Powder 12 mg/ml 1120819602 100.0 95.1 C<br />
462 Diltiazem Tablet 30mg 1120823766 100.0 95.3 C<br />
463 Mephenteramine Tablet 10mg 1120827831 100.0 95.5 C<br />
464 Lithium Carb<strong>on</strong>ate Tablet 300 mg 1120831071 100.0 95.7 C<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Sl #<br />
Drug (as per<br />
EDL)<br />
Formulati<strong>on</strong><br />
465 Lorazepam Tablet 2mg 1120834246 100.0 95.9 C<br />
466 Morphine (Sulphate or hydrochloride) Injecti<strong>on</strong> 10 mg/ml 1120837295 100.0 96.1 C<br />
467 Verapamil Hydrochloride Tablet 40 mg 1120840089 100.0 96.3 C<br />
468 Methotrexate Sodium Tablet 2.5mg 1120842195 100.0 96.5 C<br />
469 Etoposide Capsule 100mg 1120844295 100.0 96.7 C<br />
470 Ondansetr<strong>on</strong> Tablet 4mg 1120846077 100.0 96.9 C<br />
471<br />
Carboprost (PGF2α) as Tromethamine<br />
USP (Preservative Free)<br />
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Strength<br />
Injecti<strong>on</strong> 0.25mg/ml 1120847840 100.0 97.1 C<br />
472 Betamethas<strong>on</strong>e Dipropi<strong>on</strong>ate Injecti<strong>on</strong> 4mg/ml 1120849542 100.0 97.3 C<br />
473 Pyridoxine Hydrochloride (Vit B6) Tablet 25 mg 1120851240 100.0 97.5 C<br />
474 Clotrimazole Mouth Paint 1% W/V 1120852640 100.0 97.7 C<br />
475 Haloperidol Tablet 5 mg 1120853990 100.0 97.9 C<br />
476 Silver Nitrate Loti<strong>on</strong> NULL 1120855310 100.0 98.1 C<br />
477 Hyosine Butyl Bromide Injecti<strong>on</strong> 20mg/ml 1120856294 100.0 98.4 C<br />
478 Povid<strong>on</strong>e Iodine Vaginal Passaries 200mg 1120857224 100.0 98.6 C<br />
479 Imipramine Hydrochloride Tablet 25 mg 1120857899 100.0 98.8 C<br />
480 Trihexyphenidyl Hydrochloride Tablet 2 mg 1120858569 100.0 99.0 C<br />
481 Chlorpromazine Hydrochloride Tablet 100 mg 1120859199 100.0 99.2 C<br />
482 Niacinamide Tablet 50mg 1120859792 100.0 99.4 C<br />
483 Amitriptyline Tablet 25mg 1120860142 100.0 99.6 C<br />
484 Hyosine Butyl Bromide Tablet 10mg 1120860456 100.0 99.8 C<br />
485 Cinnarizine Tablet 25mg 1120860762 100.0 100.0 C<br />
Cum A<br />
Cum cost %<br />
Cum item %<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
CLASS
Annexure 3 – Prescripti<strong>on</strong> Survey tool<br />
Facility code - Name & Sign <strong>of</strong> surveyor<br />
Prescripti<strong>on</strong> Survey Tool<br />
OPD/IPD Registrati<strong>on</strong> No. – ……………………………………………………………………….. Date - …..….-02-2013<br />
1 What are the number <strong>of</strong> drugs prescribed in the prescripti<strong>on</strong><br />
(Please Menti<strong>on</strong> total number <strong>of</strong> prescribed drug)<br />
2 Are the drugs prescribed using their generic name?<br />
(all=1 Some=2 N<strong>on</strong> <strong>of</strong> the drugs=3)<br />
3. What is the durati<strong>on</strong> <strong>of</strong> prescripti<strong>on</strong>?<br />
(1-3 days=1 4-6 days=2 7 days or more=3)<br />
4. Are the drugs prescribed listed in the EDL?<br />
(all=1 Some=2 N<strong>on</strong> <strong>of</strong> the drugs =3)<br />
5. Is the drug dosage form provided?<br />
( Yes=1 No=2)<br />
6. Are the strengths <strong>of</strong> dosage form provided?<br />
( Yes=1 No=2)<br />
7. Is the diagnosis menti<strong>on</strong>ed in the prescripti<strong>on</strong>?<br />
(Yes=1 No=2) if yes please menti<strong>on</strong> below ………<br />
Diagnosis : -<br />
8. Give the following details for the drugs listed in EDL<br />
Sr<br />
1<br />
2<br />
3<br />
4<br />
5<br />
6<br />
7<br />
8<br />
EDL<br />
Code<br />
Drug Name<br />
Dosage<br />
form<br />
___________________________________________<br />
Strength <strong>of</strong><br />
drug<br />
Generic<br />
Name*<br />
Quantity<br />
Prescribed<br />
Available in<br />
Pharmacy * Yes<br />
= 1, No = 2<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
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Chhattisgarh 112
