Jan Aushadhi Medicine List Pdf Download

Generic medicines are an affordable alternative to the costlier, patented, branded medicines. However, vast majority of Indian population still has to spend "out of pocket" on costlier, branded medicines. Various surveys in India have highlighted the problem of availability and supply of cheaper generics in Indian market. Recently, Government of India has initiated the scheme of "Jan Aushadhi Stores", planned in each district in the country, to provide for cheaper generic medicines. However, several surveys have focused on poor quality image of generics, both in the mindsets of prescribers, as well as patients. This study is one of the first such studies, which compares the quality of four commonly used drugs -- Alprazolam, Cetrizine, Ciprofloxacin, Fluoxitine, available as generics from "Jan Aushadhi Stores", with that of the respective leading brands, viz., Restyl, Alerid, Ciprobid and Fludac, from the market. These medicines were tested as per the Indian pharmacopoeial guidelines. Results indicate all the four pairs of generics vs. popular branded medicines pass the relevant pharmacopoeial tests, thereby underlining that generics are of as good quality as branded medicines. The study highlights the importance of spreading awareness on quality of generics, amongst the prescribers and the public as well.

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... This forces diabetes patients to seek healthcare in the private sector through out-of-pocket (OOP) payments [13]. Patients also purchase medicines through private-sector online pharmacies and/or government schemes such as Jan Aushadhi Scheme (JAS) that aim to provide quality medicines at affordable prices to all [14][15][16]. ...

... In this context, it is important to evaluate insulin availability and affordability in India's healthcare sector. A previous study on insulin access in the northern state of Delhi was limited to the private sector market [16]. Further, the different states in India (often described as 'nations within nation') have stark differences in disease burden and health system functioning, which calls for region-specific studies [10]. ...

... It appears that the Bengaluru insulin marketlike those in Delhi (India) and other emerging countriesis witnessing a transition from human insulin to expensive analogue insulins and cartridges/pen forms of delivery [4,5,16,22]. Recent studies report that, in India, as high as 38.0 and 66.0% patients, respectively, use analogue insulin and insulin pens [23,24]. ...

Introduction: Considering limited global access to affordable insulin, we evaluated insulin access in public and private health sectors in Bengaluru, India. Methods: Employing modified WHO/HAI methodology, we used mixed-methods analysis to study insulin access and factors influencing insulin supply and demand in Bengaluru in December 2017. We assessed insulin availability, price and affordability in a representative sample of 5 public-sector hospitals, 5 private-sector hospitals and 30 retail pharmacies. We obtained insulin price data from websites of government Jan Aushadhi scheme (JAS) and four online private-sector retail pharmacies. We interviewed wholesalers in April 2018 to understand insulin market dynamics. Results: Mean availability of insulins on India's 2015 Essential Medicine List was 66.7% in the public sector, lower than private-sector retail (76.1%) and hospital pharmacies (93.3%). Among private retailers, mean availability was higher among chain (96.7%) than independent pharmacies (68.3%). Non-Indian companies supplied 67.3% products in both sectors. 79.1% products were manufactured in India, of which 60% were marketed by non-Indian companies.In private retail pharmacies, median consumer prices of human insulin cartridges and pens were 2.5 and 3.6 times, respectively, that of human insulin vials. Analogues depending on delivery device were twice as expensive as human insulin. Human insulin vials were 18.3% less expensive in JAS pharmacies than private retail pharmacies. The lowest paid unskilled worker would pay 1.4 to 9.3 days' wages for a month's supply, depending on insulin type and health sector. Wholesaler interviews suggest that challenges constraining patient insulin access include limited market competition, physicians' preference for non-Indian insulins, and the ongoing transition from human to analogue insulin. Rising popularity of online and chain pharmacies may influence insulin access. Conclusion: Insulin availability in Bengaluru's public sector falls short of WHO's 80% target. Insulin remains unaffordable in both private and public sectors. To improve insulin availability and affordability, government should streamline insulin procurement and supply chains at different levels, mandate biosimilar prescribing, educate physicians to pursue evidence-based prescribing, and empower pharmacists with brand substitution. Patients must be encouraged to shop around for lower prices from subsidized schemes like JAS. While non-Indian companies dominate Bengaluru's insulin market, rising market competition from Indian companies may improve access.

... [8] The government has opened the PMJAK stores in cities rather than in villages and small towns where availability and affordability of medicines is a bigger challenge. [10] Mass education and awareness programs on the generics and their quality sold at the Jan Aushadhi stores may help to instil confidence among the patients as well as health-care providers. [10] Only a few proportion of the study population (n = 35, 17.5%) knew where the nearest PMJAK was located at the CHC in Kengeri and all the participants agreed there should be an information board outside PMJAK. ...

