To, Shri Ananth Kumar
Minister for Chemicals & Fertilizers
New Delhi 110 001
Subject: Unscientific Fixed Dose Combinations (FDCs) promoted under Pradhan Mantri Bharatiya Janaushadhi Pariyojana
We, the members of Jan Swasthya Abhiyan (Indian chapter of People’s Health Movement) from across the country would like to draw your attention to the unscientific irrational Fixed Dose Combinations (FDCs) drugs being procured under the Pradhan Mantri Bharatiya Janaushadhi Pariyojana (PMBJP) operated by the Department of Pharmaceuticals of your ministry. Out of 580 medicines included in the recently published price-list of this Pariyojana, about 90 are unscientific FDCs. Most of these medicines are combination of vitamins and supplements or that of antibiotics, which have no pharmacological validation.
Only about a dozen of the FDCs in this list can be scientifically justified and out of these only half a dozen have been from those which have been included in the National List of Essential Medicines. (NLEM-2015). Use of irrational FDCs has been an issue of great concern when it is established that FDCs expose patients to unnecessary risk of adverse drug reactions without any benefit. There are only few therapeutic areas such as that for chronic diseases viz. tuberculosis, HIV/AIDS and malaria where the use of FDCs has been pharmacologically and clinically found to be effective.
We are aware that there is a plan for about 1000 medicines and 154 surgical and consumable items provisioned to be made available at affordable prices under the scheme through Jan Aushadhi stores. But, it is astonishing to see that a scheme which strives to promote use of generic drugs is also selling irrational Fixed Dose Combinations (FDCs). It must be noted that the WHO’s latest list of essential medicines– 2017 has approved just about 33 rational FDCs while the National List of Essential Medicines (NLEM) – 2015 of Government of India has only 24 rational FDCs. The FDCs included in the WHO and India’s national list is related to treatment of HIV, tuberculosis and malaria etc.
We understand that the Ministry is committed to expanding Pradhan Mantri Bharatiya Janaushadhi Pariyojana across the country. One of the major missions of the scheme which also serves as its core strategy is to create awareness about generic medicines, increase its usage among people and also encourage medical practitioners to prescribe medicines by the generic names so that they adhere to rational prescription practices. While we support the scheme and the spirit with which it has been brought about, we have strong objections with regard to the way the scheme is promoting prescription of irrational medicines, mostly FDCs. We therefore demand that all the FDCs, except for those which are listed in NLEM 2015, be immediately removed from the list of provisioned medicines under the scheme and their procurement, supply and sale be stopped with immediate effect.
Issued on behalf of Jan Swasthya Abhiyan.
(People’s Health Movement – India)