list of essential medicines: several antibiotics, other medicines may be cheaper
Drugs and devices listed on the NLEM must be sold at prices set by the National Pharmaceuticals Pricing Authority (NPPA), while those on the unlisted list are entitled to a maximum annual price increase of 10%. The NLEM review aims to ensure that antibiotics are available when needed and that the right antibiotics are prescribed for the right infections.
The NLEM list was last introduced in 2015. It was to be revised every three years, which never happened. In 2020, the pharmaceutical industry requested an extension due to Covid-19. Last year, the Indian Council of Medical Research (ICMR) submitted a revised NLEM list to the Minister of Health in September.
“However, the Ministry of Health has re-launched the drug review exercise which is now finalized,” the same person said. Commonly used drugs whose prices were offered last year include anti-diabetic drugs such as teneligliptin and insulin glargine, anti-tuberculosis drugs bedaquiline and delamanid, anti-parasitic ivermectin and rotavirus vaccine.
The National List of Essential Medicines (NLEM) committee headed by Balram Bhargava, former Secretary of the Department of Health Research and Director General of the Indian Council of Medical Research, has decided which medicines should be available in sufficient numbers and guaranteed quality. For drugs included in the NLEM, manufacturers are required to sell their product at or below the ceiling price set by a formula set by the government.
The calculation of a ceiling price is based on the simple average of the market prices of different drug brands with a market share of at least 1 percent.
The revised list has been formulated with a new method, breaking with the existing practice, where all essential medicines will not have their prices capped. The Standing National Medicines Committee has been tasked with preparing the restricted list of medicines to be available in adequate numbers and guaranteed quantities.
Under the earlier mechanism, the Ministry of Health prepared a list of drugs eligible for price regulation, after which the Pharmaceuticals Department of the Ministry of Chemicals and Fertilizers incorporated them into Schedule 1 of the ordinance on the control of drug prices. The National Pharmaceutical Pricing Authority then set drug prices.