... [10] Mass education and awareness programs on the generics and their quality sold at the Jan Aushadhi stores may help to instil confidence among the patients as well as health-care providers. [10] Only a few proportion of the study population (n = 35, 17.5%) knew where the nearest PMJAK was located at the CHC in Kengeri and all the participants agreed there should be an information board outside PMJAK. Absence of informative boards outside PMJAK stores was one of the major reasons for the unawareness reported in Chandigarh (2016) also. ...

Nigy Johnson
YShweta Somasundara
PadmaK Bhat
Nayana M

Background: The burden and prevalence of oral diseases are higher in developing countries, especially among the poor and disadvantaged populations. These people may suffer from various dental and systemic illnesses. Hence, provision of reducing the out-of-pocket money by purchasing generic drugs might enable better oral and general health-care-seeking behavior. Objectives: The objective was to assess the perception toward low-cost generic medicines available through the Pradhana Manthri Bhartiya Janaushadhi Pariyojana and their usage among dental patients visiting community dental outreach programs conducted in the villages near a tertiary care dental teaching hospital, Bangalore South. Materials and Methods: An exploratory descriptive cross-sectional survey was carried out over a period of 3 months among 200 residents participating in the dental outreach programs in 15 villages of Bangalore South. Data were collected using a prevalidated closed-ended interviewer-administered questionnaire. Results: Most respondents (82.5%) were not aware of Prime Minister Jan Aushadhi Kendra (PMJAK) and only 17.5% knew about the nearest PMJAK. The majority (96.5%) were not aware of the availability of dental-related medicines in PMJAK and (95.5%) preferred to buy Jan Aushadhi drugs over branded medicine if the quality of generic and branded medicine is the same. Most respondents (98%) liked to have more awareness through mass media about PMJAKs/medicines. Conclusion: The results indicate that more awareness must be created, and strict laws implemented about the Jan Aushadhi scheme to save health cost expenditure; if the quality of generic and branded medicine is the same, most people are willing to use the medicines sold at PMJA Kendras.

... The unethical promotional practices being adopted by the companies make the essential medicines unaffordable to common man. 10 Therefore it is important to know the attitudes and perceptions of physicians regarding use of generics. 11,12 Many studies have shown that compliance of patients on generic drugs was far more better as compared to their brand name counterparts. ...

... 16 The assumptions about the decreased quality of generics could be eliminated by continuing medical education of physicians about drug discovery, development, and regulations. 10,22 The major limitation of this study is the small sample size. Hence, findings of this study cannot be generalized. ...

Background: The assessment of doctors' perceptions and understanding about generic medicines may help in recognizing the key areas which may act as hurdle to mass scale use of generics. The primary objective of this study was to explore the knowledge, attitude, and practice (KAP) of doctors toward generic medicines.Methods: A cross-sectional study was carried out using a pretested questionnaire in a tertiary care teaching hospital of Jammu (J and K). The questionnaire was designed to assess the KAP about generic medicines. The doctors working in this institute during the study period were included. Data was compiled and analysed using online website, http://www.graphpad.com. P-values of < 0.05 were considered to indicate statistical significance.Results: A 62.9% doctors agreed to the fact that generic medicines were intended to be interchangeable with a branded drug (p=0.0139). Among the doctors, 77.5% were aware that generic drug manufacturers need to conduct studies to show bioequivalence between the generic medicine and their branded counterparts (p =0.0001). 88.8% of the doctors agreed that importance of generic medicines should be taught in early part of internship. 80.9% doctors did not think that switching a patient from a brand-name to generic drug may change the outcome of the therapy (p <0.0001).Conclusion: The present study showed that a good percentage of doctors were well aware of generic medicines' usage. However due to concerns expressed by a certain fraction of participants, further work is needed on how interventions for medical professionals and for the public can lead to increase in the awareness and acceptability of generic medicines.

... Therefore, low income patients are forced to buy more expensive medicines from private sector or simply go without treatment. 5,6 Branded medicines are strongly promoted and these promotional costs also add to their MRPs. 7 Studies also suggest that interactions with medical representatives influences prescribing and cause cognitive dissonance for prescribers. ...

