Amrit

AMRIT SCHEME

1. Dr. Gaurav Gupta PG-HA 2017 SGPGIMS

2. Initiative in health sector Background Introduction Objectives Operating Mechanism AMRIT Retail Outlets AMRIT Center Features Conclusion CONDOUCT PROTOCOL

3. The Government has formulated the National Health Policy, 2017, which aims at attainment of the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence New Initiatives in Health Sector

4. Introduction of new vaccines Mission Indradhanush NHM Free Drug  and Diagnostics Initiatives Setting up of New AIIMS Institutions Upgradation of district hospitals to medical college hospitals. PradhanMantri National Dialysis Services Programme The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Senior Citizen Health Insurance Scheme (SCHIS) India Newborn Action Plan Biomedical Equipment Management & Maintenance Program (BMMP) MAA- Mother's Absolute Affection Programme Kayakalp initiative Affordable Medicines and Reliable Implants for Treatment (AMRIT)

5. Universal Screening of Non-Communicable Diseases- Government of India launched Operational Guidelines on prevention, screening and control of common Non-Communicable Diseases: Hypertension, Diabetes and Common Cancer-Oral, Breast, Cervix National Quality Assurance Programme , under which, Quality Standards for District Hospitals, Community Health Centres , Primary Health Centres and Urban Primary Health Centres have been formulated New Mental Health Policy 2014 envisions promoting mental health, by providing accessible, affordable and quality health and social care to all persons with mental illness

6. Statistics indicate that Indians diagnosed with cancer are 700,000 every year. About 2.8 million people have cancer at any point of time and half a million die of the disease each year. The annual figure of women being diagnosed with breast cancer in India is 145,000, according to the World Health Organisation What’s more, cancer drug market is unregulated, thus riddled with high prices as compared to their product cost. Retailers charge dynamic rates based on the patient’s income group, offering marginal discounts. This results in most of the middle-class patients ending up paying 70 to 80 per cent of the MRP. BACKGROUND

7. A significant number of patients (nearly over 50 per cent) stop visiting hospitals after two or three cycles of chemotherapy due to unaffordable costs. Some breast-cancer patients need targeted treatment drugs, which cost around Rs.75,000 for a course; a patient could need up to 17 courses. Similarly, a drug used to treat colon, kidney, lung and gall bladder cancer can add around Rs.8 lakh to a patient’s bill—which is at around Rs.1 lakh a cycle

8. . Hence, with the aim to reduce the expenditure incurred by patients on treatment of cancer and heart diseases, the Ministry for Health & Family Welfare, has launched the Affordable Medicines and Reliable Implants for Treatment (AMRIT) programme .

9. The flagship programme of the Union  Health  ministry - AMRIT (Affordable Medicines and Reliable Implants for Treatment) - to provide affordable life-saving cancer, cardiac drugs and medical disposables was launched by the Union  Health  Minister Shri J P Nadda in November 2015 and is being implemented through mini- ratna PSU HLL Lifecare Ltd (HLL) which has been setting up pharmacies at major hospitals across the country to dispense the medicines. INTRODUCTION

10. HLL has already opened 16 AMRIT pharmacies in major cities across the country, with nine more ready to go operational soon and five additional ones under construction out of a target of 284 outlets in the next two years. Till January 2018 a total number of 111 AMRIT Pharmacies have been established in country.

11. The primary goal of AMRIT is to make available and accessible, at very affordable rates, all drugs, implants, surgical disposables that are not dispensed free of cost by the hospitals The AMRIT pharmacies stock nearly 2,200 drugs, surgical disposables and implants (including for cardiovascular, Cancer and diabetes, stents etc.) that are offered at an average discount of 63 percent on medicines OBJECTIVES

12. To open AMRIT outlets which would sell medicines and equipment at affordable prices To open in all central government hospitals Its intended beneficiaries will be patients suffering from cancer and heart diseases (non-communicable diseases). The project is implemented by government-owned HLL Lifecare Ltd (HLL) which is deputed to establish and run AMRIT chain of pharmacies across the country. These drugs and implants under the scheme will be sold based upon authentic prescriptions from doctors.

13. Government buys the medicine in bulk so to contain its cost to a minimum and affordable amount Focus is on Generic Drug because they are less costly than branded one but the quality is never compromised These drugs are the made available to AMRIT Retail outlets. Operating Mechanism

14. As part of the programme , retail outlets will sell drugs for the cancer and heart diseases at highly discounted rates. The AMRIT pharmacy sells 202 cancer and 186 cardio-vascular drugs, and 148 types of cardiac implants at very affordable prices. Patients can buy medicines and implants at 50 to 60 percent cheaper prices than the open market from AMRIT outlet The project has been floated in a tie-up with government-owned HLL Lifecare Ltd (HLL) which is deputed to establish and run the AMRIT chain of pharmacies across the country AMRIT R etail O utlets

15. AIIMS, New Delhi - The first AMRIT centre was launched at All India Institute of Medical Sciences (AIIMS), New Delhi on November 15, 2015. Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh Lady Hardinge Medical College, New Delhi RML hospital, New Delhi Safdarjung hospital, Delhi Jawaharlal Institute of Postgraduate Medical Education and Research in (JIPMER), Puducherry AIIMS, Rishikesh AIIMS, Raipur North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong Regional Institute of Medical Sciences (RIMS), Imphal All India Institute Medical Sciences (AIIMS), Jodhpur AMRIT Centers

16. This is in addition to the 52 AMRIT Deen Dayal pharmacies that were opened across the state of  Gujarat  on Monday (14.11.2016) In the first year of operation, the AMRIT pharmacies have benefited a total of 5.14 lakh patients. They have achieved collective sales of 18.51 crores of medicines worth Rs 48.19 crores in MRP, resulting in total savings of Rs 29.68 crores .\

17. The AMRIT pharmacies stock nearly 2,200 drugs, surgical disposables and implants (including for cardiovascular, cancer and diabetes, stents etc.) that are offered at an average discount of 63 percent on medicines. In the first year of operation, the AMRIT pharmacies have benefited a total of 5.14 lakh patients. They have achieved collective sales of 18.51 crores of medicines worth Rs 48.19 crores in MRP, resulting in total savings of Rs 29.68 crore SALIENT FEATURES

18. These medicines reportedly also have a better quality than the ones that are available at private medical stores with printed price tags. HLL Lifecare Ltd. (HLL), owned and run by the Government of India, is facilitating the supply of these medicines, which will have authentic prescriptions from doctors According to a  report , AMRIT pharmacies will sell ‘ Docetaxel 120mg’ used for chemotherapy cycle at Rs 888.75 (93 percent rebate) for one cycle, when the MRP of the injection is Rs 13,440. In a similar way, Caboplatin 450 mg would be sold at Rs 1,316.25 while its MRP is at Rs 2,561.57

19. High discounts are available on both medicines and surgical equipment: on medicines 60 to 70 percent and on surgical equipment we are offering up to 90-percent discount. Earlier, a patient had to pay around Rs 2.50 to Rs 3 lakh but now they are paying just Rs one lakh for the implants.

20. PRICES UNDER AMRIT PHARMACY Bare metal stent Then: Rs 1lakh Now: Rs 12,060 Drug eluting stent Then: Rs 2 lakh Now: Rs 29,000 Cobalt chromium knee replacement Then: Rs 1 lakh Now: Rs 54,000  Now: Rs 60,000-Rs 90,000 Titanium knee replacement Then: Rs 2.5lakhs Now: Rs 76,000 Total hip replacement Then:Rs 1.5 lakh Now Rs 60,000

21. Cardiovascular and cancer in recent time have become biggest killer of mankind while the government at both center and state level is making effort to provide quality health care to each class of society but the rising cost of medicine appears to be achilies heel of any intervention protocol .within this light government initiative to provide medicine at a cheaper cost will be a bull eyes hitting of the rising burden . Conclusion

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