Free drugs and free treatment

In the National Sample Survey Office (NSSO) 68th round 2011-2012, India was reported to have the highest out-of-pocket expense on healthcare, of which over 67% was spent on drugs. Recognising the importance of essential drugs being available and accessible to the general public, the Ministry of Health & Family Welfare, Govt. of India, implemented the Free Drugs Service Initiative (FDSI) under the National Health Mission (NHM) in 2015.

Objectives

• To ensure that a set of essential drugs is made available free of cost to all those who access public health care facilities.
• To reduce the Out-of-Pocket Expenses (OOPE) of patients to support their treatment and adherence to medication.

Under this initiative, provision for obtaining free of cost essential medicines is made available through public health facilities under the National Health Mission at Primary Health Centres (PHCs), Community Health Centres (CHCs), Sub Divisional Hospitals (SDH) and District Hospitals (DHs).

Under this scheme, National TB Elimination Programme (NTEP) recommended Fixed-Dose Combination (FDC) anti-TB medicines are also available for both paediatric and adult TB patients. While most of these medicines are procured centrally, few loose drugs, especially for prophylaxis, are allowed to be procured at the state or district level at times when central supply is short. 

NHM has dedicated funding for free drugs, and various levels, including Peripheral Health Institutions (PHI), are allotted preset budgets under this scheme. PHIs are supposed to procure essential drugs which are not supplied by the government-owned "General Medical Stores" from this budget. Although most of the drugs are readily provided to the PHIs, some subsidiary drugs and supplements, which are required in TB care, can be made available under this scheme. For example drugs required to treat minor adverse drug reactions, vitamins, protein supplements, expectorants, antitussives, etc. 

Resources

• Operational Guidelines - Free Drugs Service Initiative, MoHFW, GoI.

• National Strategic Plan for Tuberculosis Elimination 2017–2025, RNTCP, CTD, 2017.

• Essential Medicine List for SHC & PHC Level, Ayushman Bharat - Health and Wellness Centre, 2020.

Assessment