Venkatesh V. Khadke
Shahbaz Yasin Khanda

Background: Government of India is trying to popularize generic medicines, still most Registered Medical Practitioners (RMPs) doubt its quality and efficacy. We conducted a cross sectional survey to study the barriers that hinders the practice of writing generic prescriptions. The aim was to study doctor's knowledge, beliefs and actual practices regarding generic medicines. This study is a KAP survey model (Knowledge, attitude, practices) to study beliefs, barriers, awareness and actual practices regarding use of generic medicines amongst private practioners and RMPs of tertiary care Government hospital in Nanded city.Methods: A cross sectional survey was conducted on a sample of 300 randomly selected RMPs practicing in Nanded, Maharashtra. A 26-item questionnaire was designed, validated, and data collected through personal visits. Fisher's exact test was applied to see associations between variables using Graphpad Prism 7.Results: 234 RMPs responded to the questionnaire i.e. a response rate of 78% was achieved. 107 (45.7%) participants claimed to be actively prescribing generic medicines. 122 (52.1%) of the participants were unaware of any generic medical shop in their locality. 83 (35.5%) participants believed generics to be duplicate/ substandard. However, 16 (19.3%) of them still prescribed generics. One-third of them actually preferred its use for family.Conclusions: RMPs do not accept the use of generic medicines for concerns about its quality and efficacy. Also, there was unawareness regarding availability of generic medicines in the locality. RMPs need to be educated about manufacture, sale and quality aspects of generic medicines in India.

... The India government plans to establish at least one Jan Aushadhi store in each of the 600 districts of the country to improve access to quality medications at an affordable rate to the underprivileged people. 1,2 The high cost of medications affects the most prevalent illness of India, which is Malaria. Malaria still remains a major public health problem worldwide. ...

"Malaria kills over one million people a year and most of them are young children," a World Health Organization (WHO) report says. The high incidence of malaria cases over 275 million a year globally imposes a huge economic burden both in the government and families. In India more than 20,000 people died of malaria in 1998. The disease is endemic to several parts of our country. Malaria is a protozoal disease caused by infection with Plasmodium parasite transmitted through bite of female anopheles mosquito. The four Plasmodium species are responsible for malaria in human beings: Plasmodium vivax, Plasmodium falciparum, Plasmodium oval and Plasmodium malariae. Though the malarial incidence seems to have declined because of several measures under taken, the proportion of Plasmodium falciparum cases is increasing. The common symptoms of uncomplicated malaria are non-specific and they include fever, chills, sweating, muscle and joint pain, abdominal pain, diarrhoea, nausea, vomiting, loss of appetite. If the malaria is not properly treated especially in falciparum cases, the parasite burden increases leading the severe malaria (cerebral malaria). If untreated the cerebral malaria is almost always fatal. The diagnosis of malaria is based on clinical examination and laboratory testing for presence of parasites in blood. Chloroquine has been the choice for malaria treatment for many decades because of its efficacy, low cost, low toxicity. However, it became increasingly ineffective as chloroquine resistant strains spread across malaria endemic areas. Drug resistant Plasmodium falciparum is now reported in virtually all malaria endemic areas. All common used drugs are affected to various degrees except artemisinin type compounds. The World Health Organization (WHO) has now recommended the combination therapy with artemisinin or its derivatives. The primary objective of treatment of uncomplicated malaria is cure of infection while preventing mortality is the main objective of treatment of serious form of malaria. The recommended treatment options aim at curing the individual and resisting the development of resistance. While the combination therapy offers more efficacy and less chance of developing resistance, there is increased chance adverse effects and increased cost. Combination therapy means using at least two medicines, which attack the malaria parasite in completely different ways. Though at present the artemisinin combination therapy is costly, the continued research for producing them more cheaply and plentifully will make them affordable. The following table gives the essential details of the various combination therapies: (see given at the end) suggested by WHO. The community pharmacists need to have the following points in mind while dealing with malaria patients or dispensing anti-malaria medicines: • Never use Artesunate or similar medicines alone. Us them only in combination with other anti-malarial medicines. • Advise the patients on appropriate use of these medicines. • Insist on adherence of dose, dosing schedule and duration of treatment. • Refer the patients to health centre or doctor for diagnosis and prescription. • Educate patients on the problem of resistance if medicines are not properly used. • Advise the parents to keep medicines reach out of children. • Advise the patients to inform the side effects they experience either to you or their doctor. • Educate the public on prevention methods of malaria.

... The ways in which health systems organise their governance, resources use, organisation and management of services as well interact with people are being identified as the crucial in ensuring access to medicines, especially in public services [15] (see Fig. 1). Recent efforts at making available cheaper generic equivalents of essential drugs through Jan Aushadhi stores (people's pharmacy in Hindi) have shown promising results; the generic drugs supplied have been reported to be comparable in quality to their proprietary equivalents [16,17]. ...

