Low Cost Drug Initiative
Beginning 2010, we implemented a low-cost drug initiative at MGIMS aimed at providing appropriate and affordable drugs to our patients. This initiative to reduce the cost of drugs to the patient was made possible by first minimizing the ‘supply chain effect’ and then by overcoming the ‘marketing effect’. We did this by using a multi-pronged strategy. We involved healthcare workers in making a list of essential drugs and surgical items and deleted from the list as many “me too” and irrational drugs as was feasible in our setting. We procured drugs at substantially cheap prices by inviting competitive quotations from drug distributors and used the electronic hospital information system to buy, stock and dispense drugs and surgical items. Two 24/7 pharmacies were opened in the hospital premises to ensure that our registered inpatients and outpatients can access these drugs at affordable prices. We introduced computerized prescriber order entry (CPOE) to prescribe drugs. We also created e-prescriptions on the iPad app, specially designed for this purpose. The electronic applications help doctors identify drugs by both their generic names, check for their availability in the drug store and display their prices- thus minimizing prescription errors and improving the quality of evidence-based therapies.
We made doctors and public aware of the benefits of the initiative and banned all drug representatives from showcasing their products in the hospital. We encourage our residents to prescribe drugs by their generic names. On an average, our in-hospital pharmacy receives 2000 prescriptions every day- close to half a million prescriptions in 2014.
The low-cost drug initiative has substantially reduced the cost of medical treatment at Kasturba hospital, both in outpatient and inpatient setting. Atorvastatin, a cholesterol reducing medication, for instance, sells at the medical store for Rs 7.60 per 10 tablets instead of Rs 78, MRP price printed on the brand-named leader. Similarly, Piperacillin Tazobactam, an antibiotic that doctors choose to treat their seriously ill patients with sepsis costs Rs 132 as against the market price of Rs 450. Ceftriaxone 1 g injection used to treat infections is available in the medical store for Rs 19.20 compared to Rs 48 that popular brands command. Patients with coronary heart disease, high-cholesterol levels, high-blood pressure and diabetes can have these four disorders treated with five evidence-based drugs (aspirin 75 mg, atorvastatin 10 mg, enalapril 5 mg, amlodipine 5 mg and metformin 1 g) for Rs 145 per month- less than Rs 5 per day. The medical store manages the price cuts because of the high volume of branded generic drugs it buys from reputed companies.
Patients with catastrophic illnesses as well as those with chronic diseases have found significant difference in the cost of medications they buy at MGIMS compared to the market pharmacies. We believe that this initiative has reduced the out of pocket expenditure on drugs and has reduced the healthcare costs.