Demand Calculati<strong>on</strong> for <strong>Drugs</strong> <strong>on</strong> EDL<br />
S.<br />
No.<br />
1.<br />
2.<br />
3.<br />
4.<br />
5.<br />
6.<br />
7.<br />
8.<br />
9.<br />
10.<br />
Drug (as per EDL)<br />
Formulati<strong>on</strong><br />
Strength<br />
Annexure 4 – Store Data collecti<strong>on</strong> tool<br />
Drug Code<br />
Facility Code (P/S/T )<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
Annual C<strong>on</strong>sumpti<strong>on</strong> (A) No Stock (B) Number <strong>of</strong><br />
days<br />
Year<br />
1<br />
Year<br />
2<br />
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Year<br />
3<br />
Avera<br />
ge<br />
Year<br />
1<br />
Year<br />
2<br />
Year<br />
3<br />
Avera<br />
ge
Annexure 5 – List <strong>of</strong> c<strong>on</strong>sumables included in the ambit <strong>of</strong> the study<br />
Code Surgical List Unit Pack Facility<br />
Code<br />
C2 Absorbent Cott<strong>on</strong> Wool IP 700 Gms Roll P<br />
C3 Adhesive Plasters USP Spool Zinc<br />
Oxide Self Adhesive Plaster USP<br />
Spool T<br />
C22 Catheters malecot's Rubber &<br />
Latex<br />
C23 Central Vein Catheters T<br />
C24 Corrugated rubber/latex T<br />
C25 Crape Bandage P<br />
C26 Crape Bandage P<br />
C27 Disposable Needles Nos T<br />
C28 Disposable Needles Nos S<br />
C29 Disposable Needles Nos S<br />
C30 Disposable Needles Nos P<br />
C31 Disposable Needles Nos S<br />
C32 Disposable Needles Nos S ( R )<br />
C33 Disposable Needles Nos S ( R )<br />
C34 Disposable Scalp Vein Set Nos S<br />
C35 Disposable Scalp Vein Set Nos S<br />
C36 Disposable Sucti<strong>on</strong> Catheter Nos S<br />
C37 Disposable Sucti<strong>on</strong> Catheter Nos S<br />
C38 Disposable Syringes with Needle<br />
CGS<br />
Nos P<br />
C39 Disposable Syringes with Needle<br />
CGS<br />
C40 Disposable Syringes with Needle<br />
CGS<br />
C41 Disposable Syringes with Needle<br />
CGS<br />
C42 Disposable Syringes with Needle<br />
CGS<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
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Chhattisgarh 114<br />
T<br />
Nos S<br />
Nos S<br />
Nos S<br />
Nos T<br />
C44 Elastoplast 10cm S<br />
C51 Flatus Tube Nos T<br />
C53 Foley's Urinary Catheter Size 16 Nos S<br />
C54 Foley's Urinary Catheter Size 18 Nos S
C55 Foley's Urinary Catheter Size 20 Nos S<br />
C56 Foley's Urinary Catheter Size 22 Nos S<br />
C58 Gloves Pair P<br />
C59 Gloves Pair S<br />
C60 Gloves Pair S<br />
C61 Gloves Pair P<br />
C62 Infant feeding tubes Nos S (R )<br />
C63 Infant feeding tubes Nos S (R )<br />
C64 Infant feeding tubes Nos S (R )<br />
C65 Infant feeding tubes Nos S (R )<br />
C66 Infusi<strong>on</strong> Pump Nos S (R )<br />
C71 IV Cannula (Two way) Nos S (R )<br />
C84 Medicated sterile paraffin gauze Nos S<br />
C85 Micro drip set Nos S (R )<br />
C87 Needle Hypodermic-Insulin<br />
Needle<br />
Nos S (R )<br />
C89 Ne<strong>on</strong>atal Sucti<strong>on</strong> Tube 10 French Nos S (R )<br />
C90 Paper adhesive Plaster;Micropore<br />
10 cm<br />
Roll S<br />
C92 Pediatric drip set Nos S (R )<br />
C93 Plaster <strong>of</strong> Paris bandages BP 10 Rolls S<br />
C94 Plaster <strong>of</strong> Paris bandages BP 10 Rolls S<br />
C97 Ryle's Tube (P.V.C) Nos S<br />
C98 Ryle's Tube (P.V.C) Nos S<br />
C99 Ryle's Tube (P.V.C) Nos S<br />
C100 Ryle's Tube (P.V.C) Nos S<br />
C101 Ryle's Tube (P.V.C) Nos S<br />
C104 Simple Plain Catheters Nos T<br />
C105 Skin grafting Blade Nos T<br />
C112 Surgical Blade 100 blades/packet S<br />
C113 Surgical Blade 101 blades/packet S<br />
C114 Surgical Blade 102 blades/packet P<br />
C115 Surgical Blade 103 blades/packet S<br />
C116 Bag 6 Nos/Pkt in each S<br />
C117 Suture Needles Curved and<br />
Cutting Assorted Pack 1/2 Circle<br />
Cutting<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