Background India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially affected, as they often need lifelong medicines. Over the past years in India, there have been several efforts to improve drug availability at government primary health centres. In this study, we aim to understand health system factors that affect utilisation and access to generic medicines for people with non-communicable diseases. Methods This study aims to understand if (and how) a package of interventions targeting primary health centres and community participation platforms affect utilisation and access to generic medicines for people with non-communicable diseases in the current district context in India. This study will employ a quasi-experimental design and a qualitative theory-driven approach. PHCs will be randomly assigned to one of three arms of the intervention. In one arm, PHCs will receive inputs to optimise service delivery for non-communicable diseases, while the second arm will receive an additional package of interventions to strengthen community participation platforms for improving non-communicable disease care. The third arm will be the control. We will conduct household and facility surveys, before and after the intervention and will estimate the effect of the intervention by difference-in-difference analysis. Sample size for measuring effects was calculated based on obtaining at least 30 households for each primary health centre spread across three distance-based clusters. Primary outcomes include availability and utilisation of medicines at primary health centres and out-of-pocket expenditure for medicines by non-communicable disease households. Focus group discussions with patients and in-depth interviews with health workers will also be conducted. Qualitative and process documentation data will be used to explain how the intervention could have worked. DiscussionBy taking into consideration several health system building blocks and trying to understand how they interact, our study aims to generate evidence for health planners on how to optimise health services to improve access to medicines. Trial registrationProtocol registered on Clinical Trials Registry of India with registration identifier number CTRI/2015/03/005640 on 17th March 2015.

... The Government of India by utilizing the local resources for manufacture, distribution and sale of prescription medicines has established study supply. (Table 2) Here is list of the generic drugs that are sold at predetermined affordable price to the public [5]. At present 651 formulations of generic medicines are sold through exclusive Jan Aushadhi Kendra's. ...

... The only study done on the JAS addressed the issue of quality of generic medicines in the JAS and found that the medicines tested after procuring from Jan Aushadhi sources are of equivalent and comparable quality to their counterpart branded medicines available in the market. 17 Hence, it is not quality but cost of medicines in JAS which may make the scheme a failure. ...

Kanchan Mukherjee

Medicines constitute a substantial proportion of out-of-pocket (OOP) expenses in Indian households. In order to address this issue, the Government of India launched the Jan Aushadhi (Medicine for the Masses) Scheme (JAS) to provide cheap generic medicines to the patients (http://janaushadhi.gov.in/about_jan_aushadhi.html). These medicines are provided through the Jan Aushadhi stores established across the country. The objective of this study was to do a quick assessment for policy-makers regarding the objective of the JAS. Implications on cost savings for patients and policy implications of the scheme were analyzed. Secondary data sources were used to obtain prices of medicines under the JAS and prices of branded medicines of the same formulations. A cost analysis design was used. There are substantial differences between the JAS price and the cheapest branded medicine available in the market. However, not all JAS prices are lower than branded medicines. For example, the cheapest branded cefuroxime axetil (500 mg) (antibiotic) in the market is almost three times cheaper than its JAS price. Hence, there are cheaper brands available for some commonly prescribed medicines. From the policy perspective, it raises serious questions regarding the pricing of medicines in the JAS and its overarching goal. Since patients are dependent on physicians for medicine prescriptions and have little knowledge of the price variations among branded and generic medicines, the JAS may not provide the cheapest alternative for the patients. Hence, the government should urgently review the JAS prices to achieve its goal of providing low-cost affordable medicines.

... In contrast, the unbranded generics can be considerably cheaper than their brand equivalents offering affordability (Baltas and Argouslidis, 2007). For instance in 2008, the Indian government had launched the 'Jan Aushadhi Campaign" in each district to provide quality generic medicines at lower prices (Singhal et al., 2011). ...

Background: The access to affordable medicines is counted as a challenge, despite international measures taken towards cost containment and price regulation. Objective: To identify and review the literature on international approaches related to medicine price regulation, control, and its effectiveness. Methods: In this scoping review, peer-reviewed research and review articles, discussion papers, public documents relating to medicine pricing policies were reviewed. The search strategy was structured according to STARLITE principles. The key search terms and phrases were "medicine prices", "causes of high medicine prices", " approaches towards medicine prices control", "national medicine policies", "international approaches towards medicine price control", "containment policies", and "effects of pricing policy on medicine". Results: Medicine pricing and price regulation policies were drafted and implemented with no optimal results and things don't seem to have improved much and remain as the distant goal. These policies were either less comprehensive, outdated and fell short in implementation especially in low and middle-income countries (LMICs) due to lack of funding, infrastructure or trained professional task force. Overall, none of the policy options was preferred. Multi-pronged policy options crafted in local context are required to tackle the issue. Conclusion: The authors identify gaps in the literature and propose advanced research in the area to strengthen the healthcare system by improving medicine pricing system in each country.

... [3][4][5] To overcome this problem inflicting immense economic impact on poor population, the Indian Government had launched the Jan Aushadhi campaign in April 2008 by opening government -controlled centers in various states to provide quality generic medicines at lower prices to their counterpart branded ones to make them easily affordable to a common man. [6] Currently, our country has more than 850 Pradhan Mantri Bhartiya Jan Aushadhi Kendra's functional spreading over 28 states/union territories. As on January 31, 2017, the product basket contains >1100 items (1000 medicines and 154 surgical and consumables). ...

