ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Out-of-pocket Expenditure on Healthcare among the Urban Poor in India

Focus on healthcare patterns and their determinants among the urban poor is crucial in order to move towards universal health coverage. However, published literature on these aspects in India is scarce. This study was undertaken to estimate out-of-pocket healthcare expenditures and resultant...

Is Drug Development in India Responsive to the Disease Burden?

Although the Indian pharmaceutical industry has played an important role in the development of generic medicines, it is not clear whether drug development, which is dominated by the private sector, is informed of the disease burden and public health priorities. An attempt is made to address this question by juxtaposing the therapeutic focus of the drugs approved for marketing and the new chemical entities in the pipeline with the disease burden across age groups.

Prices of Patented Medicines in India

Medicines with valid patents generally enjoy exemption from price regulation in most countries. In India, the Drugs (Prices Control) Order lays down the rules for regulation of prices of medicines through a National List of Essential Medicines, inserted as Schedule-I of theDPCO. While any medicine that is included in Schedule-I automatically qualifies for price regulation, theDPCO exempts patented medicines that have been developed indigenously from price control for a period of five years.Can patented molecules for emerging as well as infectious diseases be brought under price regulation in India?

EWS Beds in Delhi

In 2007, the Delhi High Court ordered all private hospitals in Delhi having the free treatment condition for economically weaker section patients in their lease deed to provide free treatment to 10% poor inpatients and 25% poor outpatients. This article analyses the monthly reports of “percentage bed occupancy” of the ews beds in 34 private hospitals from 2012–13 to 2015–16. The bed occupancy of 41% hospitals was below 10% and only two hospitals featured more than 30%. A number of loopholes need to be plugged by the custodian of the public properties, which is the state in this case, to ensure that the public partners who are the poor patients are welcomed and provided non-discriminatory health services without any fee.

Political Interests and Private Healthcare Lobby Collude to Stifle Patients’ Rights in Karnataka

The amendments in the Karnataka Private Medical Establishments Bill, 2017 contained key provisions related to patient rights, cost regulation, and grievance redressal. The bill also provided substantial opportunity for private medical establishments to be part of the regulatory process, thereby defeating the very purpose of regulation. PMEs misrepresented the bill as “draconian” and rejected the amendments. PME’s resistance to the bill is part of the larger resistance of the medical fraternity in general to any regulation. This has led to a crisis in both the public and private health sectors. While the KPME Bill is an important first step in ensuring accountability of the private health sector, the Karnataka government needs to also increase budgetary allocation for the public health system and reverse its pro-private healthcare policies.

Cut Practice in Private Healthcare

The Government of Maharashtra had set up a committee to draft the Prevention of Cut Practice in Healthcare Services Act, 2017 to stop cut practice in the medical profession. In the last two decades, there has been rapid commercialisation of medical services which has led to cut-throat competition among doctors to attract patients for higher revenue generation. This article presents the views of doctors about different aspects of cut practice, such as its prevalence, trends and the ways to stop it.

Investing in Health

The publication of “Investing in Health,” the World Bank’s highly influential 1993 World Development Report, has guided structural adjustment policies and health sector reforms in many developing countries. This study looks at how investment in health has since taken place in India with the withdrawal of the state from healthcare, transformation of healthcare into a commodity, and promotion of the private healthcare sector by the state. This has led to an unregulated industry that is aggressively seeking expansion and profits from the provision of healthcare, and attracting investments by global finance capital.

Aspiring for Universal Health Coverage through Private Care

The National Health Policy 2017 makes a case for expanding private sector participation through collaboration. The policy offers little assurance of providing integrated and universal healthcare.

Hospital Pharmacies

Patients are being forced to buy high-priced drugs and medical devices from hospital pharmacies. With hospitals increasingly operating as for-profit businesses, these pharmacies are an important revenue source for hospitals. In essence, the in-house pharmacy is a spatial monopoly within the premises of the hospital with the patients obliged to buy from it at prices dictated by the management.

Abolishing User Fee and Private Wards in Public Hospitals

Abolition of any type of user fee and the decision to close private wards in hospitals run by the Delhi government may appear to be small steps. These measures are likely to reduce inequity in health services utilisation while signalling the government's intention to bring about changes for the better in health outcomes.

Economic Impact of Technology Interventions--Streptokinase

More than 20 lakh patients of ischaemic heart disease-led myocardial infarction can benefit from a life-saving clot-buster drug in India. At the turn of the century, its availability in India was poor and no domestic production existed until the first Council of Scientific and Industrial Research licensee began production in 2001-02. Its price was less than half that of the drug made by a multinational company, the major supplier in the market at that time. Its supply increased to 1,20,000 doses in 2011 after other producers entered the market. Prices dropped by more than 50%. The economic impact of streptokinase technologies, or the value that would be lost if the licensee's streptokinase did not exist, is about `580 crore for the patients.

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