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Chhattisgarh 115<br />
Size<br />
6 Nos/Pkt in each<br />
Size<br />
C129 Tube Drain PVC Nos S (R )<br />
C131 Urinary Drainage Nos P<br />
S
Sutures<br />
Absorbable Sutures<br />
Catgut Chromic(with needle)<br />
Chromic (without needles)<br />
Catgut Plain(without needles)<br />
Synthetic absorbable sutures<br />
N<strong>on</strong> absorbable sutures black braided<br />
silk(with needle)<br />
Black braided silk (without needle in reels)<br />
Black braided silk (with needle in reels)<br />
Polyamide m<strong>on</strong><strong>of</strong>ilament polyamide filament<br />
with needle<br />
Polypropylene m<strong>on</strong><strong>of</strong>ilament sterile precut<br />
lengths<br />
Polycarb<strong>on</strong> sutures<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
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Chhattisgarh 116
Bibliography<br />
1) (http://health.cg.gov.in)- Chhattisgarh State Govt. <strong>Health</strong> Dept. website<br />
2) 5 th Comm<strong>on</strong> Review Missi<strong>on</strong>, Chhattisgarh<br />
3) PHFI Standards<br />
4) High Level Expert Group <str<strong>on</strong>g>Report</str<strong>on</strong>g> <strong>on</strong> Universal <strong>Health</strong> Coverage for India. Instituted by<br />
Planning Commissi<strong>on</strong> <strong>of</strong> India Submitted to the Planning Commissi<strong>on</strong> <strong>of</strong> India, New Delhi,<br />
November, 2011<br />
5) <str<strong>on</strong>g>Report</str<strong>on</strong>g> <strong>of</strong> the Nati<strong>on</strong>al Commissi<strong>on</strong> <strong>on</strong> Macroec<strong>on</strong>omics and <strong>Health</strong>,2005<br />
6) iSixSigma; An Analytical Method for Estimating Project Benefits; Chew Jian Chieh; 2011<br />
7) Immunisati<strong>on</strong> Handbook for Medical Officers, <strong>Department</strong> <strong>of</strong> <strong>Health</strong> & <strong>Family</strong> Welfare,<br />
Government <strong>of</strong> India.<br />
8) ‘Guidelines for Diagnosis & Treatment <strong>of</strong> Malaria in India’ 2011 developed by the Nati<strong>on</strong>al<br />
Institute <strong>of</strong> Malaria Research & WHO<br />
<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
9) Prevalence <strong>of</strong> Diabetes in Urban India JAPI , June 2010; Vol 58 A Ramachandran et al ‘<br />
Current status <strong>of</strong> Diabetes in India’<br />
10) Kokiwar Prashant R, Gupta Sunil S et al Prevalence <strong>of</strong> Hypertensi<strong>on</strong> in a rural community <strong>of</strong><br />
central India, Int Journal <strong>of</strong> Biological & Medical research<br />
11) NPCDCS, Chhattisgarh, Screening <strong>of</strong> Diabetes & Hypertensi<strong>on</strong> data.<br />
12) R Prakash Upadhyay, An Overview <strong>of</strong> the Burden <strong>of</strong> N<strong>on</strong> Communicable Diseases in India,<br />
Review Article, Indian Journal <strong>of</strong> Public <strong>Health</strong>, Vol 41, No.3,2012<br />
13) http://pipnrhmmohfw.nic.in/index_files/high_focus_n<strong>on</strong>_ne/Chhattisgarh/Presentati<strong>on</strong>/NPCC%2006.04.11<br />
-final-%201.35%20pm.pdf. Nati<strong>on</strong>al Rural <strong>Health</strong> Missi<strong>on</strong> Chhattisgarh, NPCC Meeting -<br />
6thApril 2011, New Delhi)<br />
14) ICMR – Medical Research Council Workshop <strong>on</strong> Chr<strong>on</strong>ic Diseases 2009 ; The Burden <strong>of</strong><br />
Cardiovascular Disease in India<br />
15) ICMR – Medical Research Council Workshop <strong>on</strong> Chr<strong>on</strong>ic Diseases 2009 ; The Burden <strong>of</strong><br />
Diabetes in India<br />
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<str<strong>on</strong>g>Report</str<strong>on</strong>g><br />
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