Shamiya Sadiq
Vijay Khajuria
Kanika Khajuria

Background: Increased health-care expenses are a major concern in a country like ours where economic conditions are on the lower side. The Government of India to control the increased health-care expenses launched the Jan Aushadhi scheme in April 2008 by providing low-cost generic medicine. However, the results have not been as expected. Aims and Objectives: The current study was designed to have insight into this problem by studying knowledge, attitude, and practices (KAP) among doctors and patients. Materials and Methods: This study was conducted in Government Medical College, Jammu and surrounding hospitals where the doctors and patients were provided with a prevalidated questionnaire comprising total 42 questions based on KAP. A total of 104 participants (48 doctors and 56 patients) and their responses were recorded and presented as number percent. Results: All the participating physicians were aware of the Pradhan Mantri Jan Aushadhi scheme and availability of its stores. 83.3% of doctors knew that the Jan Aushadhi medicines are cheaper than other brand products, whereas 25% of doctors believed that generic medicines are slow to act. Almost all doctors (83.3%) agreed that the economic condition of the patient should be the prescribing criteria for generic medicine. 16.66% of doctors said that they prescribe Jan Aushadhi generic medicines. 75% of patients were unaware of Jan Aushadhi and all patients agreed that branded medicines are expensive and wanted cheaper alternatives. Most of the patients (87.5%) believed that Jan Aushadhi medicine is one such alternative. Conclusion: We conclude that some of the doctors are still not convinced about the efficacy and promptness of Jan Aushadhi generic medicines. Maximum doctors do not prescribe generic medicines. Hence, the doctors should be encouraged to use more of Jan Aushadhi generic medicines and patients should also be educated about this scheme.

... The product cycle is explains best usually the launch, development sustains and exit of the brand the best performing brands are called as cash cows as they generate huge profit for the company. The company invests huge money on human resource, and best effort towards the growth of the brand, in case the brand starts dealing in terms of sales then the company in the industry starts thinking above how to improve the sales, what are the regions for decline it may be due to competition/ technological breakthrough the Juniper Online Journal of Case Studies consumer preferences accordingly industry makes appropriate strategic stages so that the brand span gets extended [16] (Table 3) [17-20]. ...

... [4] To overcome the problem inflicting immense economic impact on poor population, the Indian government had launched the Jan Aushadhi campaign in April 2008 by opening government-controlled centers in various states to provide quality generic medicines at lower prices to their counterpart branded ones to make them easily affordable to a common man. [5] The doctor's prescription has a significant influence on the usage of generic medicines, particularly in developing countries where patients or relatives leave no stone unturned to buy precisely what is prescribed. [6] Physicians may favor branded medicines on various accounts. ...

... Further to add, few laboratory studies have suggested that JA drugs are of equal quality to that of branded ones. Singhal et al. [9] compared the quality of four JA drugs (alprazolam, cetirizine, ciprofloxacin, and fluoxetine) with the respective brands. JA drugs passed the relevant pharmacopoeial tests in the study, depicting that they are of good quality as that of the branded once. ...

Prasanna R Deshpande
MohdKazim Sheriff
AtmaramP Pawar

Objective: Jan Aushadhi (People's Medicine) Stores (JAS) are still struggling to get well established in India. Although the Jan Aushadhi (JA) scheme was launched in 2008, the number of JAS has not increased much until now. Therefore, we aimed to determine the working and productivity of JAS in the country. Methodology: We conducted a web-based survey of current JAS owners using a validated questionnaire. The questionnaire was sent to the E-mail addresses as mentioned on JA website. We solicited the information about the aspects such as background information, working and productivity of the store, hurdles while running a JAS, and the opinions. Results: One hundred and sixty-nine individuals responded to the survey out of 1008 (response rate = 16.76%). One hundred and forty-three (84.62%) JAS owners have reported the net monthly profit to be Rs.

... 3 The unethical promotional practices to get more prescriptions by the doctors by the pharmaceuticals make the drugs unaffordable to the common man as this adds to the cost of the medicine. 8 The importance of generic prescribing has been emphasized, primarily to reduce the cost of drugs. 9 With this background a study was planned with the aim to compare the cost of various commonly used branded medicines and generic medicines and to ascertain the rationality of emphasizing generic versus branded prescription. ...

Background: Same drug can be sold for different prices under different brand names due to various reasons. Branded medicine is the original product that has been developed by a pharmaceutical company and generic medicine is a copy of the original branded product, marketed after the expiry date of the patent and hence supposed to be of low cost as compared to their branded versions. The objective was to compare the costs of various branded and generic medicine and to ascertain the rationality of emphasizing generic versus branded prescription. Methods: Prices of 50 commonly used branded and generic medicines available as both branded and generic forms and in same concentration, dosage form and combination were selected and the percentage difference in the mean cost of generic and branded medicines was calculated. Results: The mean cost of 26 generic medicines out of the selected 50 medicines was higher than their branded versions. Mean cost of 20 branded medicines was higher than generic ones, and cost of 4 medicines was approximately same. Percentage difference in the mean costs of branded and generic medicines varied from <10% to >70%. Conclusions: Most of the drugs available in the market have brand names whether they are branded or generic medicines. Hence, doctor should write a cheapest known brand with the name of the generic salt in bracket so that the patient can buy another if that brand is not available. Furthermore, the Drug Controller of India should release a website where every doctor should be able to find the cheapest and approved drugs in the market.

... The assurance offered by doctors in this regard gives confidence to the patient about generic drugs [36]. Cost of medication forms a significant share of total medical expenses [37] and accounts for up to 80% of medical expenditure. Easy availability [38] and price affordability of medicines (PAoM) are therefore relevant factors that influence patient satisfaction. ...

G. Rejikumar
Archana Ks

Objectives: The objective of this study was to examine the formation of wellness perceptions and satisfaction from antecedents that explain various attributes regarding service quality perceptions about doctors by patients. The topic is of contemporary relevance as health-care firms are reengineering their competencies to deliver personalized health services to for unmatched experience to develop long-term relationships with patients.Methods: Responses from 280 patients about service quality attributes of doctors, wellness perceptions, and their satisfaction are collected using a structured questionnaire. An exploratory factor analysis was performed using SPSS. 20 to identify significant dimensions of doctor's service quality. The theoretical model developed with these dimensions, wellness perceptions, and patient satisfaction was estimated using partial least square-based structural equation modeling approach to test hypotheses about linkages among these constructs.Results: The dimension structure of doctor's service quality contained constructs such as "price affordability of medicines," "quality of diagnosis," "interaction quality of doctor," "appropriateness of tests prescribed," and "quality of usage prescriptions." These service quality dimensions of doctor significantly develop wellness perceptions and satisfaction among patients. Wellness perceptions act as a mediator in satisfaction development.Conclusions: Patient satisfaction and wellness perceptions are of primary importance in improving service quality in health care and to remain competitive. The health-care firms should train their professionals to interact with the patients more efficiently by adhering to the philosophy of patient centeredness in their service process.

... Social workers can help them find possible sources of funding to pay for medications [36]. Pharmacists could also educate patients about "Jan Aushadhi Stores" in India, which sell quality generic drugs at affordable prices for the public [37]. ...

Self-medication is a common practice in treating symptoms due to acute and chronic illnesses. It is a significant health dilemma in India. Exposure to advertising, low level of literacy, short duration of ailments, leftover medications, geographical barriers, embarrassment, affordability and health insurance are reasons for individuals opting for self-medication. Underserved populations in India are more likely to experience or accept self-medication due to these reasons. The major problem with self-medication is misdiagnosis, which can further perpetuate more complications. Furthermore, treating adverse events from self-medication can financially burden individuals and the healthcare systems alike. Healthcare professionals such as pharmacists can play an important role in minimizing the risks associated with self-medication through appropriate counseling and dissemination of accurate information to their patients. Recommendations for minimizing risks of self-medication include, increasing healthcare education for the public; especially the underserved populations, creating and reinforcing stricter government regulations on advertisements by drug companies, improving knowledge and comprehension of the side effects for drugs, increasing better communication between patients and healthcare providers, and improving access and quality healthcare for underserved populations. This review focuses on the reasons why individuals practice self-medication, the risks involved, and discusses possible recommendations for alleviating those risks related to self-medication.

... Branded medicines are available at higher costs because there is more spending on the promotion and research of the branded medicines. Generic medicine use is promoted to encourage proper medicine use which otherwise maybe not possible with costly branded medicines [4]. Generic drugs usually have the same efficacy as the branded medicines; the bioequivalence of generic drugs is proved to be similar to that of the branded medications. ...

Reena Shaik
Pradeep Muragundi

Objective: Even though the generic medicines are considered to be a cheaper option compared to the branded medicines in India, there is a need to study the price disparity among the generic medicines. Hence, the present study aims to evaluate the price disparity in generic medicines under Government Scheme in India.Methods: It was found that there were 101 generic medicines approved at a fixed price for procurement under the Central Government Health Services scheme. The prices of these medicines were searched for their availability as well as for current price in Bureau of Pharma PSUs of India (under Jan Aushadhi scheme) website.Results: The major category of the generic medicine were antibiotics (53.45%) followed by nonsteroidal anti-inflammatory drugs (10.89%) and cardiovascular (6.93%) drugs. It was evident from the result obtained by comparing the prices across categories that there were both positive and negative deviations.Conclusion: It was very much evident from the results of the mean of differences that even though fixed price contracts being in place, there is a price disparity in the generic drug prices seen under Government Scheme.

... 3 The unethical promotional practices by the pharmaceutical companies to get more prescriptions from the doctors make the drugs unaffordable to the common man as this adds to the cost of the medicine. 8 The importance of generic prescribing has been given importance, primarily to reduce the cost of drugs. 9 With this background a study was planned with the aim to compare the cost of various commonly used branded medicines and generic medicines and to establish the prudence of emphasizing generic versus branded prescription. ...

Mohith N.
Nalini G. K.
Deepak P.
Divyashree C. R.

Background: There is much debate regarding the importance of promoting the use of cheaper generic alternatives over brand-name drugs. While generic drugs have been noted to be comparable to brand-name drugs in their ability to treat conditions, significant debate surrounding their bioavailability or the concentration of the drug that reaches its site of action has arisen. Many experts continue to believe that generic and brand-name drugs are bioequivalent and equally viable options for effective drug treatment, as assumed in this review.Methods: Prices of commonly used branded and generic medicines in same concentration, dosage form and combination were compared with the help of Indian Drug Review, brochures of pharmaceuticals and pharmacies and Jan Aushadhi price list 2017. Mean of all the prices available of branded and generic medicine were calculated and the percentage difference in the mean costs of generic and branded medicines were calculated.Results: The mean cost of 47 branded medicines out of the selected 50 medicines was higher than their generic versions. Mean cost of 3 generic medicines was higher than branded ones. Percentage difference in the mean costs of branded and generic medicines varied from <10% to >70%.Conclusions: This study has shown a very noteworthy difference of prices between branded and generic drugs. Efforts should be taken to promote the generic medication. Misconception about low efficacy with generic drugs should be erased.

... It is important to note that this perception about both unbranded generic drugs and branded drugs is not completely correct. A study that compared four unbranded generic drugs being sold in Jan Aushadhi Kendras with their branded counterparts sold in the market, found that generics were as good in quality as the branded medicines (Singhal et al 2011). The drug procurement system currently in effect in Tamil Nadu, is also said to have a robust and efficient quality testing system ensuring that low cost and good quality unbranded generic drugs are provided to all the government hospitals in the state (Singh et al 2012 Ltd, Alembic Pharmaceuticals, and Abbott Healthcare Pvt Ltd) for providing sub-standard drugs (Thakur 2016). ...

Manu Kanchan

The announcement by the central government about bringing a law to ensure that doctors prescribe generic drugs only, has brought strong reactions from the pharmaceutical industry especially on drug quality and the price issues. The arguments put forth by the industry regarding these two issues are not completely true and appear to be coming from vested interests of the industry itself.

Amidst millions of malarial cases witnessed in India every year, access to quality anti-malarial medications is a problem. The availability, price and affordability of medications are the three important determinants of patients receiving effective healthcare services. The present study was conducted to evaluate the availability, cost and affordability of anti-malarials in India. This prospective, observational study was conducted in Cuddalore district in Tamil Nadu, India from August to September 2011. Three types of medication costs were taken into consideration for calculation purposes, the highest and the cheapest branded medication costs in private pharmacy and the Jan-Aushadhi prices. Affordability was calculated for the agriculture workers and wages fixed by government of tamilnadu for different levels of skills categorized, who were consuming the medications at the time. Total six drugs included in the study according to new treatment guidelines of malaria. There was 15.5% to 230% price variation between minimum and maximum costs of branded anti-malarials respectively. For treating Plasmodium Vivax cases of malaria; unskilled and highly skilled workers had to spend a minimum of 0.32 and 0.28 wage days respectively and a maximum of 0.43 and 0.35 wage days respectively in private pharmacies. The ACT therapy required for treating severe malaria cases(Sulfadoxime+Pyrimethamine, Artemether, Arteether, Quinine) were unavailable in Jan-Aushadhi facilities. Challenges in improving access to essential anti-malarials persist mainly due to disparity in the prices of the branded and generic anti-malarials, lack of these medications in Janaushadhi stores which provide them lower cost to poor people and inability of Indians earning low wages to purchase them at high prices from private pharmacies who stockpile them.

The purpose of the present study is to highlight the discriminations if any, between the quality of low and high-cost medicines, which would help to select the right brand of medicine. In the present work, brands of medicines having high, medium, and low prices containing either of biopharmaceutical classification system class-II or class-IV drugs were comparatively evaluated for different pharmacopoeial standards as well as for biopharmaceutical classification system solubility and permeability. An ex vivo permeability test was carried out using a simple and non-invasive everted gut sac technique. Insignificant variation in pharmaceutical quality and permeability of the tested three types of brands was observed; however, the study could not consider the state of quality assurance facilities and parameters used while manufacturing these medicines. The study will help to make aware and assure medical and pharmacy practitioners and consumers for the selection of quality quality generic medicines.

Ravindra Kembhavi
Ratnendra R Shinde
T. Hagawane
B.D. Darade

In India, 70% people spend 10-20 % of their total income on healthcare alone. The generic drugs are cheaper and provide an opportunity for patients to reducing their out of pocket expenditure in healthcare. So a study was done to assess prescription practice of physician by generic name and physician's knowledge, attitude and perception towards the same. An observational study was conducted at a tertiary health care center. Prescriptions of physicians and pediatrician were assessed for use of generic medicine in their respective OPDs. Then the knowledge, attitude and perception of physicians about use of generic medicine were assessed with help of questionnaire. Study Duration was three month. The data was analyzed by using conventional statistical methods. Total 600 prescriptions were studied of which 300 from Medicine and 300 from Pediatric OPD. It was found that in medicine OPD generic name of all medicines was written in only 14 (4.66%) prescriptions whereas in pediatric OPD it was 130 (43.33%). Responder rate of 75% was achieved. The total percentage of correct responses regarding knowledge of generic medicines was seen in 48% respondents. On further analysis it was observed that only 10% physician had very good knowledge about generics. Almost 40% physicians had inclinations for prescribing generics. 40 (66.67%) physicians were doubtful about efficacy of generics; whereas 67% physicians had average perception regarding use of generics. 38.33% of the respondents expressed their concern towards lack of quality check in locally manufactured products. In order to increase use of generics, doctors need to be educated and reassured about generic products approval system with regards to efficacy, bioequivalence, quality and safety during their professional career. Although the gap in knowledge of generic medicines among physicians is evident, in general conducive perceptions and attitudes were observed.

K. Ahire
M. Shukla
M. Gattani
M. Singh

Objectives: Cost of the medicines is a concern for the patients. Within India cost of medicines varies, the basic reason behind this is the brand price quoted by the pharmaceutical industries. Survey was undertaken to review and analyse various facts about branded and generic medicines of the same drugs. Method: By survey of Jan Aushadhi Stores price list and other resources by the authors it is found that there is a vast difference between prices of branded and generic medicines. Further survey was conducted for following target groups and individuals. The groups are Literate population (science background), Common public (educated but non science background) and Practicing Pharmacists. The different sets of questionnaire were prepared for each group and survey was conducted. The questions were designed as to check awareness, knowledge and preference of medication. Results: The highlighting results of this survey based project are that more number of consumers want economic alternative to the brand medicines which includes persons with or without science background, a remarkable number of consumers does not have knowledge about generic medicines, most of the physicians do not prefer generic medicines and most of the practicing pharmacists have very less business through generic medicines. Conclusion: Even if generic medicines are going to be made available free of cost at the government hospitals the war of prices between branded and generic may not stop. More stringent rules and regulation are required for making the drugs available at reasonable cost for the masses. For the benefit of the patients, if pharmacist needs to change a brand for generic medicine, should be permitted by law.

Anita Kotwani

The National Pharmaceutical Pricing Policy brings all medicines in the National List of Essential Medicines, 2011 under price control. In order to bring transparency and to make medicines more affordable while providing industry with enough incentives, we need to know the manufacturer's selling price and add-on costs as the medicine moves along the supply chain till it reaches the consumer. The findings of this paper indicate that the patient does not benefit from trade schemes, marketing strategies, or the free pharmaceutical market. Brand loyalty and marketing strategies do not allow "real" competition. The paper makes a number of recommendations to make medicines affordable to the common citizen.

Jocelyn Conway
Lisa Bero
Clive Ondari
Kishor M Wasan

The quality of essential medicines for pediatric populations in developing countries is largely unknown. This review examines quality studies (2000-2011) of medicines on the WHO Essential Medicine List for Children, the quality of a subset of pediatric formulations, and the association of these poor quality medicines with adverse clinical outcomes. We searched Embase, Medline, BIOSIS, and IPA using MeSH subject terms for quality measures, medicine formulations, and substandard medicines and combined these with 267 medicines, and 91 low-income and lower-middle-income countries. Seventy articles met our inclusion criteria examining the quality of 75 medicines from 28 countries. Content and dissolution tests were utilized most often. Results indicate that antibacterials, antifungals, and antiretrovirals were consistently of good quality. Quality tests on pediatric formulations were performed on 55 of 75 of the medicines studied and followed the general trend of quality results. Three studies were included that examined clinical consequences of substandard medicines-two cases of diethylene glycol poisoning and one case of substandard malaria drugs. We conclude that there is a need for more quality studies of pediatric formulations of essential medicines in developing countries and their clinical consequences. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci.