EDL Final Report 17 apr€¦ · For the rest of the items we relied on Tamil Nadu Medical Stores Corporation, Rajasthan Medical Stores Corporation and Kerala Medical Stores Corporation

Assessment of Assessment of Assessment of Assessment of

financial financial financial financial

resources for resources for resources for resources for

guaranteeing guaranteeing guaranteeing guaranteeing

access to free access to free access to free access to free

generic medicines generic medicines generic medicines generic medicines

(in edl) (in edl) (in edl) (in edl) at public at public at public at public

health facilities health facilities health facilities health facilities

in Chhattisgarhin Chhattisgarhin Chhattisgarhin Chhattisgarh

Submitted to:

Executive Director,

State Health Resource Centres, Chhattisgarh

1st Floor, State Health Training Centre,

Kalibadi Chowk, RAIPUR - 492001.

Submitted by: Submitted by: Submitted by: Submitted by:

IPE Global Pvt. Ltd.

IPE Towers,

B-84, Defence Colony,

New Delhi-110024, India

Tel: +91-11-40755900, 24339533

Fax: +91-11- 24339534

Email: [email protected]

March, 2013

Report

Assessment of financial resources for guaranteeing access to free generic medicines at public health facilities in

Chhattisgarh

ACKNOWLEDGEMENT

At the start, IPE Global Pvt. Ltd. would like to acknowledge the support and overview

provided by Honorable Commissioner of the State Shri Pratap Singh and Honorable

Director Health Services Dr. Kamal Preet Singh particularly the inputs provided during

the presentation of draft report on 18th

March, 2013.

We would also like to place on record our acknowledgements to Mr. J. P. Mishra,

Executive Director State Health Resource Center (SHRC), Chhattisgarh for providing the

necessary platform for interaction to carry out the work and mid-course corrections for

the study.

We would also like to acknowledge the valuable inputs and cooperation provided by Dr.

Surendra Pamboi, SPO (Store), Directorate of Health Services.

We also place on record our gratitude to Dr. Ms. Neha Parakh, Programme Coordinator

(TA-Medical) of SHRC Raipur for providing technical support and organizing the survey

work. We also acknowledge the inputs received from Dr. Rajesh Singh in drawing out the

samples.

We acknowledge the inputs provided by Dr. Kamlesh Jain, Nodal Officer NPCDCS,

Chhattisgarh for sharing the data and views on Non Communicable Diseases burden in

the states.

Last but not the least we acknowledge the program associates Dr. Premshankar Verma

(Programme Coordinator), Dr. Rohit Baghel (Programme Associate), Dr. Sheetal Vyas

(Programme Associate) and Dr. Roshan Gupta (Programme Associate) for coordinating

the survey and data collection work.

Report


Chhattisgarh 3

List of Abbreviations

EDL Essential Drug List

PIP Project Implementation Plan

NVDCP National Vector Borne Disease Control Programme

NLEP National Leprosy Eradication Programme

NCD Non communicable disease

NP National Programme

DPT Diphtheria Tetanus and Pertussis Vaccines

BCG BacilleCalmette–Guérin

OPV Oral Polio Vaccine

ARV Antiretroviral drug

MDT Multi Drug Therapy

MDR Multidrug-resistant

MMR Measles, mumps, and rubella

NRHM National Rural Health Mission

TNMSC Tamil Nadu Medical Services Corporation

PHC Primary Health Centre

CHC Community Health Centre

DH District Hospital

OPD Out Patient Department

IPD Inpatient Department

DLHS District Level Household Survey

OHA Oral Hypoglycaemic Agent

Report


Chhattisgarh 4

EXECUTIVE SUMMARY

The Chhattisgarh Government is considering to adopt and announce a policy guaranteeing

access to free generic medicines to all at the public health facilities in the State and has asked the

State Health Resource Centre, its technical support agency, to make an assessment of financial

envelope required to fulfil the commitment.

IPE Global Pvt Ltd was selected through a ‘Quality cum cost based ‘evaluation process.

Background

Enhancing public expenditures on health is likely to have a direct impact on poverty reduction also.

Provision of free drugs to all accessing public health system a means of reducing OOP expenditure

and increasing accessibility a model already in place in states of TN, Rajasthan, Orissa, Kerala.

For Chhattisgarh, one of the key Challenges identified is improving access and reducing OOP

expenditure by ensuring availability of free medicines (generic ) from government hospitals (from

EDL) and across the counter availability of generic drugs in general in the state.

The government has set up the Chhattisgarh Medical Services Corporation to improve inventory

management, prevent stock outs and expiry of medicines. The organization has notified the Essential

drug list and operates Jan Aushadhi (Generic Drug) Stores.

Chhattisgarh state has the 3 tier healthcare delivery system at par with the national system. Primary

healthcare is delivered through Primary Health Sub centers and Primary Health Centers (PHC).

Secondary healthcare is delivered through CHCs and DHs. Tertiary healthcare through DHs and

Medical College Hospitals.

Study

The assignment required an answer to the following question

“How much money will be required by Government of Chhattisgarh to achieve the objective of

providing good quality ‘Free Medicines for All’ as part of the goal of ‘Health Care for All’?”

The broad framework of the study required-

1) To work out the demand projection taking into account different data sets as each one in

isolation will have a demerit to influence reliability.

2) The study results are probabilistic keeping in view the short time frame in which the report

was required to be generated otherwise long term prospective study would have been ideal.

3) The Study design is cross sectional and includes secondary and primary data collection and

Prescriptions survey across various categories of health facilities (tertiary, secondary and

primary health care level).

Report


Chhattisgarh 5

Hybrid method for demand assessment

A Hybrid method for Demand assessment which is a combination of Consumption, Morbidity

Method and analytical methods was used.

Prescription Survey

Good statistically enabled samples of prescriptions were studied for frequency and quantity

of drugs from EDL. The challenge here was that the preparations prescribed were often not generic.

We converted the prescriptions into generic forms for the purpose of recording data. Qualified

personnel well versed with pharmacy sciences conducted the survey and data analysis and to assess

prescription patterns for EDL and Specialist drugs.

Primary data was collected from OPD and IPD prescriptions of drugs from Medical Colleges, Districts

Hospitals, CHCs and PHCs for estimation of drugs consumption.

Statistical tools and probability methods were used for data analysis to arrive to a scientific result for

the study. The frequency of prescription as well as quantity was analysed using mean and standard

deviation for each drug. Assuming that prescription pattern will follow a normal distribution,

probability, model for normal distribution was used to get a projection for 90% probability.

Historical Consumption data

Primary data was collected from stores of different zones for demand estimation of essential drugs

and consumables. A tool was developed to capture data of consumption for duration of three years.

It included stock consumed over 3 years including periods of stock outs.

However, Most of the historical store data had wide gaps in that the figures were available for 2

years only. The supply of most drugs was also erratic, with periods of over stocking and long stock

outs. Data obtained from the store consumption therefore could not be relied upon fully.

Morbidity pattern

Demand assessment for certain drugs was carried out/validated using the morbidity

patterns. This was especially used for drugs used in NCD and in diseases covered in National

Programme.

Expert / Analytical estimation

For drugs used in niche areas such as oncology, psychiatry and ophthalmology etc. and which did not

get covered in the prescription survey we ratified the demand by the concerned specialists.

Discussions were held with specialists both at Chhattisgarh and at Delhi before arriving at a best

estimate for these items.

Consumables which are required for day to day care delivery and are more than often loaded on to

the patients were also taken in the ambit of study, as their provision by the government will reduce

the OOP expense for the public

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Chhattisgarh 6

Price estimation

Given that the Chhattisgarh Government has set up the Chhattisgarh Medicare Services Corporation

for centralized procurement of drugs, and that such large procurements will result in extremely

competitive rates, we factored that the price per item would be much below the market price of the

drugs.

Data on rates at which drugs were procured over the past 2/3 years by the DME and DHS in the state

were sought. However, this could cater to only 30% of the items covered.

For the rest of the items we relied on Tamil Nadu Medical Stores Corporation, Rajasthan Medical

Stores Corporation and Kerala Medical Stores Corporation tender rates. The price under which

TNMSC obtained drugs was found to be much lower on account of the benefits of larger scale and

length of operations. This was addressed by adding a twenty per cent weightage to all TNMSC price

rates utilized.

Results

In view of the short time frame in which a good estimate of the financial envelope was to be

ascertained, various data sources were used to get a correct demand estimate for each drug.

From the Store consumption data and the prescription survey, drug demand for each level of facility

was worked out. Based on the prevalence rates and morbidity patterns, the drug demand was

calculated for the entire state population.

A triangulation of data was done for each item and the final estimate was chosen.

Scenario 1

The study has worked out the demand assessment for each item based on the current levels of work

load and service delivery at the various levels of facilities i.e. Tertiary, Secondary and Primary care.

Based on the current demand, the financial envelope that the Government of Chattisgarh will

require to table for providing free generic medicines (listed in the EDL) at all level of public

healthcare delivery facilities (Medical Colleges; District Hospitals; CHCs & PHCs) is INR 143.92Crores.

Scenario 2

Around 30% of the State’s population accesses the Government funded public health care delivery

system in the state. We anticipate an increase in patronage of public health care delivery once the

government starts providing assured free medicines.

Based on the model utilized by the Planning Commission, it is anticipated that over a period 52% of

the state’s population will be serviced by the Public Healthcare facilities and the outreach

programmes. The budget for provision of free generic drugs will then be INR 175.58 Crores (Rupees

One Hundred and Seventy Five Crores)

The estimated Cost of providing for medicines for NCD alone in the current study is INR 25.66 Crores.

Report


Chhattisgarh 7

Recommendations’

It is recommended that a similar exercise is undertaken by the Government over the next 2 years.

This will fine tune the item wise demand assessment and also help in ascertaining the prescription

patterns at various facilities. This will also help in designing interventions for promoting scientific

prescription practices.

The overall financial envelope is a small component of the health budget when only the price of the

item is being factored. However there is a cost of procurement, storage, transport and distribution

which also needs to be taken into account. Further the procurement process should be visited to

ensure that there is a procurement cycle for most of the items and inventory control tools like fixing

re order levels after catering to safety stocks and buffer stocks using e procurement system for

greater efficiency and transparency and minimizing stock outs will be the key factors for successful

implementation of the intent.

Report


Chhattisgarh 8

Contents

CHAPTER 1: INTRODUCTION ....................................................................................................... 10

1.1 BACKGROUND: ................................................................................................................................ 10

1.2 STATE HEALTH STATISTICS .................................................................................................................. 14

1.3 STATE HEALTH FINANCE .................................................................................................................... 16

1.4 HEALTH FINANCE ............................................................................................................................. 16

1.5 TAMIL NADU MODEL -THE FIRST ONE .................................................................................................. 18

CHAPTER 2: STUDY DESIGN & DISCUSSION ................................................................................. 20

2.1 OBJECTIVE OF THE STUDY ................................................................................................................... 20

2.2 SCOPE OF THE STUDY ........................................................................................................................ 20

2.3 STUDY DESIGN ................................................................................................................................. 21

2.3.1 INTRODUCTION ............................................................................................................................. 21

2.3.2 STUDY DESIGN .............................................................................................................................. 21

2.4 PRESCRIPTION SURVEY ...................................................................................................................... 22

2.4.1 Training of Surveyors ............................................................................................................ 22

2.4.2 Survey Tool ............................................................................................................................ 23

2.4.3 Sample .................................................................................................................................. 25

2.4.4 Data analysis & Statistical Correlation ................................................................................. 26

2.4.5 Additional information collected .......................................................................................... 27

2.4.6 Limitations ............................................................................................................................ 27

2.5 HISTORICAL CONSUMPTION DATA ...................................................................................................... 28

2.5.1 Sample ............................................................................................................................. 28

2.5.2 Analysis of data keeping stock outs in account ............................................................... 28

2.5.3 Limitations of data .............................................................................................................. 29

2.6 ASSESSMENT THROUGH MORBIDITY PATTERNS ..................................................................................... 29

2.6.1 Applicable for NCD .......................................................................................................... 29

2.7 EXPERT INPUT / ANALYTICAL ASSESSMENT ............................................................................................ 29

2.8 PRICE ESTIMATION ........................................................................................................................... 31

CHAPTER 3 DATA ANALYSIS & REPORT GENERATION .................................................................. 32

3.1 TRIANGULATION OF DATA ................................................................................................................. 41

3.1.1 Demand for Anti Rabies Vaccine ........................................................................................... 44

3.1.2 Demand for Insulin for treatment of Diabetes Mellitus ........................................................ 45

3.2 TOTAL FINANCIAL ENVELOPE .............................................................................................................. 47

3.3 FINANCIAL ENVELOPE FOR EACH LEVEL OF FACILITY ................................................................................. 49

3.4 FUNDING FOR OUTREACH PROGRAMME .............................................................................................. 49

CHAPTER 4 STUDY CONSTRAINTS / LIMITATIONS ........................................................................ 50

4.1 ITEMS NOT INCLUDED IN STUDY .......................................................................................................... 50

4.2 PROBABILISTIC STUDY ....................................................................................................................... 50

4.3 CAN BE REFINED OVER YEARS.............................................................................................................. 50

CHAPTER 5 RECOMMENDATIONS ............................................................................................... 51

5.1 FOLLOW UP STUDY ........................................................................................................................... 51

5.2 ONGOING PRESCRIPTION AUDIT .......................................................................................................... 51

5.3 RATIONALISING & REVISING THE STATE EDL ......................................................................................... 51

5.4 STRENGTHENING PROCUREMENT AND SUPPLY CHAIN. ........................................................................... 51

ANNEXURE 1 - ITEMISED LIST OF DRUGS WITH TOTAL STATE DEMAND IN NUMBER AND VALUE .. 52

ANNEXURE 2 - ABC ANALYSIS OF ITEMISED LIST OF DRUGS ......................................................... 83

ANNEXURE 3 – PRESCRIPTION SURVEY TOOL ............................................................................ 112

ANNEXURE 4 – STORE DATA COLLECTION TOOL ........................................................................ 113

ANNEXURE 5 – LIST OF CONSUMABLES INCLUDED IN THE AMBIT OF THE STUDY ....................... 114

BIBLIOGRAPHY ......................................................................................................................... 117

Report


Chhattisgarh 9

List of Tables

Table 1: Demographic profile ............................................................................................................... 11

Table 2: Public Health Infrastructure of Chhattisgarh .......................................................................... 11

Table 3: Standard population covered per health facility .................................................................... 12

Table 4: Health Infrastructure of Chhattisgarh ..................................................................................... 13

Table 5: Bed capacity of Medical colleges and DHs .............................................................................. 14

Table 6: Patients footfall in Govt. health facilities ................................................................................ 14

Table 7: Surgeries performed at District Level (2011-12) ..................................................................... 15

Table 8: Chhattisgarh Health outcome ................................................................................................. 16

Table 9: Health budgets comparison .................................................................................................... 16

Table 10: Sample distribution of prescription surveyed ....................................................................... 25

Table 11: Facilities where prescription survey was undertaken ........................................................... 26

Table 12: Sample distribution of stores data ........................................................................................ 28

Table 13: Oncology Workload ............................................................................................................... 30

Table 14: Number of drugs prescribed in the prescription .................................................................. 32

Table 15: Drugs prescribed using their generic name .......................................................................... 32

Table 16: The duration for which the medicine is prescribed .............................................................. 32

Table 17: Drugs prescribed listed in the EDL ........................................................................................ 33

Table 18: Cases where drug dosage forms were provided or nor provided ........................................ 33

Table 19: Strengths of dosage form provided ...................................................................................... 33

Table 20: Diagnosis mentioned in the prescription .............................................................................. 33

Table 21:Dosage schedule for MDT Regimen ....................................................................................... 40

Table 22: Drug Demand and budget calculation based on national prevalence rates ......................... 43

Table 23: Drug demand & cost based on local prevalence statistics .................................................... 44

Table 24: Drug demand & cost based on local prevalence statistics .................................................... 44

Table 25: Demand assessment for ARV from 3 sources ....................................................................... 45

List of Figures

Figure 1 : Illustration of demand calculation ........................................................................................ 34

Figure 2 : Demand estimation for chemotherapeutic drugs ................................................................ 35

Figure 3 : Demand estimation for drugs used in psychiatry ................................................................. 35

Figure 4: Algorithm for Diagnosis and treatment of Malaria................................................................ 37

Figure 5: Dosage schedule for treatment of Pl Vivax (under NVBDCP) ................................................ 37

Figure 6: Age wise schedule for treatment of Plasmodium Falciparum malaria (as per NVBDCP) ...... 38

Figure 7The ABC analysis for the items studied is provided at Annexure – 2 ...................................... 48

Report


Chhattisgarh 10

Chapter 1: Introduction

1.1 Background:

The Chhattisgarh Government is considering to adopt and announce a policy guaranteeing

access to free generic medicines to all at the public health facilities in the State and has asked the

State Health Resource Centre, its technical support agency, to make an assessment of financial

envelope required to fulfill the commitment. To carry out the assessment exercise, SHRC invited

proposals from agencies having expertise and institutional capacity to mobilize quick surveys to carry

out the assessment.

For Chhattisgarh, one of the key Challenges identified is improving access and reducing out of pocket

(OOP) expenditure by ensuring availability of free medicines from government hospitals (from

Essential Drug List) in the state.

The state is proposing to substantially increase government spending on public procurement of

generic medicines in order to provide them freely to patients through government hospitals and

facilities.

Drugs play a very important role in the delivery of the health care system. The availability of drugs at

the health facility not only enhances the utilization of the facilities but also increases credibility of

the public healthcare system to the community. Despite all efforts being made the State & Central

governments, the availability of drugs both in quantity and quality is not reached the desired level.

State of Chhattisgarh

Chhattisgarh is a land-locked state located in the middle of India surrounded by six other

states – Madhya Pradesh, Andhra Pradesh, Orissa, Bihar, Jharkhand and

Uttar Pradesh. This new state was formed on 1st November 2000 by

carving out sections from the southeastern part of Madhya Pradesh.

There are 27 districts and 20,715 villages.1

Unprecedented work is going on to improve the health situation

and status of the vulnerable and unattended population. The state has

achieved stupendous success in bettering basic health indicators, in

ensuring quality health services and in improving the public health

infrastructure. There are notable efforts to provide affordable care to

the people in match with the needs of the diverse population.

1 (http://health.cg.gov.in)- Chhattisgarh state Govt. Health Dept. website

Report


Chhattisgarh 11

A large concentration of tribal population lives in the hilly areas of Chhattisgarh. The state

has 9.41% and 25.88% of

Scheduled Caste and Scheduled

Tribe population respectively3

.

Along with the presence of huge

tribal population, the state is also

one of those sparsely populated

states with very remote and

difficult to reach terrain with

almost half of its land covered

with dense forests. So there is a

concern of inaccessibility of

medical care and Govt. of

Chhattisgarh feels that an

accessible and affordable

medical care should be available

to all.

Table 1: Demographic profile

Public Health delivery infrastructure:

Chhattisgarh state has the 3 tier healthcare delivery system at par with the national system.

Primary healthcare is delivered through Primary Health Sub centers and Primary Health Centers

(PHC). Secondary healthcare is delivered through CHCs and DHs. Tertiary healthcare through DHs

and Medical College Hospitals.

Rural Population (In lakhs) Census 2011 196.04

Number of Districts (RHS 2010) 18

Number of Sub Division/ Talukas 96

umber of Blocks 146

Number of Villages (RHS 2010) 20126

Number of District Hospitals 17 + 10*

Number of Community Health Centres (RHS 2010) 148 CHC+17 H=165

Number of Primary Health Centres (RHS 2010) 741

Number of Sub Centres (RHS 2010) 5076

*10 CHs are under up-gradation to District Hospitals for the newly constructed districts.

Table 2: Public Health Infrastructure of Chhattisgarh4

The public health facilities at each level, Primary, Secondary & Tertiary cater to a population .Below

given is the standard population which is to be covered per health facility:5

2 5th Common Review Mission, Chhattisgarh



5 PHFI Standards

Indicator Chhattisgarh2 India

Total population (Census 2011) CR 2.55 121.01

Decadal Growth (Census 2011) (%) 22.59 17.64

Crude Birth Rate (SRS 2009) 25.7 22.5

Crude Death Rate (SRS 2009) 8.1 7.3

Natural Growth Rate (SRS 2009) 17.6 15.2

Sex Ratio (Census 2011) 991 940

Child Sex Ratio (Census 2011) 964 914

Schedule Caste population (in crore) 0.24 16.6

Schedule Tribe population (in crore) 0.66 8.4

Total Literacy Rate (Census 2011) (%) 71.04 74.04

Male Literacy Rate (Census 2011) (%) 81.45 82.14

Female Literacy Rate (Census 2011) 60.59 65.46

Report


Chhattisgarh 12

Health Facilities Number of functioning

facilities

Population covered per facility

Sub-centres 5076 3862

PHC 741 26400

CHC level hospitals 148 CHC+17 CH=165 1.54 Lakh

District Hospitals 17+10* 15.02 Lakh

Medical colleges 3 85.13Lakh *The 10 CHCs in newly created districts are under upgradation to DH.

Table 3: Standard population covered per health facility

The state has 27 districts. Originally there were 16 administrative districts in the state. The newly

formed districts are Bijapur and Narayanpur were formed in 2007 and another 9 new districts were

carved out on 2012 namely,

♦ Sukma

♦ Kondagaon

♦ Balod

♦ Bemetra

♦ Baloda Bazar

♦ Gariaband

♦ Mungeli

♦ Surajpur and

♦ Balrampur

District wise health infrastructures are in the following table:-

Chhattisgarh Health Infrastructure6

SNo. District

No of Institution

Rural Urban Villages DH CHC

Notional PHC SHC Total

CHC

1 BALOD 1 7 0 27 191 226 213 12 726

2 BALODA BAJAR 1 7 0 27 195 230 219 10 955

3 BALRAMPUR 1 6 0 23 191 221 216 0 643

4 BASTAR 0 6 1 40 187 234 232 0 594

5 BEMETRA 1 4 1 21 125 152 145 6 710

6 BIJAPUR 1 3 1 13 90 108 105 1 762

7 BILASPUR 1 7 0 54 272 334 316 9 942

8 DANTEWADA 1 4 0 12 69 86 78 7 266

9 DHAMTARI 1 4 0 22 165 192 190 1 633

10 DURG 1 3 0 23 127 154 120 33 437

11 GARIYABANDH 1 6 0 12 194 213 207 5 703

12 JANJGIR 1 9 0 39 246 295 275 19 1005

6 http://health.cg.gov.in – Chhattisgarh State Govt. Health Dept. website

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Chhattisgarh 13

SNo. District No of Institution

Rural Urban Villages DH CHC Notional PHC SHC Total

13 JASHPUR 1 8 0 32 256 297 296 0 764

14 KANKER 1 8 0 28 204 241 233 7 1103

15 KAWARDHA 1 5 0 22 144 172 157 14 1049

16 KONDAGAON 1 4 1 16 129 151 150 0 579

17 KORBA 1 5 0 36 212 254 225 28 874

18 KORIA 1 5 0 27 154 187 174 12 671

19 MAHASAMUND 1 4 1 28 219 253 221 6 1135

20 MUNGELI 1 3 0 21 108 133 128 4 668

21 NARAYANPUR 1 2 0 7 59 69 67 1 376

22 RAIGARH 1 8 1 50 311 371 368 2 1473

23 RAIPUR 1 5 0 24 148 178 153 24 518

24 RAJNANDGAON 1 8 1 43 306 359 351 7 1609

25 SARGUJA 1 6 1 25 197 230 225 4 583

26 SUKMA 1 3 0 12 81 97 96 0 384

27 SURAJPUR 1 7 0 30 199 237 233 3 553

Total 26 147 8 714 4779 5674 5393 215 20715

Table 4: Health Infrastructure of Chhattisgarh

BED AVAILABILITY

The Bed strength of operational District Hospitals and medical colleges is given below. 10 identified

CHCs/ CH will be upgraded for functioning as District Hospitals. For the purpose of study we are

taking into account the existing DH which are 17 in numbers.

Sr. No. District Numbers of

beds

1 Raipur 100

2 Durg 430

3 Bilaspur 100

4 Sarguja 300

5 Janjgir Champa 100

6 Rajnandgaon 300

7 Raigarh 300

8 Kabardha 100

9 Korba 100

10 Mahasamund 100

11 Jashpur 100

12 Dhamtari 100

13 Kanker 100

14 Korea 100

Report


Chhattisgarh 14

Sr. No. District Numbers of

beds

15 Dantewada 100

16 Narayanpur 100

17 Bastar NA

Sr. No. Medical

College

Numbers of

beds

1 Jagdalpur 500

2 Bilaspur 500

3 Raipur 1000

Table 5: Bed capacity of Medical colleges and DHs

1.2 State Health statistics

The workload catered by the Public Health facilities can be assessed from the following:-

Total OPD & IPD7

Year Total Annual OPD

in the State

Percentage increase

of OPD over previous

year

Total annual In-

Patient

admissions in the

State

Percentage

increase of IPD

over previous

year

2005-06 3474275

NA

2006-07 3512450 1.09 380572

2007-08 3540512 0.79 402287 5.71

2008-09 3612219 1.99 426890 6.12

2009-10 3762565 4 443394 3.87

2010-11 4305814 12.62 459036 3.53

2011-12* 4736395 10 504940 10

*Projected values Table 6: Patients footfall in Govt. health facilities

Given below is the illustration of the above table which shows a gradually increasing trend:


0

2000000

4000000

6000000

20

05

-06

20

06

-07

20

07

-08

20

08

-09

20

09

-10

20

10

-11

Total Annual OPD in the State

Total Annual

OPD in the State 0

200000

400000

600000

20

05

-06

20

06

-07

20

07

-08

20

08

-09

20

09

-10

20

10

-11

Total annual In-Patient admissions in the

State

Total annual

In-Patient

admissions in

the State

Report


Chhattisgarh 15

Total number of Surgeries in Chhattisgarh being performed at the District Level from 1st

Jan, 2012 to

31st

Dec, 20128.

The illustration of the below table is given in the bar chart

Table 7: Surgeries performed at District Level (2011-12)

S. N. Activity / Measurable indicator Target 2011-12 Current status

A Maternal Health

1 Institutional Deliveries (%) 65% (4.22 lakh) 52

2 24x7 Facilities (CHCs+CH) 153 139+14 = 153

24x7 Facilities (PHCs) 100

3 Functional First Referral Units 75 26

B Population Stabilization

4 Male Sterilization 15,000 4,119

5 Female Sterilization 151,200 39,654

8 Ref: http://cg.nic.in/health/dhrs/ReportsGraph/jsy_birthASPChart.aspx

0 5000 10000

Raipur

Durg

Bilaspur

Sarguja

Janjgir Champa

Rajnandgaon

Raigarh

Kabardha

Korba

Mahasamund

Jashpur

Dhamtari

Kanker

Korea

Dantewada

Narayanpur

Kondagaon

Bijapur

No. of total…

Sr.

No.

District No. of total

surgeries

1 Raipur 320

2 Durg 8937

3 Bilaspur 1886

4 Sarguja 3669

5 Janjgir Champa 392

6 Rajnandgaon 2122

7 Raigarh 891

8 Kabardha 1368

9 Korba 1974

10 Mahasamund 1292

11 Jashpur 618

12 Dhamtari 2816

13 Kanker 2142

14 Korea 798

15 Dantewada 507

16 Narayanpur 3078

17 Kondagaon NA

18 Bijapur 296

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Chhattisgarh 16

S. N. Activity / Measurable indicator Target 2011-12 Current status

6 No. of IUD Insertions 135,000 51,998

C Disease Control

7 Annualized New Smear Positive

Detection Rate of TB (%)

56% (45/lakh) 54

8 Success Rate of New Smear Positive

Treatment initiated on DOTS (%)

95% 87

9 ABER for malaria (%) >14% 9.1

10 API for malaria (per 1000 population) NA 3.8

11 Annual New Case Detection Rate for

Leprosy (per 1,00,000 population)

31.7(per lakh

popu)

29.65

12 Cataract Surgeries performed 105,000 50,196

Table 8: Chhattisgarh Health outcome9

1.3 State Health Finance

The state has kept Health as a priority and the budget has been correspondingly increased over the

years. The fund allocation over the years is tabulated below. (Reference: http://pipnrhm-

mohfw.nic.in/index_files/high_focus_non_ne/Chhattisgarh/Presentation/NPCC%2006.04.11-final-

%201.35%20pm.pdf. National Rural Health Mission Chhattisgarh, NPCC Meeting -6thApril 2011, New

Delhi)

2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

STATE 37088 42163 56313 67588 83935 95231 109500 130123

NRHM 0 8891 13367 11665 23386 40036 52637 60914

EUSPP 0 0 2376 0 3817 0 0 2500

CARE 600 586 396 298 394 0 0 0

UNICEF 97 77 292 533 345 232 232 232

Total 37786 51717 72745 80083 111878 135499 162368 193656

Table 9: Health budgets comparison

1.4 Health Finance

OOP expense10

Government of India has initiated a provision of Universal Health Coverage (UHC) to provide

an easily accessible and affordable health care to all Indians. While financial protection was the

principal objective of this initiative, it was recognised that the delivery of UHC also requires the

availability of adequate healthcare infrastructure, skilled health workforce and access to affordable

drugs and technologies to ensure the entitled level and quality of care is given to every citizen.


10 High Level Expert Group Report on Universal Health Coverage for India. Instituted by Planning Commission of India

Submitted to the Planning Commission of India, New Delhi, November, 2011

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Chhattisgarh 17

The aim was to ensure that regardless of income

level, social status, gender, caste or religion all Indian

citizens should be able to avail affordable,

accountable, appropriate health services of assured

quality as well as public health services.11

Only 76 drugs accounting for around one-fourth of

the drug market are under price control. An

examination of the price trends of 152 drugs

(consisting of 360 formulations) reveals that

antibiotics, anti-tuberculosis and anti-malarial drugs,

and drugs for cardiac disorders, etc. registered price

increases from 1%-15% per annum during 1976-

2000. Indian households spend 50% of their total

health expenditures on drugs and medicines. Reducing this burden and ensuring access can be

achieved by: (i) bringing all drugs under price control to ensure lower prices for the households; (ii)

streamlining and putting in place a system of centralized pooled procurement of drugs so that the

public health system can save almost 30% to 40% on costs; (iii) weeding out irrational drugs and

irrational combination drugs; and (iv) encouraging ISM drugs for treating diseases for which

efficacious and low-cost drugs are available. This will address about 90% of the health needs of the

community and reduce household spending on these services. Price control should not be limited to

essential drugs as the industry can then simply switch its production to the non-controlled

categories, depriving people of access to essential drugs.12

As UHC comes in there would be a provision of free health care and medicines for both in-patient as

well as out-patient care. This would give financial protection and this in turn can reduce or reverse

the high private out of pocket spending.

Enhancing public expenditures on health is likely to have a direct impact on poverty reduction also.

Provision of free drugs to all accessing public health system a means of reducing OOP expenditure

and increasing accessibility a model already in place in states of TN, Rajasthan, Orissa, Kerala.

The government of India is actively pursuing a policy of promoting universal access to healthcare

with access to affordable medicines forming an integral part of this scheme. This is based on the

recommendations of a High Level Expert Group on Universal Health Coverage (HLEG-UHC)

constituted by the Planning Commission of India.

The report contains recommendations regarding the architecture of the Universal Health Care

(UHC). A key recommendation is recommendation 3.1.2 to “Ensure availability of free essential

medicines by increasing public spending on drug procurement”. While making this recommendation,

the HLEG report explains that “Low public spending on drugs and non-availability of free medicines

in government healthcare facilities are major factors discouraging people from accessing public

sector health facilities. Addressing this deficiency by ensuring adequate supplies of free essential

drugs is vital to the success of the proposed UHC system.” To this end, the report recommends a

11 High Level Expert Group Report on Universal Health Coverage for India. Instituted by Planning Commission of India

Submitted to the Planning Commission of India, New Delhi, November, 2011

12

Report of the National Commission on Macroeconomics and Health,2005

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Chhattisgarh 18

two-pronged approach: 1) increasing government spending on public procurement of medicines

from 0.1 per cent of the GDP to 0.5 per cent of the GDP; and 2) introducing a pooled procurement

system to ensure adequate supplies and rational prescription of quality generic drugs by the public

health system.

Tamil Nadu and Rajasthan are already distributing free drugs. Free drugs are also being given to

pregnant women under the National Rural Health Mission (NRHM).

For Chhattisgarh, one of the key Challenges identified is improving access and reducing OOP

expenditure by ensuring availability of free medicines (generic ) from government hospitals (from

EDL) and across the counter availability of generic drugs in general in the state.

The state is proposing to substantially increase government spending on public procurement of

generic medicines in order to distribute them freely to patients through government hospitals and

clinics.

The government has set up the Chhattisgarh Medical Services Corporation to improve inventory

management, prevent stock outs and expiry of medicines. The organisation has notified the Essential

drug list and operates Jan Aushadhi (Generic Drug) Stores.

1.5 Tamil Nadu model -The first one

The “Tamil Nadu Model”

Under the “Tamil Nadu model”, the procurement, storage and distribution of all drugs as

well as surgical and suture items to all government hospitals and public health centres (PHCs) is

conducted by a government company. In the state of Tamil Nadu, procurement has been

undertaken by the Tamil Nadu Medical Services Corporation (TNMSC) since 1994. The TNMSC has

been lauded for following a very clear and transparent tender process. It procures about 268 drugs

in bulk directly from the manufacturers based on an Essential Drugs List (EDL) which is reviewed and

updated periodically. These drugs are packaged with a special “TG” (Tamil Nadu Government) logo

to prevent unauthorized sale outside hospital dispensaries. Each and every batch of drugs supplied

by suppliers is subjected to quality tests by laboratories empanelled through an open bidding

process.

The drugs procured are stored in TNMSC warehouses in each district from where they are

distributed to government hospitals and PHCs in the district. Every government hospital and PHC is

issued a passbook with which it can approach the nearest warehouse to procure a drug. The entry in

the passbook serves as the basis of an inventory system which helps to prevent stock outs. The

passbooks are issued based on the budget allocation for each hospital or PHC. 90 per cent of the

allocated budget amount is deposited in a special account from which the TNMSC purchases the

drugs each time an indent is made from the hospital or PHC. 10 per cent of the budget allocation is

provided to the respective hospitals and PHCs for local purchases.

The TNMSC system has been very successful in substantially reducing the cost of procurement. It has

also been very successful in ensuring through strict quality control mechanisms in the procurement

process that medicines of high quality are made available for free to patients through the

government hospitals and PHCs. According to a World Bank report, the TNMSC system has been

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Chhattisgarh 19

highly successful in significantly increasing the number of patients using government hospitals and

PHCs.

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Chhattisgarh 20

Chapter 2: Study Design & Discussion

The Chhattisgarh State Health and Family Department has an Essential Drug List (EDL).

Essential Drug List has been defined as those drugs that satisfy the healthcare needs of the majority

of the population. They should therefore be available at all times in adequate amounts and in

appropriate dosage forms at all levels of the health care delivery system of the state.

The Chhattisgarh EDL comprises a list of Essential drugs, surgical products and sutures. A number of

non-consumables and support equipment are also included in the EDL. The drug items in the EDL

are categorized as per their usage and applicability. The Chhattisgarh EDL formulated in 2010-11 is

currently under revision.

The present study is designed based on the EDL – 2010-11.

All Survey tools for collection of data were designed as per existing EDL for data collection from

stores for demand calculation and prescription data for estimation of drugs consumption in Medical

Colleges, District Hospitals, CHCs and PHCs. While the list of items in the EDL is exhaustive,

prescription of many drugs were out of EDL in many cases. Certain drugs which came up in repeated

prescriptions and could not be included in the study as they were not part of the current ED for

example Statins.

2.1 Objective of the study

The assignment was to provide answer to the following question

“How much money will be required by Government of Chhattisgarh to achieve the objective of

providing good quality ‘Free Medicines for All’ as part of the goal of ‘Health Care for All’?”

2.2 Scope of the study

The scope of the study included

� Developing methodology for collection of information from a sample of health facilities in

the state, including instruments for data collection;

� Data collection, tabulation and analysis were organized;

� Data analysis, to make assessment of financial envelope under various assumptions (e.g.

guaranteeing access to State’s current essential drug list or a revised EDL);

� Report generation and mid-course presentation of the same to policy making bodies of the

State.

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Chhattisgarh 21

2.3 Study Design

2.3.1 Introduction

The quantum of financial resources required was calculated on the basis of demand projection.

Demand of each drug item was worked out in such a way that in almost all of the occasions it

remains available with the health center if prescribed.

Quantification is the process used to calculate or estimate the quantities of medical supplies, drugs

and equipments required. It is usually done once a year or during the planning for a new health

programme or project. Proper quantification ensures that there is enough stock to meet demands,

and avoids both under stocking and overstocking. It is also a useful tool for preparing budget

estimates, adjusting quantities to match a fixed budget, and monitoring use of supplies and

equipment by health facility staff.

The most commonly used quantification methods are:

Consumption method – This uses data about actual use or past consumption pattern to calculate

what quantities, will be required in future. The consumption method depends on reliable

consumption data and effective stock control, especially accurate record keeping. To use this

method you need a monitoring system that both provides information about actual rates of

consumption of supplies and equipment and highlights higher than expected consumption of

particular items and potential misuse of supplies.

Morbidity data method – Which uses data about prevalence and incidence of disease and health

problems and the standard treatments for these to estimate future needs.

2.3.2 Study Design

In the current study

4) We have worked out the demand projection taking into account different data sets as each

one in isolation will have a demerit to influence reliability.

5) The study results are probabilistic keeping in view the short time frame in which the report

was required to be generated otherwise long term prospective study would have been ideal.

6) The Study design is cross sectional and includes secondary and primary data collection and

Prescriptions survey across various categories of health facilities (tertiary, secondary and

primary health care level).

Hybrid method for demand assessment

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Chhattisgarh 22

A Hybrid method for Demand assessment which is a combination of Consumption, Morbidity

Method and analytical methods was used.

A. Consumption Method

For those items for which past consumption data is available we have used the consumption

method.

We obtained the data of the past consumptions of drugs for past 3 years. This data was

useful , however had low reliability as we are not sure in some cases if the amount procured

was sufficient to meet the demand or not. It also did not include complete inventory. Also

there were instances of over stocking which provided incorrect data for projection.

However the data did give an indication an overall requirement for a section of items.

B. Morbidity Method

Drug demand data was also calculated using morbidity method. This was especially used for

drugs being used for Non-Communicable Diseases (NCD) and diseases covered in National

Programmes (NCP).

C. Prescription survey

Drug demand was assessed through a prescription survey.

D. Analytical Method

For items not covered by any of the above methods and those requiring adjustments and

validation on past consumption we have used Analytical Estimation Method.

2.4 Prescription Survey

Good statistically enabled samples of prescriptions were studied for frequency and quantity

of drugs from EDL. The challenge here was that the preparations prescribed were often not generic.

We converted the prescriptions into generic forms for the purpose of recording data. Qualified

personnel well versed with pharmacy sciences conducted the survey and data analysis and to assess

prescription patterns for EDL and Specialist drugs. The survey team was led by program

associates from SHRC who were also the chief investigators.

Primary data was collected from OPD and IPD prescriptions of drugs from Medical Colleges, Districts

Hospitals, CHCs and PHCs for estimation of drugs consumption.

2.4.1 Training of Surveyors

A two day orientation training was conducted for the surveyors by experts in the field. They

were provided the necessary tools and guidance for effective outcome from the survey. The

surveyors were supported centrally from SHSRC, Chhattisgarh for any assistance.

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Chhattisgarh 23

The team was made conversant with the drugs in the EDL. The Survey team was led by a senior

qualified pharmacist and survey was conducted by pharmacist teams supported with data entry

assistants.

2.4.2 Survey Tool

A Survey tool was developed on the basis of existing EDL of the state and the tool was

piloted at Raipur Medical College Hospital. Based on the feedback from the pilot study necessary

revisions were made.

The tool also had a section for collecting data on the number of drugs prescribed and a section for

capturing broad prescribing practices.

The final Survey tool used for the study is placed as Annexure-3

Step 2: The state wise OPD for the year was taken as the universe for the purpose.

Step 3: Based on the universe, at 95% confidence level a sample size for prescriptions was

worked out.

Step 4: The state was divided into five divisions:

♦ Bastar

♦ Durg

♦ Raipur

♦ Bilaspur

♦ Sarguja

One District Hospital (DH), Tertiary Healthcare Centre (THC), Primary Health Centre

(PHC) and Community Health Centre (CHC) from each division will be selected

through randomization.

Step 5: Depending on the percent load of various OPDs all 3 medical colleges were covered.

This DH/THC/PHC/CHC, proportion of samples from the already calculated sample

size was allocated.

Yardstick for numbers of prescriptions per health facility – Numbers of prescriptions

were collected prospectively from the various level of health facilities over a period of

time

• Medical college level: 100-300 prescriptions were collected from various

specialities OPD.

• DH/SDH level: Minim. 60-80 prescriptions were selected from various OPDs

• PHC level: Minim. 10 to 15 prescriptions were collected from OPD

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Chhattisgarh 24

Step 6: The results were statistically studied for annual consumption and the results were

compared with historical data on consumption pattern obtained from central stores

and hospital stores to ensure midcourse correction.

For IPD data:

Similar audit of case sheets of IPD on sample basis were conducted for items in EDL.

Guidelines for Survey Team

� All facilities included in the sample were communicated about the prescription survey.

� The surveyors were provided a letter authorizing him/her to look into the prescriptions of

patients at the OPD & IPD.

� A nodal person was identified in each district for the prescription survey.

� Average Percentage distribution of various departments OPD & IPD was provided by the

Medical Colleges, DHs & CHCs in sample to calculate the sample allocation.

� All surveyors made themselves well conversant with the EDL 2010-2011 of Chhattisgarh.

On day of Survey –

The prescription survey was carried out over the period 20th

Feb to 05th

March 2013

concurrently across the designated five zones of the state.

1. The survey team presented the authorization letter to the administration who in

turn informed the doctors and nurses in the facility about the activities.

2. The surveyors covered 50% of the daily OPD load at the facility by taking every 2nd

prescription generated at a particular OPD. The sample size of prescriptions was

drawn as per proportion of OPD contribution from different departments. Based on

the number of surveyors deployed, this number was covered over one or two days.

3. The tool was also filled for the drugs in the Emergency Kit in the Store ( wherever

available )

4. Sample for IPD was worked out in proportion to the IPD load at the facility and the

survey will cover the drugs prescribed in the last case sheet entry.

5. The surveyors did not question the patients on the prescription.

6. Due care was exercised while dealing with female patients.

7. If a patient refused to show his/her prescription, his/her wish was honored.

8. There were non-generic prescriptions also and in that case the trade name was

noted.

9. The survey tool provided was covered for each prescription.

10. Non EDL drugs were not covered. However, in case of doubt, the drug was noted

and was checked later if it was included in the EDL or not.

11. Similarly IPD records were studied and drugs were identified from the case sheets

from the last entry.

12. At CHC and PHC department wise survey was not necessary as specialists were not

available.

13. Data entry was done in the customized excel formats in the afternoon of the same

day.

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Chhattisgarh 25

14. The prescriptions were preferably checked at the pharmacy and Red Cross store

windows so that drug availability can also be simultaneously captured. Assistance of

the pharmacist was taken.

Post Survey

15. Any doubts regarding categorization / Code of drug were cleared with the help of

the Survey Team leader prior to entering the data into the finalized excel formats.

16. Any additional inputs / information gathered by the surveyor during the period of

survey that is relevant to the study were mailed to the team leader.

17. A survey tracker mentioning the name of facility and the number of prescriptions

covered were submitted at the end of each day.

2.4.3 Sample

Samples for data collection were dispersed over 5 zones

♦ Bastar

♦ Durg

♦ Raipur

♦ Bilaspur

♦ Sarguja

. A total of 858, 787, 440 and 492 samples were collected from Medical Colleges, District

Hospitals, CHCs and PHCs respectively.

Designated Zones

for survey

Number of

Prescriptions

sampled from

Med College

Number of

Prescriptions

sampled from DH

Number of

Prescriptions

sampled from

CHC

Number of

Prescriptions

sampled from

PHC

Total Number of

Prescriptions

sampled

from zone

Bastar 266 144 98 119 627

Bilaspur 150 152 46 48 346

Durg - 248 94 215 557

Sarguja - 122 63 24 209

Raipur 442 121 139 86 788

Total 858 787 440 492 2577

Table 10: Sample distribution of prescription surveyed

Details of facilities where prescription survey was undertaken:

Zone Facility Type Location Name

Bastar

Medical College Jagdalpur

District Hospital Dantewada

CHC Geedam

Kuakonda

PHC

Barsur

Tumnar

Palnar

Potali

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Chhattisgarh 26

Zone Facility Type Location Name

Bilaspur

Medical College Bilaspur

District Hospital Raigarh

CHC Baramkela

Chable Kharsia

PHC

Saria

Lendhra

Binjkot

Sondaka

Durg

District Hospital Durg

CHC Dhamdha

Jheet

PHC

Ahiwara

Bori

Bastrel

Bhilai

Raipur

Medical College Raipur

District Hospital Mahasamund

CHC Bagbahra

Basna

PHC

Hathibahra

Khallari

Baroli

Bhanwarpur

Sarguja

District Hospital Ambikapur

CHC Batauli

Bhafouli

PHC

Bataikela

Ghutrapara

Nawanagar

Table 11: Facilities where prescription survey was undertaken

2.4.4 Data analysis & Statistical Correlation

The data collected from CHC, PHC, DH and Medical college was grouped accordingly and

amalgamated on an excel sheet. Statistical tools and probability methods were used for data analysis

to arrive to a scientific result for the study. The frequency of prescription as well as quantity was

analysed using mean and standard deviation for each drug. Assuming that prescription pattern will

follow a normal distribution, probability, model for normal distribution was used to get a projection

for 90% probability. The excel based NORMINV function for determining probability of frequency as

well as quantity was used. The multiplication of the probability of frequency of prescription of a

drug and the probability of a quantity prescribed in each prescription gave an indication of probable

demand for a CHC/PHC/DH/MC for one day. Based on this an annual demand projection has been

worked out or each level of facility. Adding up this data gave the approximate final figure for entire

state for those items which could be adequately picked up in the prescription survey.

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Chhattisgarh 27

Analytical estimation: for items not covered by above methods and those requiring adjustments on

past consumption we have used Analytical Estimation.

Basics of Analytical Estimating

Analytical estimating is a process used by bid makers, usually in the construction industry or

skilled trades, to develop an approximation of a given project's costs. In analytical estimating, the

project is carefully broken down into the various tasks necessary to complete it, and then these are

estimated for time and cost expectations based on experience. These component costs are then

assembled into an estimate of the entire project's cost. Analytical estimating is usually a practical

and reliable method for determining costs. In our study we used this technique by interviewing the

experts i.e. doctors who have been working in the facilities and handling patients in large number for

at least more than three years to indicate the frequency and quantity they come across for some the

drugs. This was more required in Medical College setting where specialist medicines are prescribed.

A comparison of at least three analytical estimation and using the mean eliminated bias to come to a

logical figure of requirement in a day.

Accuracy and Error Correction

Analytical estimating tends to be relatively accurate because errors made in the estimation of

a single task's time and resource needs are usually offset by errors in those of another task. For

example, if the estimated time for replacing a door frame turns out to be shorter than the actual

work's time demands, this error is often corrected in the larger estimate when another task takes far

less time than expected. In general, an estimate composed of these smaller tasks has incorporated

room for error as a result.13

2.4.5 Additional information collected

Additional information was collected during the survey and analysed for better

understanding of drugs usage pattern from Medical colleges, District Hospitals, CHCs and PHCs of

the state. Following information were obtained:

a) What are the numbers of drugs prescribed in the prescription?

b) Are the drugs prescribed using their generic name?

c) What is the duration of prescription?

d) Are the drugs prescribed listed in the EDL?

e) Is the drug dosage form provided?

f) Are the strengths of dosage form provided?

g) Is the diagnosis mentioned in the prescription?

2.4.6 Limitations

h) All drugs were not covered from the prescription survey.

13 iSixSigma; An Analytical Method for Estimating Project Benefits; Chew Jian Chieh; 2011

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Chhattisgarh 28

i) Irrational prescriptions may lead to skewed demand especially for antibiotics, analgesics

and Vitamin Supplements.

j) Drugs such as statins were not a part of EDL and came up in many prescriptions.

k) The demand assessed was essentially sample based are probabilistic.

2.5 Historical Consumption Data

Primary data was collected from stores of different zones for demand estimation of essential drugs

and consumables. A tool was developed to capture data of consumption for duration of three years.

It included stock consumed over 3 years including periods of stock outs.

2.5.1 Sample

Samples for data of consumption were dispersed in 5 zones of the state as under

Zone Facility Type

Number of stores

from

which consumption

data was obtained

Bastar Medical College & District Hospital 2

Bilaspur Medical College & District Hospital 2

Durg District Hospital 1

Sarguja District Hospital 1

Raipur Medical College 1

Total 7

Table 12: Sample distribution of stores data

2.5.2 Analysis of data keeping stock outs in account

Step 1: We selected the time period for calculating consumption (3 years)

Step 2: Calculated the consumption for each item during the time period

Step 3: Adjusted consumption figures for stock outs.

Stock out Adjusted RC = Real consumption x Period in calculation (months, weeks, days) Period

in stock (months, weeks, days)

Step 4: Calculated the monthly maintenance figure and quarterly maintenance figure for each

item

Step 5: Arrived at an annual consumption figure

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2.5.3 Limitations of data

a) Most of the historical store data had wide gaps in that the figures were available for 2

years only.

b) The supply of most drugs was erratic.

c) Periods of over stocking and long stock outs were seen. Data obtained from the store

consumption therefore could not be relied upon fully. Indirect methods of calculating drug

demand using prescription survey had to be resorted to.

It is our opinion, that after one or two cycle of procurement and consumption of the entire

list, other consumption data will stabilize and the demand can be assessed to higher precision levels.

2.6 Assessment through Morbidity patterns

Demand assessment for certain drugs was carried out/validated using the morbidity

patterns. This was especially used for drugs used in NCD and in diseases covered in National

Programme.

2.6.1 Applicable for NCD

The global burden and threat of non-communicable diseases constitutes one of the major

challenges for development. Non-communicable diseases are among the leading causes of

preventable morbidity and of related disability. The rapidly growing magnitude of non-

communicable diseases affects people of all ages, gender, race and income levels, and further that

poor populations and those living in vulnerable situations, in particular in developing countries, bear

a misappropriate burden.

We worked out the demand based on the national prevalence and also on the state level data

wherever available.

Drugs used for diseases covered in the National Programmes were also validated against state

statistics.

2.7 Expert input / Analytical assessment

For drugs used in niche areas such as oncology, psychiatry and ophthalmology etc. and which did not

get covered in the prescription survey we ratified the demand by the concerned specialists.

Discussions were held with specialists both at Chhattisgarh and at Delhi before arriving at a best

estimate for these items.

At this stage we also worked out the work load of the tertiary specialised services to assess the drug

demand.

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Table 13: Oncology Workload

Consumables which are required for day to day care delivery and are more than often loaded on to

the patients were also taken in the ambit of study, as their provision by the government will reduce

the OOP expense for the public.

The list of Consumables included in the Chhattisgarh EDL is exhaustive and includes all consumables

required for high end and complex multi-speciality services and specialised surgeries and

procedures.

As per the data available from the Chhattisgarh Department of Health & Family Welfare e-portal, the

total number of major & minor surgeries at district level is as shown -. Given that 70 FRUs are

operational in the state. This brings us to the conclusion that there are on an average 1226 Surgeries

per district per year and 473 surgeries per FRU per year.

As per COPP the average number of surgeries in a multi-specialty hospital are 12% of all admissions;

and 22% of all beds are catering to the surgical

care.

In view of the above, consumables were

factored into the financial envelope that the

government will require to cater in order to

reduce the OOP expense on the patient.

The consumable items included in the EDL and

catered for in the calculation of the final

envelope is appended at Annexure 3

The consumable demand was worked out for each facility level; i.e. Medical College, District

Hospital, CHC & PHC. We relied upon historical consumption data and the work load analysis of

Casualty & Emergency; Intensive Care Units , Dialysis Units and surgeries which account for major

utilisation of consumables.

Oncology Workload at Government facilities (Chhatisgarh)

Reference Chhattisgarh NPCDCS data

Period – Year 2010 2011 2012

Surgeries 1146 1200 1298

Medical (new for Chemotherapy 18750 19400 19398

Brachytherapy 1050

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The cost of limited most essential and commonly used consumables, which will have an impact on

the OOP expense, was brought under the ambit of this study.

2.8 Price Estimation

The two key variables which the study required to work on were-

1. Annual demand for each item

2. Price for each item

Given that the Chhattisgarh Government has set up the Chhattisgarh Medicare Services Corporation

for centralised procurement of drugs, and that such large procurements will result in extremely

competitive rates, we factored that the price per item would be much below the market price of the

drugs.

Data on rates at which drugs were procured over the past 2/3 years by the DME and DHS in the state

were sought. However, this could cater to only 30% of the items covered.

For the rest of the items we relied on Tamil Nadu Medical Stores Corporation, Rajasthan Medical

Stores Corporation and Kerala Medical Stores Corporation tender rates. The price under which

TNMSC obtained drugs was found to be much lower on account of the benefits of larger scale and

length of operations. This was addressed by adding a twenty per cent weightage to all TNMSC price

rates utilised.

The item wise price listed does not include tax.

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Chapter 3 Data Analysis & Report generation

A. Prescription Survey Data Analysis:

The prescription survey besides providing the demand for drugs prescribed at various facilities also

shed light on certain key prescribing patterns.

1) Number of drugs prescribed per prescription - More than 60% of prescriptions at all levels had

less than three drugs per prescription.

Table 14: Number of drugs prescribed in the prescription

2) Drugs prescribed using their generic name - The lower level facilities of PHC, CHC showed 64%

and 59% prescriptions using generic names of drugs. However at the level of District Hospital it

was 47% and at Medical Colleges only 35%.

All Some None

Medical Colleges 35% 52% 13%

District Hospitals 47% 50% 3%

CHCs 59% 39% 2%

PHCs 64% 30% 4%

Table 15: Drugs prescribed using their generic name

3) Duration of prescription - At PHC and CHC the majority of prescriptions were for 1 to 3 days

duration. However at District Hospitals 36% of prescriptions were for 4-6 days and at the

Medical College 24% were with duration more than 7 days.

1-3 Days 4-6 Days >7 Days



CHCs 77% 12% 11%

PHCs 69% 24% 8%

Table 16: The duration for which the medicine is prescribed

>3 >5 <3



CHCs 32% 1% 67%

PHCs 32% 4% 65%

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4) Drugs prescribed listed in the EDL -All levels of facilities showed that the majority of drugs

prescribed (80%) were listed in the EDL.

All Some None



CHCs 85% 14% 1%

PHCs 85% 14% 1%

Table 17: Drugs prescribed listed in the EDL

5) Drug details -It was observed that nearly all prescriptions had the drug dosage entered.

Cases where

drug dosage

forms were

provided

Cases where

drug dosage

forms were

not provided

Medical Colleges 98% 2%

District Hospitals 98% 2%

CHCs 98% 1%

PHCs 98% 1%

Table 18: Cases where drug dosage forms were provided or nor provided

a) The strength of the drugs prescribed was however not entered in most prescriptions.

Yes No



CHCs 3% 86%

PHCs 7% 86%

Table 19: Strengths of dosage form provided

b) Also, the Diagnosis was not entered in the majority of prescriptions at all level of facilities

Yes No



CHCs 4% 96%

PHCs 3% 96%

Table 20: Diagnosis mentioned in the prescription

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B. Data Analysis from Stores

As brought out below, the store data for each item on the EDL was requisitioned from

District Stores and the stores of Medical Colleges.

The monthly maintenance and quarterly consumption figures were then calculated, while

taking into account the periods of stock out for each store.

Illustration: In the figure below, the store data from 4 District Hospitals was collated. DH1

had an average annual consumption of 27700 tablets; however the average period of stock

out was 3 months per annum. The drug was available for an average of 9 months. The

average monthly consumption was therefore 3078 and the quarterly consumption figure

was 9233.

Figure 1 : Illustration of demand calculation

C. Data Analysis based on expert inputs

For items not covered by the prescription survey and for those under restricted

prescriptions, we arrived at an analytical estimation after discussion with concerned

specialist.

Illustration: To arrive at an estimate for anti-metabolites and other drugs used in Oncology,

we understood the prescription frequency for each medical college.

In the figure below, it is seen that the frequency of prescribing Cyclophosphamide Inj per

day is 5 at Medical College Raipur. Given the daily dosage is 2, the monthly requirement of

the Inj is 300 and the annual consumption around 3600. The demand for other medical

colleges was also customized in view of their work load.

Diazepam Tablet( scored)5mg D 165 P

DH 1 42900 12500 27700 0 180 90 3 9 3078 9233

DH 2 32400 28320 30360 0 120 60 2 10 3036 9108

DH 3 31900 88400 60150 0 12 5013 15038

DH 4 48400 5800 27100 0 12 2258 6775

10038

17 DHs 170654

TNMC Rate 10 x10 Rs 4.68 ( excluding tax) 7987

Annual

cost 31946

Illustration : Demand Calculation for Drugs on EDL

Dru

g (

as

pe

r E

DL)

Fo

rmu

lati

on

Str

en

gth

Dru

g C

od

e

Fa

cili

ty C

od

e (

P/S

/T )

Annual Consumption (A) No Stock (B) Number of days

No

sto

ck i

n m

on

ths

(C=

B/3

0)

Year 1 Year 2 Year 3 Average Year 1 Av

era

ge

Qu

art

erl

y c

on

sum

pti

on

( F

=

Ex

3)

Year 2 Year 3 Average Dru

g a

va

ila

bil

ity

in

mo

nth

s (D

= 1

2-C

)

Av

era

ge

Mo

nth

ly C

on

sum

pti

on

(E=

A/D

)

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Chhattisgarh 35

Figure 2 : Demand estimation for chemotherapeutic drugs

Figure 3 : Demand estimation for drugs used in psychiatry

10% 20%

Drug

dosaged

osages

Monthly

Require

ment

Annual req MC

Raipur

Annual

Req MC

Jagdalpur

Annual

Requirement

Medical

college

Total

Requirement

for state ( 3

MCs)

Busulfan Capsule 2mg 15 2 900 10800 1080 2160 14040

Carboplatin Injection 50mg/5ml 50 2 3000 36000 3600 7200 46800

Carboprost (PGF2α) as

Tromethamine USP Injection 0.25mg/ml

0.1 1 3 36 3.6 7.2 46.8

Chlorambucil Capsule 5mg 15 1 450 5400 540 1080 7020

Cisplatin Injection 10mg/10ml 25 1 750 9000 900 1800 11700

Cyclophosphamide Tablet 50mg 25 1 750 9000 900 1800 11700

Cyclophosphamide Injection 200mg 5 2 300 3600 360 720 4680

Cytarabine Injection 500mg 5 1 150 1800 180 360 2340

D actinomycin Injection 0.5mg 10 1 300 3600 360 720 4680

Daunorubicin Hydrochloride Powder for Injection 50mg 5 1 150 1800 180 360 2340

Decarbazine Injection 100mg 50 1 1500 18000 1800 3600 23400

Doxorubicin Injection 10mg/5ml 1 1 30 360 36 72 468

Doxylamine Succinate Tablet 100mg 50 1 1500 18000 1800 3600 23400

Etoposide Capsule 100mg 0.2 1 6 72 7.2 14.4 93.6

Etoposide Injection 100mg/5ml 1 1 30 360 36 72 468

Florouracil Injection 250mg 2 1 60 720 72 144 936

Hydroxyurea Capsule 500mg 3 1 90 1080 108 216 1404

Lomustine Tablet 40mg 3 1 90 1080 108 216 1404

Melphalan Tablet 2mg 3 1 90 1080 108 216 1404

Mercaptopurine Tablet 50mg 5 1 150 1800 180 360 2340

Methotrexate Injection 25mg/ ml 5 1 150 1800 180 360 2340

Methotrexate Sodium Tablet 2.5mg 5 1 150 1800 180 360 2340

Mitomycin Capsule 10mg 0.1 1 3 36 3.6 7.2 46.8

Mitoxantrone Injection 20mg 4 1 120 1440 144 288 1872

Ondansetron Syrup 2mg/5ml 3 1 90 1080 108 216 1404

Procarbazine Capsule 50mg 4 1 120 1440 144 288 1872

Vinblastine Injection 10mg 12 1 360 4320 432 864 5616

Vincristine Injection 1 mg 10 1 300 3600 360 720 4680

Dru

g (

as

pe

r E

DL)

Fo

rmu

lati

on

Str

en

gth

Estimation of demand for Chemotherapeutic drugs (at Medical Colleges)

Prescription

Frequency per

day

Amitriptyline Tablet 25mg 0.5 2 1 900

Clozapine Tablet 100mg 6 2 12 10800

Fluoxetine Hydrochloride (for

use above 8 years of age)Tablet 20mg

5 2 10 9000

Fluphenazine Decanoate or

EnantateInjection 25 mg

10 1 10 9000

Haloperidol Tablet 5 mg 5 1 5 4500

Haloperidol Injection 5 mg 6 1 6 5400

Haloperidol Liquid 2mg/ml 1 1 1 900

Imipramine Hydrochloride Tablet 25 mg 0.5 2 1 900

Lithium Carbonate Tablet 300 mg 5 1 5 4500

Olanzapine Tablet 10 mg 10 1 10 9000

Risperidone Tablet 3mg 10 1 10 9000

Do

se /

Da

y

To

tal

da

ily

de

ma

nd

pe

r M

C

An

nu

al

de

ma

nd

fo

r

sta

te

Demand Calculation for Drugs used in Psychiatry ( Medical Colleges only)

Dru

g (

as

pe

r

ED

L)

Fo

rmu

lati

o

n

Str

en

gth

Fre

qu

en

cy

of

da

ily

pre

scri

pti

o

n

Report


Chhattisgarh 36

D. Data Analysis based on morbidity statistics

The demand for drugs for Non-communicable diseases and diseases covered under National

and State driven programmes were calculated using the national and state level prevalence

rates and other epidemiological statistics.

The Standard Treatment Guidelines available under the various National Programmes and

the STG developed by the Armed Forces Medical College, Pune in collaboration with Ministry

of Health & Family Welfare & WHO Country Office, India were utilized for calculation of drug

demand.

Illustration:

� Calculation of demand for Antimalarial Drugs-

The state of Chhattisgarh is endemic for Malaria with a high disease burden as brought out

below

The district level load of Malaria is brought out below based on the DHS MIS available in the

Chhattisgarh Department of Health & Family Welfare portal.

The statistics available in the Directorate of NVBDCP and the State Health HMIS for the year

2011 reveal-

� The state has an average API of 6.13 (2011 State NVBDCP data)

� The districts of Bastar, Dantewada, Jashpur, Korba, Korea, Narayanpur have a high

API (Annual Parasitic Index) > 10

� BSE ( Blood Smear examined)– 167656

� TPC- 152106

� Pf % - 72.15%

The demand for various antimalarial drugs was worked out Based on the ‘Guidelines for

Diagnosis & Treatment of Malaria in India’ 2011 developed by the National Institute of

Malaria Research & WHO. The treatment was based on the algorithm as provided below-

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Chhattisgarh 37

Figure 4: Algorithm for Diagnosis and treatment of Malaria

The dosage schedule and the number of tablets and injections were then calculated using

the STG as developed under the NVBDCP.

Figure 5: Dosage schedule for treatment of Pl Vivax (under NVBDCP)

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Chhattisgarh 38

Figure 6: Age wise schedule for treatment of Plasmodium Falciparum malaria (as per NVBDCP)

� Calculation of demand for Injection Quinine -

Total Pfx 40% x10%x 10

� Calculation of demand for Injection Artesunate -

Total Pfx 60% x10%x 3

� Demand for Rapid Diagnostic Kit -

(Total Blood slide x 40%x40%) x60%

� Calculation for Insulin demand for treatment of Diabetes Mellitus

In view of the essentially rural population of Chhattisgarh, the prevalence of Diabetes

Mellitus in the state was taken as 8%.

Prevalence of Diabetes in Urban India JAPI, June 2010; Vol 58 A Ramachandran et al ‘Current

status of Diabetes in India’

Report


Chhattisgarh 39

The Insulin demand was then worked out assuming that 10% of the diabetic subset

accessing the public health care system will require Insulin.

The various forms of Insulin for which demand was calculated were

� Family Planning statistics used for calculation of demand-

� Total Fertility Rate 2.6

� Contraceptive Prevalence Rate ( Permanent + IUCD ) 63%

� Number of IUDs insertions

� Family Planning Indicators – Based on DLHS -2 & DLHS 3

Period 2010-11 2011-12

Number of IUD

insertions

105245 102000

DLHS-2 DLHS-3

Pill % 1.8% 1.7%

IUD % 0.5% 0.6%

Condoms % 2% 1.6%

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Chhattisgarh 40

For calculation of Demand for Anti Filarials under MDA

The following algorithm was used-

Calculation of drug demand for Leprosy treatment -

Leprosy Prevalence Rate of Chhattisgarh - Number of patients per 10000 populations – 1.78

per 10000 with nearly four to five thousand new cases being detected annually.

The districts of Mahasamund, Raigarh, Janjgir, Raipur, Bilaspur, Korba, Kawardha, Durg,

Dhamtari, Jagdalpur, Jashpur, Rajnandgaon have ANCDR more than 10 / 100000 population.

Dosage schedule for MDT Regimen

Calculation

MDT Regimen

Drug Dosage Frequency Duration

demand

per

patient

MB

Rifampicin 600mg once a month

12 month

12

Dapsone 100mg Daily 365

Clofazamine 300mg once a month 12

Clofazimine 50mg Daily 365

PB Rifampicin 600mg once a month

6 month

6

Dapsone 100mg Daily 183

Table 21:Dosage schedule for MDT Regimen

Demand calculation for Vaccines -

The calculation was based on the guidelines provided in the Immunisation Handbook of

Department of Health & Family Welfare, Government of India.

The under mentioned tool was used for assessing the vaccine demand.

A wastage rate of 25% or a wastage multiplication of 1.33 was applied for all vaccines

1

a

b

c

MDA for Fialria

Single day MDA with DEC and Albendazole

Age group Drug dose

< 2yrs Nil

2 - 5 yrs (100 mg ) 1 tabs

6- 14 yrs (100 mg ) 2 tabs

15 and above 3 tabs

Calculation

Yearly requirement calculation DEC 100mg = total population in area x 2.5

Albendazole 400mg = " x 1

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Chhattisgarh 41

Annu

al

Targe

t

Mon

thly

Targ

et

Benefeciaries per month Vaccine vials & Vit A per month T

ota

l Po

pu

lati

on

Pre

gn

an

t w

om

en

Infa

nts

Pre

gn

an

t w

om

en

Infa

nts

TT

BC

G

DP

T

OP

V

He

pa

titi

s B

Me

asl

es

DT

Vit

am

in A

TT

BC

G

DP

T

OP

V

He

p B

Me

asl

es

DT

Vit

A

Sy

rin

ge

.1m

l

Sy

rin

ge

0.5

ml

Re

con

stit

uti

on

a b c d e f g h i j k l m n o p q r s t u v w

Ba

sed

on

Ce

nsu

s

Ba

sed

on

ce

nsu

s

Ba

sed

on

ce

nsu

s

a/1

2

b/1

2

cx2

dx1

dx4

dx4

dx3

dx1

dx1

dx9

(ex1

.33

)/1

0

(fx1

.33

)/1

0

(gx1

.33

)/1

0

(hx1

.33

)/1

0

(ix1

.33

)/1

0

(jx1

.33

)/1

0

(kx1

.33

)/1

0

{(d

x1m

l) +

(dx8

x2m

l)}x

1.1

1

fx1

.1

(e+

g+

i+j+

k)x

1.1

(n+

r)x1

.1

3.1 Triangulation of Data

In view of the short time frame in which a good estimate of the financial envelope was to be

ascertained, various data sources were used to get a correct demand estimate for each drug.

From the Store consumption data and the prescription survey, drug demand for each level of facility

was worked out. Based on the prevalence rates and morbidity patterns, the drug demand was

calculated for the entire state population.

A triangulation of data was done for each item and the final estimate was chosen.

Triangulation for demand Assessment for Anti-Hypertensive Drugs is brought out below-

Illustration:

Demand assessment for Anti-Hypertensive based on Morbidity patterns-

Scenario 1:

Report


Chhattisgarh 42

Assuming -

� Prevalence rate of Hypertension14

to be 10% ( In age group 30 years and above )

� Total population of state being 25540196

� 76 per cent of Chhattisgarh population being rural

� 35 per cent of the state Polpulation being above the age of 30 years ( census 2011)

� 30 per cent of state Population currently accessing public healthcare system

Standard Treatment Guidelines (STG) for Hypertension advocates step ladder use of combination

drug therapy from the following Drug Groups -

Drug Group

( Anti Hypertensives )

Average Percent of

prescriptions with drug

group

Diuretics 30%

Beta Blockers 30%

ACE Inhibitors 40%

Calcium Channel Blockers 30%

Aldosterone antagonists 10%

Angiotensin Receptor blockers 30%

Based on the above the demand for each anti-hypertensive drug was calculated and the budget

ascertained.

In the above scenario , the annual amount for procurement of anti-hypertensive worked out to INR

6.7 Crore.

Drug Group

Dosage

per day

Patient

load

Unit

price

Annual

demand

Annual

Amount

Diuretics

80452

Hydrochlorthiazide (25mg) 1 80452 0.44 29364840 12920530

B Blockers

80452

Atenolol(50mg) 1 40226 0.15 14682420 2202363

Metoprolol (50mg) 1 40226 0.37 14682420 5432495

Calcium Channel Blockers

80452

Ditiazem 1 8045 0.19 2936484 557932

Nifedipine (5mg) 1 24135 0.3 8809452 2642836

14 ICMR – Medical Research Council Workshop on Chronic Diseases 2009 ; The Burden of

Cardiovascular Disease in India

Report


Chhattisgarh 43

Drug Group

Dosage

per day

Patient

load

Unit

price

Annual

demand

Annual

Amount

Amlodepin (5mg) 1 0.06 11745936 704756.2

Nifedipine (20mg) 1 8045 0.13 2936484 381742.9

Verapamil Inj 1 4023 5.87 1468242 8618581

Verapamil Tab 1 8045 0.4 2936484 1174594

Aldosterone antag

26817

Spirinolactone (100mg) 1 26817 1.62 9788280 15857014

Angiotensin Receptor

Blockers

80452

Losartan (25mg) 1 80452 0.46 29364840 13507827

ACE I

107269

Enalapril(5mg) 1 107269 0.08 39153120 3132250

Total Amount 67132919

Table 22: Drug Demand and budget calculation based on national prevalence rates

Scenario 2:

Assuming the prevalence rate of Hypertension in Chattisgarh to be 2.7% as brought out from the

screening results covering the 3 designated NCDC .The item wise demand and cost is tabulated

below.

The total cost for anti hypertensives now comes to INR 1.8 Crore

Drug Group

Dosage

per day

Patient

load

Unit

price

Annual

demand

Annual

Amount

Diuretics

21722

Hydrochlorthiazide (25mg) 1 21722 0.44 7928506.9 3488543

B Blockers

21722

Atenolol(50mg) 1 10861 0.15 7928506.9 1189276

Metoprolol (50mg) 1 10861 0.37 3964253.4 1466774

Calcium Channel Blockers

21722

Ditiazem 1 2172 0.19 792850.69 150642

Nifedipine (5mg) 1 6517 0.3 2378552.1 713566

Amlodepin (5mg) 1 8689 3171402.8 190284

Nifedipine (20mg) 1 2172 0.13 792850.69 103071

Verapamil Inj 1 1086 5.87 396425.34 2327017

Verapamil Tab 1 2172 0.4 792850.69 317140

Aldo antag

7241

Spirinolactone (100mg) 1 7241 1.62 2642835.6 4281394

Angiotensin Receptor

Blockers

21722

Losartan (25mg) 1 21722 0.46 7928506.9 3647113

ACE I

28963

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Chhattisgarh 44

Drug Group

Dosage

per day

Patient

load

Unit

price

Annual

demand

Annual

Amount

Enalapril(5mg) 1 28963 0.08 10571343 845707


Table 23: Drug demand & cost based on local prevalence statistics

Scenario 3:

The same drug demand when assessed utilizing the data obtained from stores resulted in total cost

coming to only INR 25 lakhs.

This is attributed to the erratic store supply, long periods of stock outs and the insufficient supply of

ACE Inhibitors and ARBs.

Drug Group Dosage

per day

Unit

price

Demand Amt

I Diuretics

Hydrochlorthiazide (25mg) 1 0.44 505490 372767

Ii B Blockers

Atenolol(50mg) 1 0.15 1992324 298849

Metoprolol (50mg) 1 0.37 1399571 1077063

Iii Calcium Channel Blockers

Ditiazem 1 0.19 21688 4164

Nifedipine (5mg) 1 0.3 140227 42068

Amlodepin (5mg) 1 0.06 2726157 142969

Nifedipine (20mg) 1 0.13 155808 20567

Verapamil Inj 1 5.87 7056 41405

Verapamil Tab 1 0.4 7056 2794

Iv Aldo antag

Spirinolactone (100mg) 1 1.62 341837 452186

V Angiotensin Receptor Blockers

Losartan (25mg) 1 0.46 77904 35836

Vi ACE I

Enalapril(5mg) 1 0.08 526000 69432


Table 24: Drug demand & cost based on local prevalence statistics

In the current study we utilized the figures based on the national prevalence rate as brought out in

scenario 1.

3.1.1 Demand for Anti Rabies Vaccine

The consumption data from stores shows an average annual state level consumption of 3056

ARV. The prescription survey calculated an annual requirement of 16,867 ARV.

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Chhattisgarh 45

However, on taking into account the actual incidence of Dog Bite in the state from the HMIS we

calculated an annual demand of 13282 ARV.

Incidence as per Chhattisgarh Govt. HMIS

Drug (as per EDL)

Demand from

Store

Demand

from

Prescription

survey 2010-11 2011-12 2012-13

ARV 3056 16867 14827 15018 13282

Table 25: Demand assessment for ARV from 3 sources

The demand for Anti Snake Venom Serum on the other hand was 774 based on store consumption,

424 based on the prescription survey and 575 based on actual incidence rates. In this case we kept

the current store consumption data.

3.1.2 Demand for Insulin for treatment of Diabetes Mellitus

Scenario 1:

Calculation based on Morbidity pattern

Assuming –

• Population of Chhattisgarh is 25540196

• Prevalence of Diabetes15

(National) is 8 per cent of the population

• 30 Per cent health seeking people access the public health system in the state of

Chhattisgarh

• Ten Per cent of Diabetic patients are on Insulin

Calculation

15 ICMR – Medical Research Council Workshop on Chronic Diseases 2009 ; The Burden of Diabetes

in India

Diabetic subset 612965

Per cent of patients on Insulin 10%

Number of patients on Insulin 61296

Number of ptients on OHAs 551668

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Chhattisgarh 46

Dose calculation for Insulin 30IU/day/patient

Total doses 671196350.9

Insulin in EDL Strength Cost/unit per

cent

Doses cost

1 Insulin Injection (Soluble) 40IU/ml

(70.04 per 10ml

vial)

0.18 per IU

30% 201358905 35257944

2 Insulin Injection (Soluble) 100IU/ml 30% 201358905 35257944

3 Isophane Insulin 40IU/ml 20% 134239270 23505296

4 Isophane Insulin 100IU/ml 20% 134239270 23505296

117526481

The Insulin demand for the state is 1677991 IU at a cost of INR 11.75 Crore

Scenario 2:

Calculation of Insulin demand based on the NCD screening programme prevalence rate of- 4.1

per cent

Number of patients on

Insulin

31414

Number of patients on OHAs 282730

Dose calculation for Insulin 30IU/day/patient

Total doses 343988129.8

Insulin in EDL Strength Cost/unit per cent Doses cost

Insulin Injection (Soluble) 40IU/ml Rs 70.04 per

10 ml vial

Rs 0.18/IU

30% 103196439 18069696

Insulin Injection (Soluble) 100IU/ml 30% 103196439 18069696

Isophane Insulin 40IU/ml 20% 68797626 12046464

Isophane Insulin 100IU/ml 20% 68797626 12046464

60232322

The Insulin demand is 343988130 IU at a cost of INR 6 Cr.

In the current study we have based the Insulin demand on scenario 1.

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Chhattisgarh 47

3.2 Total financial envelope

The study has worked out the demand assessment for each item based on the current levels

of work load and service delivery at the various levels of facilities i.e Tertiary, Secondary and

Primary care.

Scenario 1

On current levels of utilization of Public Health delivery system

Based on the current demand , the financial envelope that the Government of Chattisgarh

will require to table for providing free generic medicines (listed in the EDL) at all level of

public healthcare delivery facilities ( Medical Colleges; District Hospitals ; CHCs & PHCs ) is

INR 143.92Crores.

The above figure is reached

1. Taking into account the current load of patients.

2. Utilising the item wise price used in procurement by Chhattisgarh and other

State governments

3. The item wise price is excluding tax

4. The item wise demand does not cater for Wastage except for the calculation of

Vaccine demand.

5. The Reserve / Buffer stock has not been catered to in the assessment of the

annual demand

6. The overall demand has been calculated for 3 Medical Colleges, 17 District

Hospitals, 148 CHCs and 741 PHCs.

7. The National Programme for Prevention and control of Cancer, Diabetes, CVD &

Stroke (NPCDCS) has been rolled out in the state. The burden of NCD is also due

to the chronicity of the illness and the requirement of lifelong medication.The

estimated Cost of providing for medicines for NCD alone in the current study is

INR 25.66 Crores..

8.

Scenario 2

On increased levels of utilization once free generic drugs are made available

Around 30 per cent of Chhattisgarh’s population accesses the Government funded public

health care delivery system in the state. We anticipate an increase in patronage of public

health care delivery once the government starts providing assured free medicines .

Based on the model utilized by the Planning Commission, it is anticipated that over a period

52% of the state’s population will be serviced by the Public Healthcare facilities and the

outreach programmes.

The budget for provision of free generic drugs will then be INR 175.58 Crores (Rupees One

Hundred and Seventy Five Crores)

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Chhattisgarh 48

ABC Analysis

ABC analysis is an inventory categorization method which consists in dividing items into

three categories, A, B and C: A being the most valuable items, C being the least valuable

ones. This method aims to draw attention on the critical few (A-items) and not on the trivial

many (C-items).

The Pareto principle states that 80% of the overall financial value is based on only 20% of

total items. In other words, demand is not evenly distributed between items. The ABC

approach states that, to rate items from A to C:

We have done an ABC analysis to understand the items of high total value.

The items rated A numbering only 48 are contributing to sixty per cent of the total cost. 97

items were categorized B and rest 340 contributing only 10 per cent of the budget C.

ABC ANALYSIS: OF ITEMISED DRUG LIST

Category Per cent number

of Items Per cent of Budget

A 10% 60%

B 20% 30%

C 70% 10%

Total 100% 100%

Figure 7The ABC analysis for the items studied is provided at Annexure – 2

A, 48, 10%

B, 97, 20%

C, 340, 70%

ABC ANALYSIS: NUMBER OF DRUG ITEMS IN EACH

CATEGORY

A

B

C

Report


Chhattisgarh 49

3.3 Financial envelope for each level of facility

The average financial envelope for provision of free generic medicines (under EDL) at the

various levels of public healthcare delivery based on the current level of utilization is tabulated

below-

Medical

College

District Hospital CHC PHC

Estimated Annual Cost

in INR for providing free

generic medicines (EDL)

at various facilities

6.9 Cr

2.8 Cr

0.31 Cr

0.04 Cr

3.4 Funding for Outreach Programme

In the state of Chhattisgarh where the population density is sparse (150 per sqkm.) and the

habitation is quite disperse dispensing health services is a challenge. In order to provide basic health

services to these underserved area the state has The state has put in place 73 MMUs.

Chhatisgarh has a vast network of Mitanins who are present at every 350 population in the state.

Medicines required to replenish the Mitanin Kit every quarter.

The drug demand for outreach programme has been included in the total state requirement.

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Chhattisgarh 50

Chapter 4 Study constraints / limitations

4.1 Items not included in study

The study did not include high end consumable items such as Cardiac Stents, prosthesis,

Dental implants and also long use consumables such as Ambu Bags, Laryngoscopes etc.

4.2 Probabilistic study

The study has been carried out using sample based data. The seasonal trends, non-

standardization of prescription patterns, irregular supply data, would contribute to certain errors in

accuracy. Therefore the study is probabilistic in nature and can be a guided tool for decision making

as a base case. A follow up in the subsequent years and initiating a systematic monthly maintenance

figures at facility levels would refine the results further.

4.3 Can be refined over years

Given the time constraint, this study has tried to reach the best estimate for demand of

drugs and the cost that will be incurred by the Government for providing them free.

Once cycle of procurement and consumption of the entire list gets stabilized the demand data can

be reached with higher precision for all levels of care.

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Chhattisgarh 51

Chapter 5 Recommendations

5.1 Follow up study

It is recommended that a similar exercise is undertaken by the Government over the next 2

years. This will fine tune the item wise demand assessment and also help in ascertaining the

prescription patterns at various facilities. This will also help in designing interventions for promoting

scientific prescription practices.

5.2 Ongoing prescription audit

Irrational prescribing is a common phenomenon. It leads to high expenses, unwanted

adverse effects, and shortages of drugs.

The National Health Policy 2002 of India also gives thrust on rational use of drugs. The

deleterious impact of poor quality prescriptions, under- and over-dosing, duplication and multiplicity

of drugs on the restricted public finances, is a cause of concern.

The Government of Chhattisgarh has developed the essential drugs list for the use of the

prescribers and had introduced the same. However, it may be mentioned here that, the prescribing

behaviour of the doctors through prescriptions audit has not yet been evaluated in the state to

assess the prevailing prescribing practices. Hence, the study will help to know the extent of rational

prescribing practices prevailing in the public sector health facilities, and how it is affecting the

availability and access to essential medicines. This would also help in strengthening the essential

drugs programme in Chhattisgarh by improving availability and access to essential medicines by

carrying out various policy interventions to improve medicines use in the state like revision of EDL,

STG, establishing drugs formulary for various level of health care delivery system, establishment of

drugs & therapeutic committee, selection of essential drugs for procurement & its rational use etc.

5.3 Rationalising & Revising the State EDL

The state is already in the process of revising EDL. This may change the financial envelop.

5.4 Strengthening Procurement and Supply Chain.

The overall financial envelope is a small component of the health budget when only the

price of the item is being factored. However there is a cost of procurement, storage, transport and

distribution which also needs to be taken into account. Further the procurement process should be

visited to ensure that there is a procurement cycle for most of the items and inventory control tools

like fixing re order levels after catering to safety stocks and buffer stock,s using e procurement

system for greater efficiency and transparency and minimizing stock outs will be the key factors for

successful implementation of the intent.

Report

Assessment of financial resources for guaranteeing access to free generic medicines at public health facilities in Chhattisgarh 52

Annexure 1 - Itemised List of Drugs with Total state demand in number and value

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1 Acetazolamide Tablet 250 mg Tablet 1.07 156897 167879

2 Acetyl Salicylic Acid (ASA) Tablet (Enteric

Coated) 75 mg Tablet 0.66 1082399 714383


Coated) 150 mg Tablet 0.15 289931 43490


Coated) 325 mg Tablet 0.17 4593951 771784

5 Acyclovir Tablet 200 mg Tablet 0.67 181354 121507

6 Acyclovir Oral Solution 200mg/5ml 60 ml bottle 10.20 709 7232

7 Acyclovir Ophthalmic

Ointment 3% 5 gms tube 31.20 5832 181958

8 Acyclovir Cream NULL 7.25 2025 14681

9 Acyclovir (as sodium salt) Powder for

Injection 250 mg 10 ml vial 68.49 1418 97119

10 Adenosine Injection 3mg/ml 2 ml ampule 69.33 3348 232138

11 Albendazole Tablet

(Chewable) 400 mg Tablet 0.90 3617246 3255522

12 Albendazole Suspension 200mg/5ml 10ml bottle 3.60 123469 444488

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13 Albumin Injection 20% in 50ml 2050 21168 43394400

14 Allopurinol Tablet 100mg Tablet 0.52 35280 18346

15

Aluminium Hydroxide+ Magnesium

Hydroxide + Active

Dimethicon/Simethicon

Chewable Tablet 500mg (250mg+250mg

+50mg) Tablet 0.29 7454790 2161889

16


Hydroxide + Active


Gel 250mg+250mg+50mg/5ml 60 ml bottle 13.45 269089 3619244

17 Amikacin Injection 100mg/2ml Vial 3.72 215337 801053



20 Aminophylline Injection 25 mg/ml 10 ml ampule 3.28 128026 419927

21 Amiodarone Tablet 200mg Tablet 0.36 35280 12701

22 Amiodarone Injection (50mg/ml) 3ml Amp 3 ml vial 20.18 7056 142390

23 Amitriptyline Tablet 25mg tablet 0.14 2430 350

24 Amlodipine Tablet 2.5 mg Tablet 0.05 1373358 61801

25 Amlodipine Tablet 5 mg Tablet 0.06 1352798 81168

26 Amoxicillin + Clavulanic acid Suspension 125mg + 31.25mg

(156mg)/5ml 30 ml bottle 6.60 637687 4208732


(312mg)/5ml 30 ml bottle 9.00 649044 5841398

28 Amoxicillin + Clavulanic acid Injection 250mg +50mg (300mg) Vial 13.20 889027 11735151

Report


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29 Amoxicillin + Clavulanic acid Injection 500mg + 100mg (600mg) Vial 22.20 950352 21097811

30 Amoxicillin + Clavulanic acid Injection 1gm + 200mg (1.2 gm) Vial 15.00 990478 14857174

31 Amoxicillin + Clavulanic acid Tablet 250mg + 125mg (375mg) Tablet 6.78 859550 5827750

32 Amoxicillin + Clavulanic acid Tablet 500mg + 125mg (625mg) Tablet 4.79 471855 2260185

33 Amoxicillin anhydrous Tablet or Capsule 250 mg Tablet 0.93 1926036 1791213

34 Amoxicillin anhydrous Tablet or Capsule 500 mg Tablet 0.95 4830369 4588851

35 Amoxicillin anhydrous Powder for Oral

Suspension 125 mg/5 ml 30ml bottle 9.81 353642 3469226

36 Amphotericin B Powder for

Injection 50 mg Vial 85.90 1418 121801

37 Ampicillin Sodium Tablet 250mg Tablet 0.93 6080053 5654449

38 Ampicillin Sodium Tablet 500mg Tablet 1.63 410101 668465

39 Ampicillin Sodium Powder for


40 Anti rabies Vaccine (Verocell) Injection IM

administration 200 – 400 IU Vial 243.36 4819 1172782

41 Anti rabies Vaccine (Chickembryo) Injection IM

administration 2.5 IU Vial 129.15 12048 1555967

42 Anti-D Immunoglobulin Polyclonal

(Thiomersal free) Injection 300mcg Vial 1500.00 1453 2178750

Report


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43 Antitetanus Immunoglobulin

(Human) Injection 500 IU Vial 806.40 400 322560

44 Artemether Injection 80 mg/ml 1ml ampule 7.95 3518 27970

45 Artesunate Tablet 50 mg Tablet 0.13 951041 125537

46 Artesunate Injection 60mg 2ml ampule 26.90 19753 531356

47 Ascorbic Acid (Vit C) Tablet (Scored) 100 mg Tablet 0.17 4473399 751531

48 Atenolol Tablet 50 mg Tablet 0.15 1926047 288907

49 Atracurium Injection 10mg/ml 2.5ml ampule 43.99 71064 3126247

50 Atropine Tablet 1mg Tablet 0.05 155360 7457

51 Atropine Sulphate Injection 0.6 mg/ml 2.5ml ampule 1.60 237342 379747

52 Atropine Sulphate Solution (Eye

Drop) 0.50% 5ml 15.67 1944 30466

53 Atropine Sulphate Eye ointment 1% tube 13.20 38880 513216

54 Azithromycin Tablet 250 mg Tablet 3.62 834478 3020811

55 Azithromycin Tablet 500 mg Tablet 5.67 122959 697177

56 Azithromycin Syrup 100 mg/5ml 15ml bottle 7.74 176172 1363569

57 BCG Vaccine Injection Vial 18.00 73849 1329282

58 Benzathine benzyl penicillin Powder for

Injection

1.44 g benzylpenicillin

(=2.4 million IU) 5ml vial 8.40 15016 126134

59 Benzyl penicillin (sodium or

potassium salt)

Powder for

Injection 600 mg (= 1 million IU) Vial 3.74 25521 95552

60 Benzoic acid compound (Benzoic

acid + Salicylic acid) Ointment (6%+ 3% ) tube 3.77 16850 63491

Report


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61 Benzoyl Peroxide Lotion 5% 20gms 7.74 115872 896849

62 Benzyl Benzoate 25% Lotion or Cream 25% 100ml bottle 17.09 558486 9544532

63 Benzyl penicillin (sodium or

potassium salt)

Powder for

Injection 600 mg (= 1 million IU) Vial 20.94 34070 713421

64 Betamethasone Ointment/Cream 0.1% (as vale rate) 15g tube 6.72 436175 2931098

65 Betamethasone Dipropionate Injection 4mg/ml 1ml ampule 1.20 1418 1702

66 Betamethasone Dipropionate +

Phenylephrine + Lignocaine Ointment 0.025%+0.1%+2.5% 20gms tube 7.88 3150 24835

67 Betaxolol Hydrochloride Solution (Eye

Drop) 0.50% 5ml 6.96 3888 27060

68 Bisacodyl Tablet 5mg Tablet 0.26 1471422 382570

69 Bleomycin Injection 15mg Vial 384 1418 544512

70 Bromhexine Hydrochloride Syrup 4mg/5ml 60ml 7.92 2148857 17018948

71 Bupivacaine hydrochloride Injection 0.25% in vial 20ml vial 12.65 5156 65227

72 Bupivacaine hydrochloride

Injection for

Spinal

Anaesthesia

0.5% in 4-ml ampoule to

be mixed with 7.5%

glucose solution

20ml vial 5.78 28200 162996

73 Busulfan Capsule 2mg Capsule 1.12 14040 15725

74 Calcium Gluconate Injection 100 mg/ml in 10-ml

ampoule 10 ml ampule 3.28 1636033 5366188

75 Calcium Salts Tablet (as elemental

calcium)(300mg) Tablet 0.28 15454997 4327399

Report


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76 Carbamazepine Syrup 20 mg/ml 100ml bottle 2.29 38957 89289

77 Carbamazepine Tablet (Control

Release) (200mg) Tablet 0.44 531282 235889


Release) 400 mg Tablet 0.74 1150564 851417

79 Carboplatin (15ml) Injection (15ml) 50mg/5ml Vial 462 10780 4980312

80

Carboprost (PGF2α) as

Tromethamine USP (Preservative

Free)

Injection 0.25mg/ml 1ml ampule 36.72 48 1763

81 Cefadroxyl Tablet 250mg Tablet 1.03 1698983 1753350

82 Cefadroxyl Tablet 500mg Tablet 2.74 779940 2137037

83 Cefadroxyl Syrup 125mg/5ml 30ml bottle 7.68 395980 3041123

84 Cefalexin Tablet or Capsule 500mg Tablet 2.71 430635 1167021

85 Cefalexin Tablet or Capsule 250mg Tablet 0.98 5429906 5343027

86 Cefalexin (Powder for

reconstitution with water) Oral Solution 125mg/5ml 30ml bottle 9.07 1574204 14278028

87 Cefalexin (Powder for

reconstitution with water) Oral Solution 250mg/5ml 30ml bottle 11.07 628200 6954174

88 Cefixime Capsule 100mg Capsule 1.73 99396 171956

89 Cefixime Capsule 200mg Capsule 3.26 458256 1493914

90 Cefixime Dry Syrup 50mg/5ml 30ml bottle 19.23 12567 241663

91 Ceftazidime Injection 250mg Vial 18.84 42008 791439

92 Ceftazidime Injection 1gm Vial 33.36 47657 1589849

Report


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93 Ceftriaxone Sodium Powder for

Injection 250mg Vial 5.51 6323 34829

94 Ceftriaxone Sodium Powder for

Injection 1gm (Vial) 30ml vial 13.23 99700 1319034

95 Cetirizine Dihydrochloride Tablet 10mg Tablet 0.12 5598504 671820

96 Chlorambucil Capsule 5mg Capsule 10.00 3593 35919

97 Chloramphenicol Capsule 250 mg Capsule 0.87 3215986 2797908

98 Chloramphenicol Palmitate Oral Suspension 150 mg/5 ml 60ml bottle 6.13 41305 253201

99 Chloramphenicol Sodium Succinate Powder for

Injection 1 gm vial 22.05 4882 107643

100 Chlorhexidine 5% for dilution 500ml 500 ml bottle 20.40 27154 553942

101 Chloroquine (as hydrochloride,

phosphate or sulphate) Injection 40 mg/ml 5ml ampule 11.28 418855 4724683

102 Chloroquine (as phosphate or

sulphate) Tablet 150 mg base Tablet 0.36 15908658 5727117


sulphate) Syrup 50 mg /5ml (60ml bottle) 60ml bottle 5.98 354798 2120273

104 Chlorpheniramine Injection 10 mg/ml 1ml ampule 0.92 169715 156817

105 Chlorpheniramine (hydrogen

maleate) Tablet 4 mg Tablet 0.60 9335426 5601256

106 Chlorpheniramine (hydrogen

maleate)

Oral Solution

Syrup 2mg/5ml 50ml bottle 4.00 1518599 6068321

107 Chlorpromazine Hydrochloride Tablet 100 mg Tablet 0.44 1418 630

108 Chlorpromazine Hydrochloride Syrup 25 mg/5ml 7.56 14112 106687

Report


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109 Chlorpromazine Hydrochloride Injection 25 mg/ml 2ml ampule 3.05 14112 43042

110 Chloramphenacol Eye ointment 5 gm tube tube 4.54 52600 238594

111 Cinnarizine Tablet 25mg Tablet 0.14 2127 306

112 Ciprofloxacin Hydrochloride Tablet 250 mg Tablet 0.60 5018281 3010968

113 Ciprofloxacin Hydrochloride Tablet 500 mg Tablet 1.38 5072183 6999613

114 Ciprofloxacin Hydrochloride Infusion 2mg/ml 100ml bottle 9.98 255267 2547568

115 Ciprofloxacin Hydrochoride Solution (Eye/Ear

Drop) 0.3% w/v sterile aqueous 5ml 2.98 348840 1039542

116 Ciprofloxacin Hydrochoride Ointment

(Eye/Ear) 0.30% 5gm tube 3.56 122939 437664

117 Cisplatin Injection 10mg/10ml Vial 36.00 11700 421200

118 Clofazimine Capsule 50 mg Capsule 1.17 1457482 1705254

119 Clotrimazole Ear Drops 1% W/V 10ml 6.38 25862 164998

120 Clotrimazole Mouth Paint 1% W/V 0.97 1441 1400

121 Clotrimazole Cream 2% W/W (15gm tube) 15 gms tube 2.79 717485 2001784

122 Cloxacillin Sodium Capsule 500 mg Capsule 0.86 283500 244944

123 Cloxacillin Sodium Powder for Oral

Solution 125 mg/5 ml 30ml bottle 6.96 751906 5233262

124 Cloxacillin Sodium Powder for

Injection 500 mg in vial Vial 22.00 1811226 39839725

125 Clozapine Tablet 100mg Tablet 1.09 29160 31843

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126 Condoms with or without

Spermicide (Nonoxinol)

As per NACO/

RCH supply NULL 0.89 3880638 3446007

127 Conjugated Equine Oestrogen Tablet 0.625mg Tablet 14.40 18571 267429

128 Copper-containing device As per RCH

Supply NULL 18.05 175000 3158750

129 Cyclophosphamide Tablet 50mg Tablet 1.06 11700 12355

130 Cyclophosphamide Injection 200mg 30ml vial 13.63 4680 63798

131 Cytarabine Injection 1 g 5ml vial 93.60 2340 219024

132 D actinomycin Injection 0.5mg Vial 98.64 4680 461635

133 Dapsone Tablet 50 mg Tablet 0.31 2148025 670184

134 Daunorubicin Hydrochloride Powder for

Injection 20mg Vial 78.20 2340 182988

135 DDT Powder As per NVBDCP Supply 900MT 5600000

136 Decarbazine Injection 200mg 97.64 23400 2284870

137 Deltamethrin Solution As per NVBDCP Supply 190MT 5000000

138 Dexamethasone Tablet 4 mg Tablet 0.12 3192596 383112

139 Dexamethasone Tablet 1mg Tablet 0.96 17672 16965

140 Dexamethasone Tablet 500 micrograms Tablet 0.16 182200 28423

141 Dexamethasone Phosphate

Disodium Injection 4 mg/ml 2ml ampule 3.73 1611221 6009854

Report


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142 Dextrose

Injectable

Solution

(Intravenous

Fluid) 5%

500ml 500ml 20.25 330758 6697853

143 Dextrose

Injectable

Solution

(Intravenous

Fluid)

10% Isotonic 500 ml 500ml 21.08 307495 6481989

144 Dextrose

Injectable

Solution

(Intravenous

Fluid) 25%

50% Hypertonic 100ml 500ml 12.50 48532 606649

145 Dextrose with Sodium Chloride

Injectable

Solution

(Intravenous

Fluid)

5% Dextrose, 0.18%

Sodium chloride

(equivalent to Na+ 30

mmol/l, Cl- 30 mmol/l)

250/500ml 10.54 1335658 14072496

146 Dextrose with Sodium Chloride

Injectable

Solution

(Intravenous

Fluid)

5% Dextrose, 0.9%

Sodium chloride 250/500ml 8.76 454856 3984540

147 Diazepam Tablet (Scored) 5 mg Tablet 0.18 754017 135723

148 Diazepam Suspension 2mg/5ml 60ml bottle 8.40 33775 283709

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149 Diazepam Injection 5 mg/ml 2ml ampule 2.63 280779 738448

150 Diclofenac sodium Tablet 50mg Tablet 0.27 6600140 1782038

151 Diclofenac sodium Tablet 100 mg Tablet 0.31 407653 126372

152 Diclofenac sodium Injection 25mg/ml PG surfactant

free (3ml) 3ml ampule 1.93 1197312 2310811

153 Diclofenac sodium Gel 1% w/v 25 gms tube 4.98 1306516 6506448

154 Dicyclomine Hydrochloride Tablet 10mg Tablet 0.07 1775554 124289

155 Dicyclomine Hydrochloride Injection 10mg/ml (2ml) 2 ml ampule 1.67 656610 1096538

156 Diethyl carbamazine citrate Tablet 100mg Tablet 0.13 63850490 8428265

157 Diethyltoluamide Cutaneous

Solution NULL 24.00 150000 3600000

158 Digoxin Tablet 250 mcg Tablet 0.30 1855175 556553

159 Digoxin Oral Solution 50 mcg/ml 30ml 26.40 634137 16741215

160 Digoxin Injection 250 mcg/ml 2ml ampule 5.16 25550 131838

161 Diltiazem Tablet 30mg Tablet 0.19 21688 4164

162 Diltiazem Injection 30mg Vial 25.76 46353 1194246

163 Dinoprostone Injection 0.5mg 24.00 363 8712

164 Diphtheria Antitoxin Injection 10 000 IU Vial 3.60 2583 9299

165 Diphtheria Antitoxin Injection 20 000 IU Vial 3.60 2929 10544

166 Diphtheria,Pertussis and Tetanus

combined (DPT) vaccine Injection NULL Vial 15.00 314158 4712370

167 Dobutamine Injection 50 mg /ml 5ml ampule 26.12 16707 436387

Report


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168 Domperidone Tablet 10mg Tablet 0.17 1768500 300645

169 Domperidone Syrup 1mg/ml 30ml 4.74 44374 210333

170 Dopamine Hydrochloride Injection 40 mg 5ml vial 7.72 61606 475598

171 Doxorubicin Injection 10mg/5ml 5ml vial 69.60 468 32573

172 Doxycycline Hydrochloride Capsule 100 mg Capsule 0.82 849926 696940

173 Doxylamine Succinate Tablet 100mg Tablet 18.00 23400 421200

174

Electrolyte G (Multi-Electrolyte with

5% Dextrose IV Injection Type III

USP)

Injectable

Solution

(Intravenous

Fluid)

Each 100ml Contains:

Anhydrous Dextrose 5gm;

Sodium Chloride 0.37gm;

Potassium Chloride

0.13gm; Ammonium

Chloride 0.37gm; Sodium

Sulphite 15mg

100ml 28.45 223201 6350079

175

Electrolyte M (Multi-Electrolyte

with 5% Dextrose IV Injection Type

III IP)

Injectable

Solution

(Intravenous

Fluid)


Anhydrous Dextrose 5 g;

Sodium Acetate

Trihydrate 0.28 g

500ml 25.73 224373 5773108

Report


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176 Electrolyte P (Multi-Electrolyte with

5% Dextrose IV Injection Type I IP)

Injectable

Solution

(Intravenous

Fluid)

Each 100ml contains: 500ml 25.73 241361 6210214

177 Enalapril Tablet (Scored) 2.5mg Tablet 0.18 263000 47340

178 Enalapril Tablet (Scored) 5 mg Tablet 0.08 263000 22092

179 Epinephrine Hydrochloride

(Adrenaline) Injection 1 mg/ml 1ml ampule 1.52 30871 46924

180 Ergometrine Hydrogen Maleate Tablet 125 micrograms Tablet 0.46 197902 91035

181 Ergometrine Hydrogen Maleate Injection 200 micrograms 1ml ampule 1.52 145851 221694

182 Erythromycin Stearate Tablet or Capsule 250 mg Tablet 1.06 1747203 1845046

183 Erythromycin Stearate Tablet or Capsule 500mg Tablet 1.97 764635 1504802

184 Erythromycin Stearate Powder for Oral

Suspension 125 mg/5ml 60ml bottle 8.70 216278 1881614

185 Ethambutol Hydrochloride Tablet 800 mg Tablet 2.69 1386180 3726052

186 Ethanol (Spirit) Cutaneous

Solution 70% (denatured) 500 ml 500ml 40.86 15300 625158

187 Ethinylestradiol Tablet 50 micrograms Tablet 0.58 5638048 3270068

188 Ethinylestradiol + Levonorgestrel Tablet 50 micrograms + 250

micrograms Tablet 1.08 11265118 12166327


micrograms Tablet 0.81 10908 8836

190 Ethinylestradiol + Norethisterone Tablet 35 micrograms + 1.0 mg Tablet 1.18 8457072 9945517

Report


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191 Etiophylline + Theophylline Tablet 77mg + 23mg (100mg) Tablet 0.18 856455 154162

192 Etiophylline + Theophylline Injection 1.80 80375 144675

193 Etoposide Capsule 100mg Capsule 21.88 96 2100

194 Etoposide Injection 100mg/5ml 5ml vial 52.80 468 24710

195 Factor IX Complex (Coagulation

factors II,VII,IX X) Injection Dried 13200.00 1080 14256000

196 Factor VIII Concentrate Injection Dried 3450.00 3528 12171600

197 Fentanyl Citrate Injection 0.05mg/ml 2ml ampule 10.38 10584 109862

198 Ferrous Fumarate Drop 5mg/ml 9.32 8050 75058

199 Ferrous Sulphate Tablet 200mg equivalent to 60

mg elemental iron Tablet 0.16 19687501 3071250

200 Ferrous Sulphate + Folic Acid Tablet

200mg equivalent to 60

mg iron + 400 micrograms

folic acid

Tablet 0.05 1545489 70474

201 Ferrous Sulphate + Folic Acid Tablet equivalent to 20 mg iron +

0.1mg folic acid Tablet 0.08 30309782 2364163

202 Ferrous Sulphate + Folic Acid Syrup

equivalent to 20 mg Iron +

0.1mg Folic acid per 1ml

in bottle

60 ml bottle 8.80 2515208 22123774

Report


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203 Florouracil Injection 250mg/5ml 5ml ampule 6.12 936 5728

204 Fluconazole Capsule 150 mg Capsule 1.18 377929 445956

205 Fluconazole Capsule 200 mg Capsule 1.56 420558 656071

206 Fluconazole Injection 2 mg/ml Vial 15.12 21168 320060

207 Fluconazole Oral Suspension 50 mg/5-ml 47.52 35280 1676506

208 Fluorescein Sodium Strip NULL 0.97 9720 9448

209 Fluoxetine Hydrochloride (for use

above 8 years of age) Tablet 20mg Tablet 0.23 24000 5472

210 Fluphenazine Decanoate or

Enantate Injection 25 mg 1ml ampule 7.20 19000 136800

211 Folic Acid Tablet 1mg Tablet 0.07 231025 16634

212 Folic Acid Tablet 5mg Tablet 0.12 3386401 406368

213 Folic Acid (Sodium salt) Injection 15 mg/2ml 1ml ampule 9.80 3341 32758

214 Framycetin Sulphate Cream NULL 5.58 153000 853740

215 Furazolidone Tablet

(Dispersible) 100 mg Tablet 0.19 5813332 1104533

216 Furazolidone Suspension 100 mg/5ml 5 gms 5.16 7056 36409

217 Furosemide Tablet 40mg Tablet 0.16 263724 42196

218 Furosemide Tablet 20mg Tablet 0.62 737726 460341

219 Furosemide Oral Solution 20mg/5ml 0.64 46996 29890

220 Furosemide Injection 10 mg/ml 2ml ampule 1.34 89821 120361

221 Gentamicin Sulphate Injection 10 mg/ml 2ml vial 2.62 124344 325285

222 Gentamicin Sulphate Injection 40 mg/ml 2ml vial 2.95 1125070 3318958

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223 Gentamicin Sulphate Solution (Eye/ Ear

Drop) NULL 5ml 2.98 215044 640832

224 Glibenclamide Tablet 2.5 mg Tablet 0.28 20639288 5696443

225 Glibenclamide Tablet 5 mg Tablet 0.04 30958932 1114522

226 Glimipride Tablet 1mg Tablet 0.24 20639288 4953429

227 Glimipride Tablet 2mg Tablet 0.26 10319644 2683107

228 Glipizide Tablet 5mg Tablet 0.10 61917863 5944115

229 Glutaraldehyde Aqueous Solution NULL 5 lit can 173.25 26 4505

230 Glycopyrrolate USP Injection 0.2mg/ml 1ml ampule 1.65 5000 8250

231 Haloperidol Tablet 5 mg Tablet 0.15 9000 1350

232 Haloperidol Injection 5 mg 1ml ampule 4.00 10800 43200

233 Haloperidol Liquid 2mg/ml 30ml 6.77 1800 12182

234 Halothane Inhalation 500 ml 250ml bottle 1095.15 5560 6089034

235 Heparin Sodium Injection 5000 IU/ml 1ml ampule 80.32 3096 248671

236 Hepatitis B Vaccine Injection 20mcg 10ml Vial 96.60 221546 21401344

237 Homatropine Solution (Eye

Drop) NULL 5ml vial 12.24 20376 249402

238 Hydrochlorothiazide Tablet (Scored) 25 mg Tablet 0.44 193874 86080

239 Hydrochlorothiazide Tablet 25mg Tablet 0.92 311616 286687

240 Hydrocortisone Acetate Ointment or

Cream 1% (as vale rate) 15 gms tube 9.60 55460 532416

241 Hydrocortisone Acetate Suppository;

Retention Enema 25 mg 12.00 5560 66720

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242 Hydrocortisone Sodium Succinate powder for


243 Hydrogen Peroxide Solution NULL 1 Lit 35.16 35837 1260024

244 Hydroxocobalamin Injection 1 mg 1ml ampule 18.00 120586 2170541

245 Hydroxyethyl Starch Injection NULL 500ml 150.91 5270 795241

246 Hydroxyurea Capsule 500mg Capsule 2.15 11567 24845

247 Hyosine Butyl Bromide Tablet 10mg Tablet 1.51 208 314

248 Hyosine Butyl Bromide Injection 20mg/ml 4.73 208 984

249 Ibuprofen Tablet 200 mg Tablet 0.47 5957600 2800072

250 Ibuprofen Tablet 400 mg Tablet 0.67 3791322 2540186

251 Ibuprofen Suspension 100mg/5ml 60ml bottle 6.96 771957 5372819

252 Imipenem Monohydrate +

Cilastatin Sodium

Powder for

Injection 250mg + 250mg Vial 382.58 8100 3098930

253 Imipramine Hydrochloride Tablet 25 mg Tablet 0.75 900 675

254 Insulin Injection (Soluble) Injection 40 IU/ml 10ml Vial 70.04 503397 35257926

255 Insulin Injection (Soluble) Injection 100 IU/ml 10ml Vial 70.04 201359 14103184

256

Intermediate-Acting Insulin (as

Compound Insulin Zinc suspension

or Isophane Insulin)

Injection 40 IU/ml 10ml Vial 95.40 335598 32016049

257

Intermediate-acting Insulin (as

compound Insulin Zinc suspension

or Isophane Insulin)

Injection 100 IU/ml 10ml Vial 116.64 134239 15657637

258 Iodine D361 Solution 8mg/5ml 19.20 6246 119929

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259 Iohexol 350 mg Iodine/ml 50 ml 278.43 2600 723918

260 Iron Sucrose Injection 50mg

33.10 5332 176477

261 Iron Sucrose Injection 100mg 43.68 10584 462309

262 Isoflurane Inhalation

(Vaporiser) NULL 100ml bottle 430 7240 3113200

263 Isoniazid Tablet 300mg Tablet 0.37 827496 307829

264 Isosorbide Dinitrate Tablet

(Sublingual) 5 mg Tablet 1.75 1860373 3255653

265 Isosorbide Dinitrate Tablet


266 Isosorbide Monoinitrate Tablet


267 Isoxsuprine Injection 5mg/ml 2ml ampule 6.00 18850 113100

268 Isoxsuprine Hydrochloride Tablet 40 mg Tablet 7.43 183155 1360839

269 Ivermectin Tablet (Scored) 6mg Tablet 3.90 57101 222695

270 Ketamine hydrochloride Injection 50 mg /ml in 2ml Vial 2ml Vial 6.74 23772 160223

271 Labetalol Tablet 100mg Tablet 2.64 7056 18628

272 Labetalol Injection 10mg/ml 20ml vial 146.67 7056 1034904

273 Lactulose Syrup 667mg/ml 60ml bottle 47.40 151796 7195122

274 Levodopa + Carbidopa Tablet 100 mg + 10 mg Tablet 0.96 77904 74788

275 Levonorgesterel Tablet 750mcg Tablet 4.20 7723 32437

276 Levothyroxine Sodium Tablet 100 microgram Tablet 0.23 5577930 1271768

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277 Lidocaine hydrochloride Injection NULL 30ml vial 5.60 47544 266246

278 Lidocaine hydrochloride

Injection for

Spinal

Anaesthesia

5% to be mixed with 7.5%

glucose solution 2ml ampule 7.08 142632 1009835

279 Lidocaine hydrochloride Jelly (Topical) NULL 30 gms tube 10.49 4050 42476

280 Lidocaine hydrochloride Viscous Solution

(Topical) NULL 30 ml 7.08 3396 24044

281 Lidocaine hydrochloride +

Epinephrine (adrenaline) Injection

1%+ epinephrine 1:200

000 30 ml vial 5.99 72442 433925

282 Liquid Paraffin Liquid NULL 500ml 500 ml bottle 93.45 6971 651440

283 Lithium Carbonate Tablet 300 mg Tablet 0.36 9000 3240

284 Lomustine Tablet 40mg Tablet 26.40 1404 37066

285 Lorazepam Tablet 2mg Tablet 0.18 17640 3175

286 Lorazepam Injection 4mg 7.66 17640 135052

287 Losartan Tablet 25mg Tablet 0.46 77904 35836

288 Magnesium Sulphate Injection 500 mg/ml (2ml) 2ml ampule 1.94 45445 88163

289 Mannitol Intravenous

Injection NULL 100ml bottle 15.10 36685 553798

290 Measles Vaccine Injection NULL Vial 15.50 73849 1144660

291 Mebendazole Tablet 100mg Tablet 0.96 130058 124855

292 Mebendazole Suspension 100mg/5ml 30ml bottle 5.76 16518 95143

293 Medroxy Progesterone Acetate Tablet 5 mg Tablet 0.67 207439 139399

294 Melphalan Tablet 2mg Tablet 3.65 1404 5122

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295 Mephenteramine Tablet 10mg Tablet 0.38 10584 4064

296 Mephenteramine Injection 30 mg/ml 10ml Vial 7.20 10584 76205

297 Mercaptopurine Tablet 50mg Tablet 3.41 2340 7975

298 Metformin Hydrochloride Tablet 500 mg Tablet 0.33 61917863 20432895

299 Methotrexate Injection 25mg/ ml 2ml vial 23.40 2340 54756

300 Methotrexate Sodium Tablet 2.5mg Tablet 0.90 2340 2106

301 Methyl Prednisolone Injection 40mg/ml 500mg vial 56.00 29773 1667313

302 Methyldopa Tablet (Film

Coated) 250 mg Tablet 1.12 38952 43470

303 Methylrosanilinium Chloride

(Gentian Violet)

Cutaneous

Solution NULL 100ml bottle 5.20 69080 359218

304 Metoclopramide Hydrochloride Tablet 10 mg Tablet 0.08 1597715 127817

305 Metoclopramide Hydrochloride Injection 5 mg/ml 2ml ampule 1.60 198960 318336

306 Metoprolol Tablet 25mg Tablet 0.80 1288015 1035564

307 Metoprolol Tablet 50 mg Tablet 0.37 111556 41499

308 Metoprolol Injection 1mg/ml 5ml ampule 13.33 18860 251408

309 Metronidazole Tablet 200mg Tablet 0.19 1045549 200745

310 Metronidazole Tablet 400mg Tablet 0.55 6522985 3587642

311 Metronidazole Infusion/

Injection 500 mg 100ml bottle 4.49 452334 2030075

312 Metronidazole Benzoate Oral Suspension 200 mg/5 ml 60ml bottle 5.87 436472 2561216

313 Miconazole Solution (Eye

Drop) 1% 10ml 4.38 13955 61122

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314 Miconazole Nitrate Ointment or

Cream 2% 15gms tube 4.78 666417 3185473

315 Midazolam Injection (1mg/ml. ) 5ml vial 8.87 2300 20396

316 Misoprostol Tablet 100mcg Tablet 2.34 792680 1854870

317 Misoprostol Tablet 200mcg Tablet 4.18 234813 981516

318 Mitomycin Capsule 10mg Capsule 75.96 60 4558

319 Mitoxantrone Injection 20mg 10ml Vial 317.65 1872 594645

320 MMR (Live Vaccine) Injection NULL

18.00 73849 1329282

321 Morphine (Sulphate or

hydrochloride) Injection 10 mg/ml 1ml ampule 8.40 363 3049

322

Multivitamin (B1,B2,B6,

Niacinamide, Pantothenate, Folic

Acid, Ascorbic Acid, Biotin)

Tablet/ Capsule

10mg + 10mg + 3mg +

100mg + 50mg + 1.5mg +

150mg + 100mcg

Tablet 1.32 16984659 22419750

323 Naloxone hydrochloride Injection 400 micrograms/ml 1ml ampule 11.60 1764 20462

324 Neomycin Sulphate + Bacitracin

Zinc Ointment 5 mg + 500 IU/gm 15gms tube 13.87 954700 13241682

325 Neostigmine Metilsulfate Injection 500 micrograms 1ml ampule 2.67 31514 84141

326 Neostigmine Metilsulfate Injection 2.5 mg 5ml ampule 2.05 44148 90592

327 Nevirapine Tablet 200mg Tablet 4.69 1109800 5207182

328 Nevirapine Oral Suspension 50mg/5ml 100ml A 29.15 100000 2914800

329 Niacinamide Tablet 50mg Tablet 0.03 21168 593

330 Nifedipine Capsule 5 mg Capsule 0.30 140227 42068

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331 Nifedipine Tablet (Sustained

Released) (10mg) Tablet 0.13 155808 20567

332 Nitro Glycerine Injection 25mg (5ml Amp) 12.60 2249 28343

333 Nitrofurantoin Tablet 100 mg Tablet 0.38 155808 59207

334 Nitrofurantoin Syrup 100mg/5ml 60ml bottle 6.34 233712 1481734

335 Nor adrenaline Injection 4mg/2ml 2ml ampule 15.56 92966 1446543

336 Norethisterone Tablet 5mg Tablet 0.65 237175 154164

337 Norfloxacine Tablet 400mg Tablet 1.24 3595114 4457941

338 Nystatin Oral Solution 50mg/5ml (100000 IU/ml) 78.00 1072 83616

339 Nystatin Tablet 10000 IU Tablet 3.25 2600 8455

340 Ofloxacin Tablet 200mg Tablet 0.88 2040333 1795493

341 Ofloxacin Tablet 400mg Tablet 1.71 1364785 2333783

342 Ofloxacin Eye drops

solution NULL 5 ml 2.98 298845 890559

343 Olanzapine Tablet 5mg Tablet 0.60 12000 7200

344 Olanzapine Tablet 10 mg Tablet 1.68 7187 12073

345 Omeprazole Tablet 20mg Tablet 0.34 4179376 1420988

346 Omeprazole Tablet 40mg Tablet 1.19 2393254 2843186

347 Ondansetron Injection 2mg/ml 2ml ampule 2.00 25242 50483

348 Ondansetron Syrup 2mg/5ml 30ml 4.55 15523 70632

349 Ondansetron Tablet 4mg Tablet 0.44 4050 1782

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350 Oral Rehydration Salts Powder Sachet

(Low osmolarity

245mmol/l) 4.1 g/200ml;

Components to

reconstitute 200 ml of

Glucose-electrolyte

solution: Glucose: 2.7 g;

Sodium Chloride: 0.52 g;

Potassium Chloride: 0.3g;

Trisodium Citrate

Dehydrate*: 0.58 g

1

sachet(200ml) 1.90 2922136 5540370

351 Oral Rehydration Salts (for Glucose-

electrolyte solution) Powder Sachet

20.5 g/l; Components to

reconstitute 1 litre of

Glucose-electrolyte

solution: Glucose: 13.5

g/L; Sodium Chloride: 2.6

g/L; Potassium Chloride:

1.5 g/L; Trisodium Citrate

dehydrate*: 2.9 g/L

1 sachet(1

litre) 1.94 421393 817502

352 Oseltamivir Capsule 45 mg Capsule 10.78 3500 2873708

353 Oseltamivir Oral Powder 12 mg/ml 25ml bottle 48.00 90 4320

354 Oxygen Inhalation Cylinder cylinder 117.60 98459 11578778

355 Oxytocin Injection 10 IU 1ml ampule 2.10 117246 246216

356 Pancuronium Injection 2mg/ml 10ml Vial 0.24 142040 34090

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357 Paracetamol Tablet 500 mg Tablet 0.26 19113754 4969576

358 Paracetamol Syrup 125 mg/5ml 60ml bottle 5.69 605357 3444480

359 Paracetamol Suppository 250mg 4.00 2000 7992

360 Pentazocine Injection 30mg/ml 3.05 115428 352056

361 Pentazocine Tablet 25mg Tablet 0.65 82355 53366

362 Pentoprozole Injection 40mg 1ml ampule 12.24 454184 5559215

363 Pentoprozole Tablet 40mg Tablet 0.63 4215133 2655534

364 Pethidine Injection 50mg/ml 1ml ampule 4.32 9702 41912

365 Phenobarbitone Tablet 60mg Tablet 0.07 156096 11239

366 Phenobarbitone Syrup 20mg/5ml 60ml bottle 11.88 7056 83825

367 Phenobarbitone Injection 200mg/ml 1ml ampule 6.12 3401 20816

368 Phenol Liquid 5 lt can 23.52 5541 130328

369 Phenylephrine Injection 35.00 5260 184100

370 Phenylephrine Solution (Eye

Drop) 4 PC 5 ml 24.50 4075 99859

371 Phenytoin Sodium Tablet 100 mg Tablet 0.31 1164100 360871

372 Phenytoin Sodium Injection 50 mg/ml 5ml vial 3.89 12672 49296

373 Phytomenadione Injection 10 mg/ml 5ml ampule 2.22 35280 78322

374 Phytomenadione Tablet 10 mg Tablet 3.43 15833 54340

375 Pilocarpine Hydrochloride or

Nitrate

Solution (Eye

Drop) 2 PC 5ml 27.30 6041 164927

376 Piperacillin + Tazobactum Powder for

Injection 4gm+500mg Vial 72.91 89278 6509292

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377 Podophyllum Resin Cutaneous

Solution 10 –2% 250.00 100 25000

378 Poliomyelitis Vaccine Oral Drop NULL 15.57 314158 4891440

379 Polyvalent Snake Antivenom Serum Injection 10ml Vial 190.00 13811 2624057

380 Potassium Chloride Injection

11.2% (equivalent to K+

1.5 mmol/ml, Cl- 1.5

mmol/ml)

20ML AMPULE 5.33 10040 53513

381 Potassium Iodide Tablet 60 mg Tablet 4.80 2000 9600

382 Povidone Iodine Ointment/ Drop NULL 5.58 35130 196028

383 Povidone Iodine Solution NULL 500ML 30.43 17949 546187

384 Povidone Iodine Ointment NULL 10gm tube 6.71 469595 3150982

385 Povidone Iodine Vaginal Passaries 200mg 0.62 1500 930

386 Pralidoxime Injection 25mg/ml 20ml vial 47.25 17640 833490

387 Prednisolone Tablet 10mg Tablet 0.48 894649 429432

388 Prednisolone Tablet 20mg Tablet 0.70 42336 29466

389 Prednisolone Liquid 5mg/5ml 120ml bottle 8.52 7056 60117

390 Prednisolone Sodium Phosphate Solution (Eye

Drop) NULL 5ml 21.90 38880 851472

391 Primaquine Diphosphate Tablet 7.5 mg Tablet 0.26 2224057 587151

392 Primaquine Diphosphate Tablet 15 mg Tablet 0.60 382690 229614

393 Procarbazine Capsule 50mg Capsule 17.64 1872 33022

394 Prochlorperazine Tablet 25 mg Tablet 1.40 11500 16100

395 Promethazine Hydrochloride Injection 25 mg/ml 2ml ampule 1.94 11084 21502

Report


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396 Promethazine Hydrochloride Syrup 5 mg/5 ml 60ml bottle 6.77 164190 1111566

397 Propofol Injection NULL 10ml vial 31.25 22680 708750

398 Propranolol Tablet 10 mg Tablet 0.20 1432759 280821

399 Propranolol Tablet 40 mg Tablet 0.14 155808 21813

400 Propyl Thiouracil Tablet 100 mg Tablet 1.44 35280 50803

401 Protamine Sulphate Injection 10 mg/ml 5ml ampule 28.08 35280 990662

402 Pyrazinamide Tablet 500 mg Tablet 0.73 59409 43488

403 Pyrazinamide Tablet 750 mg Tablet 1.10 41305 45601

404 Pyridoxine Hydrochloride (Vit B6) Tablet 25 mg Tablet 0.02 84900 1698

405 Quinine (bisulphate or sulphate) Tablet 300 mg Tablet 2.70 79420 214434

406 Quinine (bisulphate or sulphate) Oral Solution 150mg/5ml 60ml bottle 48.54 59741 2899850

407 Quinine Dihydrochloride Injection 300 mg/ml 2ml ampule 11.50 43895 504793

408 Rabies Immunoglobulin Human Injection 300 /1500 IU vial 208.80 23504 4907622

409 Ranitidine Tablet 150 mg Tablet 0.32 7736326 2475624

410 Ranitidine Injection 50mg/ 2ml 2ml ampule 1.60 1147198 1835517

411 Rapid Diagnostic Kit NVBDCP Supply NULL 6.77 115600 782612

412 Riboflavin (Vit B2) Tablet 5mg Tablet 0.96 159000 152640

413 Rifampicin Tablet or Capsule 600 mg Tablet 2.53 2842980 7198425

414 Risperidone Tablet 3mg Tablet 0.50 9000 4500

415 Salbutamol Sulphate Tablet 4 mg Tablet 0.15 671221 100683

416 Salbutamol Sulphate Tablet 2 mg Tablet 0.90 172870 155583

417 Salbutamol Sulphate Syrup 2 mg/5 ml 100ml 6.94 789495 5479098

418 Salbutamol Sulphate Injection 50 micrograms/ml 5ml ampule 0.72 40676 29287

Report


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419 Salbutamol Sulphate

Respirator

Solution for use

in Nebulizers

5 mg/ml 15ml 7.61 737597 5613117

420 Salbutamol Sulphate MDI (CFC free) 100mcg/dose in 200

doses 200mdi 64.20 581162 37310601

421 Salbutamol Sulphate Capsule (Rotacap) 200mcg capsule 0.08 872488 73289

422 Salbutamol Sulphate

Respirator

Solution for use

in Nebulizers

5 mg/ml 10ml vial 8.12 727037 5906445

423 Salicylic Acid Topical Solution NULL 10.80 5750 62100

424 Salmeterol + Fluiticasone Inhaler 25mcg + 125mcg/ dose 120 dose 254.40 8100 2060640

425 Sertraline Tablet 50mg Tablet 0.38 24300 9331

426 Sevoflurane Inhalation

(Vaporiser) 250 ml bottle 250 ml bottle 3500.00 5574 19509000

427 Silver Nitrate Solution (Eye

Drop) NULL 5ml 24.96 208 5192

428 Silver Nitrate Lotion NULL 15gms tube 13.20 100 1320

429 Silver Sulfadiazine Cream 1% w/w 5gm tube 20.69 61719 1276966

430 Sodium bi Carbonate

Injectable

Solution

(Intravenous

Fluid)

1.4% Isotonic (equivalent

to Na+ 167 mmol/l, HCO3-

167 mmol/l) 10ml

10ml ampule 3.28 49661 162888

Report


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431 Sodium bi Carbonate Glycerine

(Soda Bocarb Glycerine) Ear Drop NULL 5ml 6.00 77616 465696

432 Sodium Chloride

Injectable

Solution

(Intravenous

Fluid)

0.9% Isotonic (equivalent

to Na+ 154 mmol/l, Cl-

154 mmol/l (500ml)

500ml 7.49 222936 1669343

433 Sodium Chloride + Dextrose 500 ml 500ml 6.87 129360 888703

434 Sodium Hypochlorite Powder for

Solution NULL

9.00 103488 931392

435 Sodium Lactate, Compound

Solution (Ringer Lactate Solution)

Injectable

Solution

(Intravenous

Fluid)

Each 100ml contains 500ml 9.24 571352 5279289

436 Spironolactone Tablet 25 mg Tablet 0.60 99598 59759

437 Spironolactone Tablet 100mg Tablet 1.62 242239 392428

438 Streptokinase Injection 15,00,000 IU vial 450.00 2150 967500

439 Streptomycin Sulphate Powder for

Injection 1 g vial 6.72 5260 35347

440 Sulfadoxine + Pyrimethamine Tablet 500mg+ 25mg Tablet 2.12 23200 49277

441 Sulfasalazine Tablet 500 mg Tablet 2.16 31162 67309

442 Sulphacetamide Sodium Solution (Eye

Drop) NULL 10ml 6.68 364140 2433911

443 Sulphamethoxazole + Trimethoprim Tablet 200 mg + 40 mg Tablet 0.32 2434041 778893

444 Sulphamethoxazole + Trimethoprim Tablet 400 mg + 80 mg Tablet 0.74 5038037 3728148

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445 Sulphamethoxazole + Trimethoprim Oral Suspension 200 mg + 40 mg/5 ml 60ml bottle 14.40 596766 8593429

446 Surgical Spirit Solution NULL 500ml 41.47 35677 1479607

447 Suxamethonium Chloride

(Succinylchloline)

Powder for

Injection 50 mg/ml vial 9.96 41400 412344

448 Synthetic pyrethroid (MT) Solution As per NVBDCP Supply 0.00 574 578000

449 Terbutaline Tablet 2.5mg Tablet 0.20 72468 14783

450 Terbutaline Injection 0.5mg/ml 1ml ampule 11.33 3528 39972

451 Tetanus Vaccine (Tetanus Toxoid) Injection NULL 5ml ampule 17.10 1037400 17739540

452 Tetracaine Hydrochloride Solution NULL 10.92 1944 21228

453 Tetracycline Hydrochloride Ointment (Eye) NULL 5gms tube 14.40 886 12758

454 Thiamine Hydrochloride (Vit B1) Injection 50mg 10ml 1.31 5000 6540

455 Thiopentone sodium Injection 0.5 g ampule 17.56 64800 1137629

456 Thiopentone sodium Injection 1.0 g ampule 22.89 77720 1779011

457 Timolol Maleate Solution (Eye

Drop) NULL 5ml 5.16 29160 150466

458 Tinidazole Tablet 500mg Tablet 0.60 700353 420212

459 Tinidazole Tablet 1gm Tablet 2.76 101275 279519

460 Tobramycine Eye drops

solution NULL 5ml 4.59 38880 178459

461 Tranexamic Acid Tablet 500mg Tablet 2.01 12150 24422

462 Tranexamic Acid Injection 500mg/5ml ampule 32.40 12039 390051

463 Trihexyphenidyl Hydrochloride Tablet 2 mg Tablet 0.19 3493 671

Report


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464 Tropicamide Eye Drops

Solution NULL 5ml 27.60 40752 1124755

465 Tuberculin, Purified Protein

Derivative (PPD) Injection NULL vial 66.00 8490 560340

466 Valproic Acid (Sodium Salt) Tablet (Control

Release) 200mg Tablet 0.15 54336 8150

467 Valproic acid (Sodium salt) Liquid Oral

Solution 200mg/5ml vial 8.40 35712 299981

468 Vancomycin Hydrochloride Powder for

Injection 500mg vial 61.58 363 22354

469 Vecuronium Powder for

Injection 20mg vial 36.96 8400 310464

470 Verapamil Hydrochloride Tablet 40 mg Tablet 0.40 7056 2794

471 Verapamil Hydrochloride Injection 2.5 mg/ml 2ml ampule 5.87 7056 41405

472 Vinblastine Injection 10mg vial 154.80 5616 869357

473 Vincristine Injection 1 mg vial 27.41 4680 128269

474 Vitamin A Palmitate Capsule 25000 IU Capsule 1.35 2387940 3223718

475 Vitamin A Palmitate (as per NRHM

supply)

Oral Oily Solution

(100ml) 100 000 IU/ml

multidose

dispenser 56.00 104776 5867456

476 Vitamin B12 (Cyanocobalamin) Injection 500mcg/ml ampule 1.10 73060 80658

477 Vitamin D3 Granules 1gm sachet 3.87 1510830 5846913

478 Vitamin K Injection 1mg/ml ampule 13.33 25337 337743

479 Warfarin Sodium Tablet (Score) 5 mg Tablet 0.96 36792 35320

480 Water for injection Injection NULL (10ml) ampule 0.82 131500 107830

Report


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481 Xylometazoline Nasal Drop 0.05% Not in children less

than 3 month 10ml 11.21 998607 11192391

482 Zidovudine Capsule 300 mg Capsule 10.80 1131500 12220200

483 Zidovudine Oral Liquid 50 mg/5 ml 100ml bottle 21.60 10000 216000

484 Zidovudine IV or Infusion

Injection 10mg/ml 20ml vial 24.00 9000 216000

485 Zinc Sulphate Dispersible Tablet

(Scored) 20mg Tablet 0.11 606583 66724

Report


Annexure 2 - ABC Analysis of Itemised List of Drugs

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1 Albumin Injection 20% in 50ml 43394400 3.9 0.2 A

2 Cloxacillin Sodium Powder for Injection 500 mg in vial 83234125 7.4 0.4 A

3 Salbutamol Sulphate MDI (CFC free) 100mcg/dose in 200 doses 120544726 10.8 0.6 A

4 Insulin Injection (Soluble) Injection 40 IU/ml 155802652 13.9 0.8 A

5

Intermediate-Acting Insulin (as

Compound Insulin Zinc suspension or

Isophane Insulin)

Injection 40 IU/ml 187818701 16.8 1.0 A

6

Multivitamin (B1,B2,B6, Niacinamide,

Pantothenate, Folic Acid, Ascorbic

Acid, Biotin)

Tablet/ Capsule

10mg + 10mg + 3mg + 100mg

+ 50mg + 1.5mg + 150mg +

100mcg

210238451 18.8 1.2 A

7 Ferrous Sulphate + Folic Acid Syrup

equivalent to 20 mg Iron +

0.1mg Folic acid per 1ml in

bottle

232362225 20.7 1.4 A

8 Hepatitis B Vaccine Injection 20mcg 253763569 22.6 1.6 A

9 Amoxicillin + Clavulanic acid Injection 500mg + 100mg (600mg) 274861380 24.5 1.9 A

10 Metformin Hydrochloride Tablet 500 mg 295294274 26.3 2.1 A

Report


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11 Sevoflurane Inhalation

(Vaporiser) 250 ml bottle 314803274 28.1 2.3 A

12 Tetanus Vaccine (Tetanus Toxoid) Injection NULL 332542814 29.7 2.5 A

13 Bromhexine Hydrochloride Syrup 4mg/5ml 349561763 31.2 2.7 A

14 Digoxin Oral Solution 50 mcg/ml 366302978 32.7 2.9 A

15

Intermediate-acting Insulin (as

compound Insulin Zinc suspension or

Isophane Insulin)

Injection 100 IU/ml 381960615 34.1 3.1 A

16 Amoxicillin + Clavulanic acid Injection 1gm + 200mg (1.2 gm) 396817789 35.4 3.3 A

17 Cefalexin (Powder for reconstitution

with water) Oral Solution 125mg/5ml 411095817 36.7 3.5 A

18 Factor IX Complex (Coagulation

factors II,VII,IX X) Injection Dried 425351817 37.9 3.7 A

19 Insulin Injection (Soluble) Injection 100 IU/ml 439455002 39.2 3.9 A

20 Dextrose with Sodium Chloride Injectable Solution

(Intravenous Fluid)

5% Dextrose, 0.18% Sodium

chloride (equivalent to Na+ 30

mmol/l, Cl- 30 mmol/l)

453527498 40.5 4.1 A

21 Neomycin Sulphate + Bacitracin Zinc Ointment 5 mg + 500 IU/gm 466769180 41.6 4.3 A

22 Zidovudine Capsule 300 mg 478989380 42.7 4.5 A

23 Factor VIII Concentrate Injection Dried 491160980 43.8 4.7 A

Report


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micrograms 503327308 44.9 4.9 A

25 Amoxicillin + Clavulanic acid Injection 250mg +50mg (300mg) 515062458 46.0 5.2 A

26 Oxygen Inhalation Cylinder 526641237 47.0 5.4 A

27 Xylometazoline Nasal Drop 0.05% Not in children less

than 3 month 537833627 48.0 5.6 A

28 Ethinylestradiol + Norethisterone Tablet 35 micrograms + 1.0 mg 547779144 48.9 5.8 A

29 Benzyl Benzoate 25% Lotion or Cream 25% 557323676 49.7 6.0 A

30 Sulphamethoxazole + Trimethoprim Oral Suspension 200 mg + 40 mg/5 ml 565917105 50.5 6.2 A

31 Diethyl carbamazine citrate Tablet 100mg 574345369 51.2 6.4 A

32 Rifampicin Tablet or Capsule 600 mg 581543795 51.9 6.6 A

33 Lactulose Syrup 667mg/ml 588738917 52.5 6.8 A

34 Ciprofloxacin Hydrochloride Tablet 500 mg 595738529 53.2 7.0 A

35 Cefalexin (Powder for reconstitution

with water) Oral Solution 250mg/5ml 602692703 53.8 7.2 A

36 Dextrose

Injectable Solution

(Intravenous Fluid)

5%

500ml 609390556 54.4 7.4 A

Report


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37 Piperacillin + Tazobactum Powder for Injection 4gm+500mg 615899849 54.9 7.6 A

38 Diclofenac sodium Gel 1% w/v 622406296 55.5 7.8 A

39 Dextrose Injectable Solution

(Intravenous Fluid) 10% Isotonic 500 ml 628888285 56.1 8.0 A

40 Electrolyte G (Multi-Electrolyte with

5% Dextrose IV Injection Type III USP)

Injectable Solution

(Intravenous Fluid)


Anhydrous Dextrose 5gm;

Sodium Chloride 0.37gm;

Potassium Chloride 0.13gm;

Ammonium Chloride 0.37gm;

Sodium Sulphite 15mg

635238365 56.7 8.2 A

41 Electrolyte P (Multi-Electrolyte with

5% Dextrose IV Injection Type I IP)

Injectable Solution

(Intravenous Fluid) Each 100ml contains: 641448579 57.2 8.5 A

42 Halothane Inhalation 500 ml 647537613 57.8 8.7 A

43 Chlorpheniramine (hydrogen maleate) Oral Solution Syrup 2mg/5ml 653605933 58.3 8.9 A

44 Dexamethasone Phosphate Disodium Injection 4 mg/ml 659615788 58.8 9.1 A

45 Glipizide Tablet 5mg 665559903 59.4 9.3 A

Report


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46 Salbutamol Sulphate Respirator Solution

for use in Nebulizers 5 mg/ml 671466347 59.9 9.5 A

47 Vitamin A Palmitate (as per NRHM

supply)

Oral Oily Solution

(100ml) 100 000 IU/ml 677333803 60.4 9.7 A

48 Vitamin D3 Granules 1gm 683180716 61.0 9.9 A


(312mg)/5ml 689022115 61.5 10.1 B

50 Amoxicillin + Clavulanic acid Tablet 250mg + 125mg (375mg) 694849864 62.0 10.3 B

51 Electrolyte M (Multi-Electrolyte with

5% Dextrose IV Injection Type III IP)

Injectable Solution

(Intravenous Fluid)


Anhydrous Dextrose 5 g;

Sodium Acetate Trihydrate

0.28 g

700622973 62.5 10.5 B


sulphate) Tablet 150 mg base 706350090 63.0 10.7 B

53 Glibenclamide Tablet 2.5 mg 712046533 63.5 10.9 B

54 Ampicillin Sodium Tablet 250mg 717700982 64.0 11.1 B

55 Salbutamol Sulphate Respirator Solution

for use in Nebulizers 5 mg/ml 723314099 64.5 11.3 B

56 Chlorpheniramine (hydrogen maleate) Tablet 4 mg 728915355 65.0 11.5 B

Report


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57 DDT Powder As per NVBDCP Supply 734515355 65.5 11.8 B

58 Pentoprozole Injection 40mg 740074570 66.0 12.0 B

59 Oral Rehydration Salts Powder Sachet

(Low osmolarity 245mmol/l)

4.1 g/200ml; Components to

reconstitute 200 ml of

Glucose-electrolyte solution:

Glucose: 2.7 g; Sodium

Chloride: 0.52 g; Potassium

Chloride: 0.3g; Trisodium

Citrate Dehydrate*: 0.58 g

745614940 66.5 12.2 B

60 Salbutamol Sulphate Syrup 2 mg/5 ml 751094038 67.0 12.4 B

61 Ibuprofen Suspension 100mg/5ml 756466856 67.5 12.6 B

62 Calcium Gluconate Injection 100 mg/ml in 10-ml ampoule 761833044 68.0 12.8 B

63 Cefalexin Tablet or Capsule 250mg 767176072 68.4 13.0 B

64 Sodium Lactate, Compound Solution

(Ringer Lactate Solution)

Injectable Solution

(Intravenous Fluid) Each 100ml contains 772455360 68.9 13.2 B

65 Cloxacillin Sodium Powder for Oral

Solution 125 mg/5 ml 777688623 69.4 13.4 B

66 Nevirapine Tablet 200mg 782895804 69.8 13.6 B

Report


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67 Deltamethrin Solution As per NVBDCP Supply 787895804 70.3 13.8 B

68 Carboplatin (15ml) Injection (15ml) 50mg/5ml 792876117 70.7 14.0 B

69 Paracetamol Tablet 500 mg 797845693 71.2 14.2 B

70 Glimipride Tablet 1mg 802799122 71.6 14.4 B

71 Rabies Immunoglobulin Human Injection 300 /1500 IU 807706744 72.1 14.6 B

72 Poliomyelitis Vaccine Oral Drop NULL 812598184 72.5 14.8 B

73 Chloroquine (as hydrochloride,

phosphate or sulphate) Injection 40 mg/ml 817322867 72.9 15.1 B

74 Diphtheria,Pertussis and Tetanus

combined (DPT) vaccine Injection NULL 822035237 73.3 15.3 B

75 Amoxicillin anhydrous Tablet or Capsule 500 mg 826624088 73.7 15.5 B

76 Norfloxacine Tablet 400mg 831082029 74.1 15.7 B

77 Calcium Salts Tablet (as elemental

calcium)(300mg) 835409428 74.5 15.9 B


(156mg)/5ml 839618161 74.9 16.1 B

79 Dextrose with Sodium Chloride Injectable Solution

(Intravenous Fluid)

5% Dextrose, 0.9% Sodium

chloride 843602701 75.3 16.3 B

80 Sulphamethoxazole + Trimethoprim Tablet 400 mg + 80 mg 847330849 75.6 16.5 B

81 Ethambutol Hydrochloride Tablet 800 mg 851056901 75.9 16.7 B

Report


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82


Hydroxide + Active


Gel 250mg+250mg+50mg/5ml 854676144 76.3 16.9 B

83 Diethyltoluamide Cutaneous Solution NULL 858276144 76.6 17.1 B

84 Metronidazole Tablet 400mg 861863786 76.9 17.3 B

85 Amoxicillin anhydrous Powder for Oral

Suspension 125 mg/5 ml 865333012 77.2 17.5 B

86 Condoms with or without Spermicide

(Nonoxinol)

As per NACO/ RCH

supply NULL 868779019 77.5 17.7 B

87 Paracetamol Syrup 125 mg/5ml 872223499 77.8 17.9 B

88 Gentamicin Sulphate Injection 40 mg/ml 875542456 78.1 18.1 B

89 Ethinylestradiol Tablet 50 micrograms 878812524 78.4 18.4 B

90 Isosorbide Dinitrate Tablet (Sublingual) 5 mg 882068177 78.7 18.6 B

91 Albendazole Tablet (Chewable) 400 mg 885323699 79.0 18.8 B

92 Vitamin A Palmitate Capsule 25000 IU 888547417 79.3 19.0 B

93 Miconazole Nitrate Ointment or Cream 2% 891732890 79.6 19.2 B

94 Copper-containing device As per RCH Supply NULL 894891640 79.8 19.4 B

95 Povidone Iodine Ointment NULL 898042622 80.1 19.6 B

96 Atracurium Injection 10mg/ml 901168869 80.4 19.8 B

97 Isoflurane Inhalation

(Vaporiser) NULL 904282069 80.7 20.0 B

Report


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98 Imipenem Monohydrate + Cilastatin

Sodium Powder for Injection 250mg + 250mg 907381000 81.0 20.2 B

99 Ferrous Sulphate Tablet 200mg equivalent to 60 mg

elemental iron 910452250 81.2 20.4 B

100 Cefadroxyl Syrup 125mg/5ml 913493373 81.5 20.6 B

101 Azithromycin Tablet 250 mg 916514185 81.8 20.8 B

102 Ciprofloxacin Hydrochloride Tablet 250 mg 919525153 82.0 21.0 B

103 Ampicillin Sodium Powder for Injection 500 mg 922531468 82.3 21.2 B

104 Betamethasone Ointment/Cream 0.1% (as vale rate) 925462566 82.6 21.4 B

105 Nevirapine Oral Suspension 50mg/5ml 928377366 82.8 21.6 B

106 Quinine (bisulphate or sulphate) Oral Solution 150mg/5ml 931277216 83.1 21.9 B

107 Oseltamivir Capsule 45 mg 934150925 83.3 22.1 B

108 Omeprazole Tablet 40mg 936994111 83.6 22.3 B

109 Ibuprofen Tablet 200 mg 939794183 83.8 22.5 B

110 Chloramphenicol Capsule 250 mg 942592091 84.1 22.7 B

111 Glimipride Tablet 2mg 945275198 84.3 22.9 B

112 Pentoprozole Tablet 40mg 947930732 84.6 23.1 B

113 Polyvalent Snake Antivenom Serum Injection 10ml 950554788 84.8 23.3 B

114 Metronidazole Benzoate Oral Suspension 200 mg/5 ml 953116004 85.0 23.5 B

115 Ciprofloxacin Hydrochloride Infusion 2mg/ml 955663573 85.3 23.7 B

116 Ibuprofen Tablet 400 mg 958203758 85.5 23.9 B

Report


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117 Ranitidine Tablet 150 mg 960679382 85.7 24.1 B

118 Sulphacetamide Sodium Solution (Eye Drop) NULL 963113294 85.9 24.3 B

119 Ferrous Sulphate + Folic Acid Tablet equivalent to 20 mg iron +

0.1mg folic acid 965477457 86.1 24.5 B

120 Ofloxacin Tablet 400mg 967811239 86.3 24.7 B

121 Diclofenac sodium Injection 25mg/ml PG surfactant free

(3ml) 970122051 86.6 24.9 B

122 Decarbazine Injection 200mg 972406920 86.8 25.2 B

123 Amoxicillin + Clavulanic acid Tablet 500mg + 125mg (625mg) 974667105 87.0 25.4 B

124 Anti-D Immunoglobulin Polyclonal

(Thiomersal free) Injection 300mcg 976845855 87.2 25.6 B

125 Hydroxocobalamin Injection 1 mg 979016396 87.3 25.8 B

126


Hydroxide + Active


Chewable Tablet 500mg (250mg+250mg

+50mg) 981178285 87.5 26.0 B

127 Cefadroxyl Tablet 500mg 983315322 87.7 26.2 B


sulphate) Syrup 50 mg /5ml (60ml bottle) 985435595 87.9 26.4 B

129 Salmeterol + Fluiticasone Inhaler 25mcg + 125mcg/ dose 987496235 88.1 26.6 B

Report


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130 Metronidazole Infusion/ Injection 500 mg 989526310 88.3 26.8 B

131 Clotrimazole Cream 2% W/W (15gm tube) 991528094 88.5 27.0 B

132 Hydrocortisone Sodium Succinate powder for Injection 100 mg 993432760 88.6 27.2 B

133 Erythromycin Stearate Powder for Oral

Suspension 125 mg/5ml 995314374 88.8 27.4 B

134 Misoprostol Tablet 100mcg 997169245 89.0 27.6 B

135 Erythromycin Stearate Tablet or Capsule 250 mg 999014291 89.1 27.8 B

136 Ranitidine Injection 50mg/ 2ml 1000849808 89.3 28.0 B

137 Ofloxacin Tablet 200mg 1002645301 89.5 28.2 B

138 Amoxicillin anhydrous Tablet or Capsule 250 mg 1004436514 89.6 28.5 B

139 Diclofenac sodium Tablet 50mg 1006218551 89.8 28.7 B

140 Thiopentone sodium Injection 1.0 g 1007997562 89.9 28.9 B

141 Cefadroxyl Tablet 250mg 1009750913 90.1 29.1 B

142 Clofazimine Capsule 50 mg 1011456167 90.2 29.3 B

143 Fluconazole Oral Suspension 50 mg/5-ml 1013132672 90.4 29.5 B

144 Sodium Chloride Injectable Solution

(Intravenous Fluid)

0.9% Isotonic (equivalent to

Na+ 154 mmol/l, Cl- 154

mmol/l (500ml)

1014802015 90.5 29.7 B

145 Methyl Prednisolone Injection 40mg/ml 1016469328 90.7 29.9 B

146 Ceftazidime Injection 1gm 1018059177 90.8 30.1 C

Report


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147 Anti rabies Vaccine (Chickembryo) Injection IM

administration 2.5 IU 1019615144 91.0 30.3 C

148 Erythromycin Stearate Tablet or Capsule 500mg 1021119945 91.1 30.5 C

149 Cefixime Capsule 200mg 1022613859 91.2 30.7 C

150 Nitrofurantoin Syrup 100mg/5ml 1024095593 91.4 30.9 C

151 Surgical Spirit Solution NULL 1025575200 91.5 31.1 C

152 Nor adrenaline Injection 4mg/2ml 1027021743 91.6 31.3 C

153 Omeprazole Tablet 20mg 1028442731 91.8 31.5 C

154 Azithromycin Syrup 100 mg/5ml 1029806300 91.9 31.8 C

155 Isoxsuprine Hydrochloride Tablet 40 mg 1031167140 92.0 32.0 C

156 BCG Vaccine Injection 1032496422 92.1 32.2 C

157 MMR (Live Vaccine) Injection NULL 1033825704 92.2 32.4 C

158 Ceftriaxone Sodium Powder for Injection 1gm (Vial) 1035144738 92.4 32.6 C

159 Silver Sulfadiazine Cream 1% w/w 1036421704 92.5 32.8 C

160 Levothyroxine Sodium Tablet 100 microgram 1037693472 92.6 33.0 C

161 Hydrogen Peroxide Solution NULL 1038953496 92.7 33.2 C

162 Diltiazem Injection 30mg 1040147743 92.8 33.4 C

163 Anti rabies Vaccine (Verocell) Injection IM

administration 200 – 400 IU 1041320525 92.9 33.6 C

164 Cefalexin Tablet or Capsule 500mg 1042487546 93.0 33.8 C

165 Measles Vaccine Injection NULL 1043632205 93.1 34.0 C

166 Thiopentone sodium Injection 0.5 g 1044769834 93.2 34.2 C

167 Tropicamide Eye Drops Solution NULL 1045894589 93.3 34.4 C

Report


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168 Glibenclamide Tablet 5 mg 1047009111 93.4 34.6 C

169 Promethazine Hydrochloride Syrup 5 mg/5 ml 1048120677 93.5 34.8 C

170 Furazolidone Tablet (Dispersible) 100 mg 1049225210 93.6 35.1 C

171 Dicyclomine Hydrochloride Injection 10mg/ml (2ml) 1050321748 93.7 35.3 C

172 Ciprofloxacin Hydrochoride Solution (Eye/Ear

Drop) 0.3% w/v sterile aqueous 1051361290 93.8 35.5 C

173 Metoprolol Tablet 25mg 1052396854 93.9 35.7 C

174 Labetalol Injection 10mg/ml 1053431757 94.0 35.9 C

175 Lidocaine hydrochloride Injection for Spinal

Anaesthesia

5% to be mixed with 7.5%

glucose solution 1054441592 94.1 36.1 C

176 Protamine Sulphate Injection 10 mg/ml 1055432254 94.2 36.3 C

177 Misoprostol Tablet 200mcg 1056413770 94.3 36.5 C

178 Streptokinase Injection 15,00,000 IU 1057381270 94.3 36.7 C

179 Sodium Hypochlorite Powder for Solution NULL 1058312662 94.4 36.9 C

180 Benzoyl Peroxide Lotion 5% 1059209511 94.5 37.1 C

181 Ofloxacin Eye drops solution NULL 1060100069 94.6 37.3 C

182 Sodium Chloride + Dextrose 500 ml 1060988773 94.7 37.5 C

183 Vinblastine Injection 10mg 1061858129 94.7 37.7 C

184 Framycetin Sulphate Cream NULL 1062711869 94.8 37.9 C

185 Prednisolone Sodium Phosphate Solution (Eye Drop) NULL 1063563341 94.9 38.1 C

Report


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Release) 400 mg 1064414759 95.0 38.4 C

187 Pralidoxime Injection 25mg/ml 1065248249 95.0 38.6 C

188 Oral Rehydration Salts (for Glucose-

electrolyte solution) Powder Sachet

20.5 g/l; Components to

reconstitute 1 litre of

Glucose-electrolyte solution:

Glucose: 13.5 g/L; Sodium

Chloride: 2.6 g/L; Potassium

Chloride: 1.5 g/L; Trisodium

Citrate dehydrate*: 2.9 g/L

1066065751 95.1 38.8 C

189 Amikacin Injection 100mg/2ml 1066866804 95.2 39.0 C

190 Hydroxyethyl Starch Injection NULL 1067662045 95.3 39.2 C

191 Ceftazidime Injection 250mg 1068453484 95.3 39.4 C

192 Rapid Diagnostic Kit NVBDCP Supply NULL 1069236096 95.4 39.6 C

193 Sulphamethoxazole + Trimethoprim Tablet 200 mg + 40 mg 1070014989 95.5 39.8 C


Coated) 325 mg 1070786773 95.5 40.0 C

195 Ascorbic Acid (Vit C) Tablet (Scored) 100 mg 1071538304 95.6 40.2 C

196 Diazepam Injection 5 mg/ml 1072276752 95.7 40.4 C

197 Iohexol 350 mg Iodine/ml 1073000670 95.7 40.6 C


Coated) 75 mg 1073715053 95.8 40.8 C

199 Benzyl penicillin (sodium or potassium

salt) Powder for Injection 600 mg (= 1 million IU) 1074428473 95.9 41.0 C

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200 Propofol Injection NULL 1075137223 95.9 41.2 C

201 Azithromycin Tablet 500 mg 1075834401 96.0 41.4 C

202 Doxycycline Hydrochloride Capsule 100 mg 1076531340 96.0 41.6 C

203 Cetirizine Dihydrochloride Tablet 10mg 1077203161 96.1 41.9 C

204 Dapsone Tablet 50 mg 1077873344 96.2 42.1 C

205 Ampicillin Sodium Tablet 500mg 1078541810 96.2 42.3 C

206 Fluconazole Capsule 200 mg 1079197881 96.3 42.5 C

207 Liquid Paraffin Liquid NULL 500ml 1079849321 96.3 42.7 C

208 Gentamicin Sulphate Solution (Eye/ Ear

Drop) NULL 1080490153 96.4 42.9 C

209 Ethanol (Spirit) Cutaneous Solution 70% (denatured) 500 ml 1081115311 96.5 43.1 C

210 Dextrose

Injectable Solution

(Intravenous Fluid)

25%

50% Hypertonic 100ml 1081721959 96.5 43.3 C

211 Mitoxantrone Injection 20mg 1082316604 96.6 43.5 C

212 Primaquine Diphosphate Tablet 7.5 mg 1082903755 96.6 43.7 C

213 Synthetic pyrethroid (MT) Solution As per NVBDCP Supply 1083481755 96.7 43.9 C

214 Tuberculin, Purified Protein Derivative

(PPD) Injection NULL 1084042095 96.7 44.1 C

215 Digoxin Tablet 250 mcg 1084598647 96.8 44.3 C

216 Chlorhexidine 5% for dilution 500ml 1085152589 96.8 44.5 C

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217 Mannitol Intravenous

Injection NULL 1085706387 96.9 44.7 C

218 Povidone Iodine Solution NULL 1086252573 96.9 44.9 C

219 Bleomycin Injection 15mg 1086797085 97.0 45.2 C

220 Hydrocortisone Acetate Ointment or Cream 1% (as vale rate) 1087329501 97.0 45.4 C

221 Artesunate Injection 60mg 1087860857 97.1 45.6 C

222 Atropine Sulphate Eye ointment 1% 1088374073 97.1 45.8 C

223 Quinine Dihydrochloride Injection 300 mg/ml 1088878865 97.1 46.0 C

224 Dopamine Hydrochloride Injection 40 mg 1089354464 97.2 46.2 C

225 Sodium bi Carbonate Glycerine (Soda

Bocarb Glycerine) Ear Drop NULL 1089820160 97.2 46.4 C

226 Iron Sucrose Injection 100mg 1090282469 97.3 46.6 C

227 D actinomycin Injection 0.5mg 1090744104 97.3 46.8 C

228 Furosemide Tablet 20mg 1091204445 97.4 47.0 C

229 Isosorbide Dinitrate Tablet (Sublingual) 10 mg 1091660682 97.4 47.2 C

230 Fluconazole Capsule 150 mg 1092106637 97.4 47.4 C

231 Albendazole Suspension 200mg/5ml 1092551125 97.5 47.6 C

232 Ciprofloxacin Hydrochoride Ointment (Eye/Ear) 0.30% 1092988789 97.5 47.8 C

233 Dobutamine Injection 50 mg /ml 1093425176 97.6 48.0 C

234 Lidocaine hydrochloride + Epinephrine

(adrenaline) Injection 1%+ epinephrine 1:200 000 1093859101 97.6 48.2 C

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235 Prednisolone Tablet 10mg 1094288533 97.6 48.5 C

236 Cisplatin Injection 10mg/10ml 1094709733 97.7 48.7 C

237 Doxylamine Succinate Tablet 100mg 1095130933 97.7 48.9 C

238 Tinidazole Tablet 500mg 1095551145 97.7 49.1 C

239 Aminophylline Injection 25 mg/ml 1095971071 97.8 49.3 C

240 Suxamethonium Chloride

(Succinylchloline) Powder for Injection 50 mg/ml 1096383415 97.8 49.5 C

241 Folic Acid Tablet 5mg 1096789783 97.9 49.7 C

242 Spironolactone Tablet 100mg 1097182211 97.9 49.9 C

243 Tranexamic Acid Injection 500mg/5ml 1097572262 97.9 50.1 C

244 Dexamethasone Tablet 4 mg 1097955374 98.0 50.3 C

245 Bisacodyl Tablet 5mg 1098337944 98.0 50.5 C

246 Atropine Sulphate Injection 0.6 mg/ml 1098717691 98.0 50.7 C

247 Phenytoin Sodium Tablet 100 mg 1099078562 98.1 50.9 C

248 Methylrosanilinium Chloride (Gentian

Violet) Cutaneous Solution NULL 1099437780 98.1 51.1 C

249 Pentazocine Injection 30mg/ml 1099789837 98.1 51.3 C

250 Vitamin K Injection 1mg/ml 1100127580 98.2 51.5 C

251 Gentamicin Sulphate Injection 10 mg/ml 1100452865 98.2 51.8 C

252 Antitetanus Immunoglobulin (Human) Injection 500 IU 1100775425 98.2 52.0 C

253 Fluconazole Injection 2 mg/ml 1101095485 98.2 52.2 C

254 Metoclopramide Hydrochloride Injection 5 mg/ml 1101413821 98.3 52.4 C

255 Vecuronium Powder for Injection 20mg 1101724285 98.3 52.6 C

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256 Isoniazid Tablet 300mg 1102032114 98.3 52.8 C

257 Domperidone Tablet 10mg 1102332759 98.3 53.0 C

258 Valproic acid (Sodium salt) Liquid Oral Solution 200mg/5ml 1102632740 98.4 53.2 C

259 Atenolol Tablet 50 mg 1102921647 98.4 53.4 C

260 Hydrochlorothiazide Tablet 25mg 1103208334 98.4 53.6 C

261 Diazepam Suspension 2mg/5ml 1103492043 98.5 53.8 C

262 Propranolol Tablet 10 mg 1103772864 98.5 54.0 C

263 Tinidazole Tablet 1gm 1104052383 98.5 54.2 C

264 Conjugated Equine Oestrogen Tablet 0.625mg 1104319811 98.5 54.4 C

265 Lidocaine hydrochloride Injection NULL 1104586058 98.5 54.6 C

266 Chloramphenicol Palmitate Oral Suspension 150 mg/5 ml 1104839259 98.6 54.8 C

267 Metoprolol Injection 1mg/ml 1105090666 98.6 55.1 C

268 Homatropine Solution (Eye Drop) NULL 1105340069 98.6 55.3 C

269 Heparin Sodium Injection 5000 IU/ml 1105588739 98.6 55.5 C

270 Oxytocin Injection 10 IU 1105834955 98.7 55.7 C

271 Cloxacillin Sodium Capsule 500 mg 1106079899 98.7 55.9 C

272 Cefixime Dry Syrup 50mg/5ml 1106321562 98.7 56.1 C

273 Chloramphenacol Eye ointment 5 gm tube 1106560156 98.7 56.3 C


Release) (200mg) 1106796045 98.7 56.5 C

275 Adenosine Injection 3mg/ml 1107028183 98.8 56.7 C

276 Primaquine Diphosphate Tablet 15 mg 1107257797 98.8 56.9 C

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278 Ivermectin Tablet (Scored) 6mg 1107708868 98.8 57.3 C

279 Ergometrine Hydrogen Maleate Injection 200 micrograms 1107930562 98.8 57.5 C

280 Cytarabine Injection 1 g 1108149586 98.9 57.7 C

281 Zidovudine Oral Liquid 50 mg/5 ml 1108365586 98.9 57.9 C

282 Zidovudine IV or Infusion

Injection 10mg/ml 1108581586 98.9 58.1 C

283 Quinine (bisulphate or sulphate) Tablet 300 mg 1108796020 98.9 58.4 C

284 Isosorbide Monoinitrate Tablet (Sublingual) 5 mg 1109006360 98.9 58.6 C

285 Domperidone Syrup 1mg/ml 1109216694 99.0 58.8 C

286 Metronidazole Tablet 200mg 1109417439 99.0 59.0 C

287 Povidone Iodine Ointment/ Drop NULL 1109613467 99.0 59.2 C

288 Phenylephrine Injection 1109797567 99.0 59.4 C

289 Daunorubicin Hydrochloride Powder for Injection 20mg 1109980555 99.0 59.6 C

290 Acyclovir Ophthalmic

Ointment 3% 1110162513 99.0 59.8 C

291 Tobramycine Eye drops solution NULL 1110340972 99.1 60.0 C

292 Iron Sucrose Injection 50mg 1110517449 99.1 60.2 C

293 Cefixime Capsule 100mg 1110689405 99.1 60.4 C

294 Acetazolamide Tablet 250 mg 1110857285 99.1 60.6 C

295 Clotrimazole Ear Drops 1% W/V 1111022283 99.1 60.8 C

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296 Pilocarpine Hydrochloride or Nitrate Solution (Eye Drop) 2 PC 1111187211 99.1 61.0 C

297 Bupivacaine hydrochloride Injection for Spinal

Anaesthesia

0.5% in 4-ml ampoule to be

mixed with 7.5% glucose

solution

1111350207 99.2 61.2 C

298 Sodium bi Carbonate Injectable Solution

(Intravenous Fluid)

1.4% Isotonic (equivalent to

Na+ 167 mmol/l, HCO3- 167

mmol/l) 10ml

1111513095 99.2 61.4 C

299 Ketamine hydrochloride Injection 50 mg /ml in 2ml Vial 1111673318 99.2 61.6 C

300 Chlorpheniramine Injection 10 mg/ml 1111830135 99.2 61.9 C

301 Salbutamol Sulphate Tablet 2 mg 1111985718 99.2 62.1 C

302 Norethisterone Tablet 5mg 1112139882 99.2 62.3 C

303 Etiophylline + Theophylline Tablet 77mg + 23mg (100mg) 1112294044 99.2 62.5 C

304 Riboflavin (Vit B2) Tablet 5mg 1112446684 99.2 62.7 C

305 Timolol Maleate Solution (Eye Drop) NULL 1112597149 99.3 62.9 C

306 Etiophylline + Theophylline Injection 1112741824 99.3 63.1 C

307 Amiodarone Injection (50mg/ml) 3ml Amp 1112884214 99.3 63.3 C

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308 Medroxy Progesterone Acetate Tablet 5 mg 1113023613 99.3 63.5 C

309 Fluphenazine Decanoate or Enantate Injection 25 mg 1113160413 99.3 63.7 C

310 Diazepam Tablet (Scored) 5 mg 1113296136 99.3 63.9 C

311 Lorazepam Injection 4mg 1113431188 99.3 64.1 C

312 Digoxin Injection 250 mcg/ml 1113563026 99.3 64.3 C

313 Phenol Liquid 1113693353 99.4 64.5 C


315 Vincristine Injection 1 mg 1113951871 99.4 64.9 C

316 Metoclopramide Hydrochloride Tablet 10 mg 1114079688 99.4 65.2 C

317 Diclofenac sodium Tablet 100 mg 1114206060 99.4 65.4 C

318 Benzathine benzyl penicillin Powder for Injection 1.44 g benzylpenicillin (=2.4

million IU) 1114332195 99.4 65.6 C

319 Artesunate Tablet 50 mg 1114457732 99.4 65.8 C

320 Mebendazole Tablet 100mg 1114582587 99.4 66.0 C

321 Dicyclomine Hydrochloride Tablet 10mg 1114706876 99.5 66.2 C

322 Amphotericin B Powder for Injection 50 mg 1114828677 99.5 66.4 C

323 Acyclovir Tablet 200 mg 1114950184 99.5 66.6 C

324 Furosemide Injection 10 mg/ml 1115070544 99.5 66.8 C

325 Iodine D361 Solution 8mg/5ml 1115190473 99.5 67.0 C

326 Isoxsuprine Injection 5mg/ml 1115303573 99.5 67.2 C

327 Fentanyl Citrate Injection 0.05mg/ml 1115413435 99.5 67.4 C

328 Water for injection Injection NULL (10ml) 1115521265 99.5 67.6 C

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329 Chloramphenicol Sodium Succinate Powder for Injection 1 gm 1115628908 99.5 67.8 C

330 Chlorpromazine Hydrochloride Syrup 25 mg/5ml 1115735595 99.5 68.0 C

331 Salbutamol Sulphate Tablet 4 mg 1115836278 99.6 68.2 C

332 Phenylephrine Solution (Eye Drop) 4 PC 1115936136 99.6 68.5 C

333 Acyclovir (as sodium salt) Powder for Injection 250 mg 1116033255 99.6 68.7 C

334 Benzyl penicillin (sodium or potassium

salt) Powder for Injection 600 mg (= 1 million IU) 1116128807 99.6 68.9 C

335 Mebendazole Suspension 100mg/5ml 1116223950 99.6 69.1 C

336 Ergometrine Hydrogen Maleate Tablet 125 micrograms 1116314985 99.6 69.3 C

337 Neostigmine Metilsulfate Injection 2.5 mg 1116405576 99.6 69.5 C

338 Carbamazepine Syrup 20 mg/ml 1116494866 99.6 69.7 C

339 Magnesium Sulphate Injection 500 mg/ml (2ml) 1116583028 99.6 69.9 C

340 Hydrochlorothiazide Tablet (Scored) 25 mg 1116669108 99.6 70.1 C

341 Neostigmine Metilsulfate Injection 500 micrograms 1116753250 99.6 70.3 C

342 Phenobarbitone Syrup 20mg/5ml 1116837075 99.6 70.5 C

343 Nystatin Oral Solution 50mg/5ml (100000 IU/ml) 1116920691 99.6 70.7 C

344 Amlodipine Tablet 5 mg 1117001859 99.7 70.9 C

345 Vitamin B12 (Cyanocobalamin) Injection 500mcg/ml 1117082517 99.7 71.1 C

346 Phytomenadione Injection 10 mg/ml 1117160839 99.7 71.3 C

347 Mephenteramine Injection 30 mg/ml 1117237044 99.7 71.5 C

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348 Ferrous Fumarate Drop 5mg/ml 1117312102 99.7 71.8 C

349 Levodopa + Carbidopa Tablet 100 mg + 10 mg 1117386890 99.7 72.0 C

350 Salbutamol Sulphate Capsule (Rotacap) 200mcg 1117460179 99.7 72.2 C

351 Ondansetron Syrup 2mg/5ml 1117530811 99.7 72.4 C

352 Ferrous Sulphate + Folic Acid Tablet

200mg equivalent to 60 mg

iron + 400 micrograms folic

acid

1117601285 99.7 72.6 C

353 Sulfasalazine Tablet 500 mg 1117668594 99.7 72.8 C

354 Zinc Sulphate Dispersible Tablet

(Scored) 20mg 1117735318 99.7 73.0 C

355 Hydrocortisone Acetate Suppository;

Retention Enema 25 mg 1117802038 99.7 73.2 C

356 Bupivacaine hydrochloride Injection 0.25% in vial 1117867265 99.7 73.4 C

357 Cyclophosphamide Injection 200mg 1117931062 99.7 73.6 C

358 Benzoic acid compound (Benzoic acid

+ Salicylic acid) Ointment (6%+ 3% ) 1117994553 99.7 73.8 C

359 Salicylic Acid Topical Solution NULL 1118056653 99.7 74.0 C

360 Amlodipine Tablet 2.5 mg 1118118454 99.8 74.2 C

361 Miconazole Solution (Eye Drop) 1% 1118179576 99.8 74.4 C

362 Prednisolone Liquid 5mg/5ml 1118239693 99.8 74.6 C

363 Spironolactone Tablet 25 mg 1118299452 99.8 74.8 C

364 Nitrofurantoin Tablet 100 mg 1118358659 99.8 75.1 C

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365 Methotrexate Injection 25mg/ ml 1118413415 99.8 75.3 C

366 Phytomenadione Tablet 10 mg 1118467755 99.8 75.5 C

367 Potassium Chloride Injection 11.2% (equivalent to K+ 1.5

mmol/ml, Cl- 1.5 mmol/ml) 1118521268 99.8 75.7 C

368 Pentazocine Tablet 25mg 1118574634 99.8 75.9 C

369 Propyl Thiouracil Tablet 100 mg 1118625437 99.8 76.1 C

370 Ondansetron Injection 2mg/ml 1118675921 99.8 76.3 C

371 Phenytoin Sodium Injection 50 mg/ml 1118725216 99.8 76.5 C

372 Sulfadoxine + Pyrimethamine Tablet 500mg+ 25mg 1118774493 99.8 76.7 C

373 Enalapril Tablet (Scored) 2.5mg 1118821833 99.8 76.9 C

374 Epinephrine Hydrochloride

(Adrenaline) Injection 1 mg/ml 1118868757 99.8 77.1 C

375 Pyrazinamide Tablet 750 mg 1118914358 99.8 77.3 C


Coated) 150 mg 1118957847 99.8 77.5 C

377 Pyrazinamide Tablet 500 mg 1119001335 99.8 77.7 C

378 Methyldopa Tablet (Film Coated) 250 mg 1119044805 99.8 77.9 C

379 Haloperidol Injection 5 mg 1119088005 99.8 78.1 C

380 Chlorpromazine Hydrochloride Injection 25 mg/ml 1119131047 99.8 78.4 C

381 Lidocaine hydrochloride Jelly (Topical) NULL 1119173523 99.8 78.6 C

382 Furosemide Tablet 40mg 1119215719 99.9 78.8 C

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383 Nifedipine Capsule 5 mg 1119257787 99.9 79.0 C

384 Pethidine Injection 50mg/ml 1119299699 99.9 79.2 C

385 Metoprolol Tablet 50 mg 1119341198 99.9 79.4 C

386 Verapamil Hydrochloride Injection 2.5 mg/ml 1119382603 99.9 79.6 C

387 Terbutaline Injection 0.5mg/ml 1119422575 99.9 79.8 C

388 Lomustine Tablet 40mg 1119459641 99.9 80.0 C

389 Furazolidone Suspension 100 mg/5ml 1119496050 99.9 80.2 C

390 Chlorambucil Capsule 5mg 1119531968 99.9 80.4 C

391 Losartan Tablet 25mg 1119567804 99.9 80.6 C

392 Streptomycin Sulphate Powder for Injection 1 g 1119603151 99.9 80.8 C

393 Warfarin Sodium Tablet (Score) 5 mg 1119638472 99.9 81.0 C

394 Ceftriaxone Sodium Powder for Injection 250mg 1119673300 99.9 81.2 C

395 Pancuronium Injection 2mg/ml 1119707390 99.9 81.4 C

396 Procarbazine Capsule 50mg 1119740412 99.9 81.6 C

397 Folic Acid (Sodium salt) Injection 15 mg/2ml 1119773170 99.9 81.9 C

398 Doxorubicin Injection 10mg/5ml 1119805743 99.9 82.1 C

399 Levonorgesterel Tablet 750mcg 1119838179 99.9 82.3 C

400 Clozapine Tablet 100mg 1119870022 99.9 82.5 C

401 Atropine Sulphate Solution (Eye Drop) 0.50% 1119900488 99.9 82.7 C

402 Furosemide Oral Solution 20mg/5ml 1119930378 99.9 82.9 C

403 Prednisolone Tablet 20mg 1119959844 99.9 83.1 C

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404 Salbutamol Sulphate Injection 50 micrograms/ml 1119989131 99.9 83.3 C

405 Dexamethasone Tablet 500 micrograms 1120017554 99.9 83.5 C

406 Nitro Glycerine Injection 25mg 1120045897 99.9 83.7 C

407 Artemether Injection 80 mg/ml 1120073867 99.9 83.9 C

408 Betaxolol Hydrochloride Solution (Eye Drop) 0.50% 1120100928 99.9 84.1 C

409 Podophyllum Resin Cutaneous Solution 10 –2% 1120125928 99.9 84.3 C

410 Hydroxyurea Capsule 500mg 1120150773 99.9 84.5 C

411 Betamethasone Dipropionate +

Phenylephrine + Lignocaine Ointment 0.025%+0.1%+2.5% 1120175607 99.9 84.7 C

412 Etoposide Injection 100mg/5ml 1120200318 99.9 84.9 C

413 Tranexamic Acid Tablet 500mg 1120224739 99.9 85.2 C

414 Lidocaine hydrochloride Viscous Solution

(Topical) NULL 1120248783 99.9 85.4 C

415 Vancomycin Hydrochloride Powder for Injection 500mg 1120271137 99.9 85.6 C

416 Enalapril Tablet (Scored) 5 mg 1120293229 99.9 85.8 C

417 Propranolol Tablet 40 mg 1120315042 100.0 86.0 C

418 Promethazine Hydrochloride Injection 25 mg/ml 1120336544 100.0 86.2 C

419 Tetracaine Hydrochloride Solution NULL 1120357773 100.0 86.4 C

420 Phenobarbitone Injection 200mg/ml 1120378588 100.0 86.6 C

421 Nifedipine Tablet (Sustained

Released) (10mg) 1120399155 100.0 86.8 C

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422 Naloxone hydrochloride Injection 400 micrograms/ml 1120419617 100.0 87.0 C

423 Midazolam Injection (1mg/ml. ) 1120440014 100.0 87.2 C

424 Labetalol Tablet 100mg 1120458642 100.0 87.4 C

425 Allopurinol Tablet 100mg 1120476987 100.0 87.6 C

426 Dexamethasone Tablet 1mg 1120493953 100.0 87.8 C

427 Folic Acid Tablet 1mg 1120510586 100.0 88.0 C

428 Prochlorperazine Tablet 25 mg 1120526686 100.0 88.2 C

429 Busulfan Capsule 2mg 1120542411 100.0 88.5 C

430 Terbutaline Tablet 2.5mg 1120557195 100.0 88.7 C

431 Acyclovir Cream NULL 1120571876 100.0 88.9 C

432 Tetracycline Hydrochloride Ointment (Eye) NULL 1120584634 100.0 89.1 C

433 Amiodarone Tablet 200mg 1120597335 100.0 89.3 C

434 Cyclophosphamide Tablet 50mg 1120609690 100.0 89.5 C

435 Haloperidol Liquid 2mg/ml 1120621873 100.0 89.7 C

436 Olanzapine Tablet 10 mg 1120633946 100.0 89.9 C

437 Phenobarbitone Tablet 60mg 1120645185 100.0 90.1 C

438 Diphtheria Antitoxin Injection 20 000 IU 1120655729 100.0 90.3 C

439 Potassium Iodide Tablet 60 mg 1120665329 100.0 90.5 C

440 Fluorescein Sodium Strip NULL 1120674777 100.0 90.7 C

441 Sertraline Tablet 50mg 1120684108 100.0 90.9 C

442 Diphtheria Antitoxin Injection 10 000 IU 1120693407 100.0 91.1 C


micrograms 1120702243 100.0 91.3 C

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SS

444 Dinoprostone Injection 0.5mg 1120710955 100.0 91.5 C

445 Nystatin Tablet 10000 IU 1120719410 100.0 91.8 C

446 Glycopyrrolate USP Injection 0.2mg/ml 1120727660 100.0 92.0 C

447 Valproic Acid (Sodium Salt) Tablet (Control

Release) 200mg 1120735811 100.0 92.2 C

448 Paracetamol Suppository 250mg 1120743803 100.0 92.4 C

449 Mercaptopurine Tablet 50mg 1120751777 100.0 92.6 C

450 Atropine Tablet 1mg 1120759235 100.0 92.8 C

451 Acyclovir Oral Solution 200mg/5ml 1120766466 100.0 93.0 C

452 Olanzapine Tablet 5mg 1120773666 100.0 93.2 C

453 Thiamine Hydrochloride (Vit B1) Injection 50mg 1120780206 100.0 93.4 C

454 Florouracil Injection 250mg/5ml 1120785935 100.0 93.6 C

455 Fluoxetine Hydrochloride (for use

above 8 years of age) Tablet 20mg 1120791407 100.0 93.8 C

456 Silver Nitrate Solution (Eye Drop) NULL 1120796598 100.0 94.0 C

457 Melphalan Tablet 2mg 1120801720 100.0 94.2 C

458 Mitomycin Capsule 10mg 1120806278 100.0 94.4 C

459 Glutaraldehyde Aqueous Solution NULL 1120810782 100.0 94.6 C

460 Risperidone Tablet 3mg 1120815282 100.0 94.8 C

461 Oseltamivir Oral Powder 12 mg/ml 1120819602 100.0 95.1 C

462 Diltiazem Tablet 30mg 1120823766 100.0 95.3 C

463 Mephenteramine Tablet 10mg 1120827831 100.0 95.5 C

464 Lithium Carbonate Tablet 300 mg 1120831071 100.0 95.7 C

Report


Sl

#

Dru

g (

as

pe

r

ED

L)

Fo

rmu

lati

on

Str

en

gth

Cu

m A

Cu

m c

ost

%

Cu

m i

tem

%

CLA

SS

465 Lorazepam Tablet 2mg 1120834246 100.0 95.9 C

466 Morphine (Sulphate or hydrochloride) Injection 10 mg/ml 1120837295 100.0 96.1 C

467 Verapamil Hydrochloride Tablet 40 mg 1120840089 100.0 96.3 C

468 Methotrexate Sodium Tablet 2.5mg 1120842195 100.0 96.5 C

469 Etoposide Capsule 100mg 1120844295 100.0 96.7 C

470 Ondansetron Tablet 4mg 1120846077 100.0 96.9 C

471 Carboprost (PGF2α) as Tromethamine

USP (Preservative Free) Injection 0.25mg/ml 1120847840 100.0 97.1 C

472 Betamethasone Dipropionate Injection 4mg/ml 1120849542 100.0 97.3 C

473 Pyridoxine Hydrochloride (Vit B6) Tablet 25 mg 1120851240 100.0 97.5 C

474 Clotrimazole Mouth Paint 1% W/V 1120852640 100.0 97.7 C

475 Haloperidol Tablet 5 mg 1120853990 100.0 97.9 C

476 Silver Nitrate Lotion NULL 1120855310 100.0 98.1 C

477 Hyosine Butyl Bromide Injection 20mg/ml 1120856294 100.0 98.4 C

478 Povidone Iodine Vaginal Passaries 200mg 1120857224 100.0 98.6 C

479 Imipramine Hydrochloride Tablet 25 mg 1120857899 100.0 98.8 C

480 Trihexyphenidyl Hydrochloride Tablet 2 mg 1120858569 100.0 99.0 C

481 Chlorpromazine Hydrochloride Tablet 100 mg 1120859199 100.0 99.2 C

482 Niacinamide Tablet 50mg 1120859792 100.0 99.4 C

483 Amitriptyline Tablet 25mg 1120860142 100.0 99.6 C

484 Hyosine Butyl Bromide Tablet 10mg 1120860456 100.0 99.8 C

485 Cinnarizine Tablet 25mg 1120860762 100.0 100.0 C

Report


Chhattisgarh 112

Annexure 3 – Prescription Survey tool

Facility code - Name & Sign of surveyor

___________________________________________

Prescription Survey Tool

OPD/IPD Registration No. – ……………………………………………………………………….. Date - …..….-02-2013

1 What are the number of drugs prescribed in the prescription

(Please Mention total number of prescribed drug)

2 Are the drugs prescribed using their generic name?

(all=1 Some=2 Non of the drugs=3)

3. What is the duration of prescription?

(1-3 days=1 4-6 days=2 7 days or more=3)

4. Are the drugs prescribed listed in the EDL?

(all=1 Some=2 Non of the drugs =3)

5. Is the drug dosage form provided?

( Yes=1 No=2)

6. Are the strengths of dosage form provided?

( Yes=1 No=2)

7. Is the diagnosis mentioned in the prescription?

(Yes=1 No=2) if yes please mention below ………

Diagnosis : -

8. Give the following details for the drugs listed in EDL

Sr

EDL

Code

Drug Name

Dosage

form

Strength of

drug

Generic

Name*

Quantity

Prescribed

Available in

Pharmacy * Yes

= 1, No = 2

1

2

3

4

5

6

7

8

Report


Chhattisgarh 113

Annexure 4 – Store Data collection tool

Demand Calculation for Drugs on EDL

S.

No.

Dru

g (

as

pe

r E

DL)

Fo

rmu

lati

on

Str

en

gth

Dru

g C

od

e

Fa

cili

ty C

od

e (

P/S

/T )

Annual Consumption (A) No Stock (B) Number of

days

Year

1

Year

2

Year

3

Avera

ge

Year

1

Year

2

Year

3

Avera

ge

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Report


Chhattisgarh 114

Annexure 5 – List of consumables included in the ambit of the study

Code Surgical List Unit Pack Facility

Code

C2 Absorbent Cotton Wool IP 700 Gms Roll P

C3 Adhesive Plasters USP Spool Zinc

Oxide Self Adhesive Plaster USP

Spool T

C22 Catheters malecot's Rubber &

Latex

T

C23 Central Vein Catheters T

C24 Corrugated rubber/latex T

C25 Crape Bandage P

C26 Crape Bandage P

C27 Disposable Needles Nos T

C28 Disposable Needles Nos S


C30 Disposable Needles Nos P


C32 Disposable Needles Nos S ( R )

C33 Disposable Needles Nos S ( R )

C34 Disposable Scalp Vein Set Nos S

C35 Disposable Scalp Vein Set Nos S

C36 Disposable Suction Catheter Nos S

C37 Disposable Suction Catheter Nos S

C38 Disposable Syringes with Needle

CGS

Nos P


CGS

Nos S


CGS

Nos S


CGS

Nos S


CGS

Nos T

C44 Elastoplast 10cm S

C51 Flatus Tube Nos T

C53 Foley's Urinary Catheter Size 16 Nos S


Report


Chhattisgarh 115



C58 Gloves Pair P

C59 Gloves Pair S

C60 Gloves Pair S

C61 Gloves Pair P

C62 Infant feeding tubes Nos S (R )




C66 Infusion Pump Nos S (R )

C71 IV Cannula (Two way) Nos S (R )

C84 Medicated sterile paraffin gauze Nos S

C85 Micro drip set Nos S (R )

C87 Needle Hypodermic-Insulin

Needle

Nos S (R )

C89 Neonatal Suction Tube 10 French Nos S (R )

C90 Paper adhesive Plaster;Micropore

10 cm

Roll S

C92 Pediatric drip set Nos S (R )

C93 Plaster of Paris bandages BP 10 Rolls S

C94 Plaster of Paris bandages BP 10 Rolls S

C97 Ryle's Tube (P.V.C) Nos S





C104 Simple Plain Catheters Nos T

C105 Skin grafting Blade Nos T

C112 Surgical Blade 100 blades/packet S


C114 Surgical Blade 102 blades/packet P


C116 Bag 6 Nos/Pkt in each

Size

S

C117 Suture Needles Curved and

Cutting Assorted Pack 1/2 Circle

Cutting

6 Nos/Pkt in each

Size

S

C129 Tube Drain PVC Nos S (R )

C131 Urinary Drainage Nos P

Report


Chhattisgarh 116

Sutures

Absorbable Sutures

Catgut Chromic(with needle)

Chromic (without needles)

Catgut Plain(without needles)

Synthetic absorbable sutures

Non absorbable sutures black braided

silk(with needle)

Black braided silk (without needle in reels)

Black braided silk (with needle in reels)

Polyamide monofilament polyamide filament

with needle

Polypropylene monofilament sterile precut

lengths

Polycarbon sutures

Report


Chhattisgarh 117

Bibliography

1) (http://health.cg.gov.in)- Chhattisgarh State Govt. Health Dept. website

2) 5th

Common Review Mission, Chhattisgarh

3) PHFI Standards

4) High Level Expert Group Report on Universal Health Coverage for India. Instituted by

Planning Commission of India Submitted to the Planning Commission of India, New Delhi,

November, 2011

5) Report of the National Commission on Macroeconomics and Health,2005

6) iSixSigma; An Analytical Method for Estimating Project Benefits; Chew Jian Chieh; 2011

7) Immunisation Handbook for Medical Officers, Department of Health & Family Welfare,

Government of India.

8) ‘Guidelines for Diagnosis & Treatment of Malaria in India’ 2011 developed by the National

Institute of Malaria Research & WHO

9) Prevalence of Diabetes in Urban India JAPI , June 2010; Vol 58 A Ramachandran et al ‘

Current status of Diabetes in India’

10) Kokiwar Prashant R, Gupta Sunil S et al Prevalence of Hypertension in a rural community of

central India, Int Journal of Biological & Medical research

11) NPCDCS, Chhattisgarh, Screening of Diabetes & Hypertension data.

12) R Prakash Upadhyay, An Overview of the Burden of Non Communicable Diseases in India,

Review Article, Indian Journal of Public Health, Vol 41, No.3,2012

13) http://pipnrhm-

mohfw.nic.in/index_files/high_focus_non_ne/Chhattisgarh/Presentation/NPCC%2006.04.11

-final-%201.35%20pm.pdf. National Rural Health Mission Chhattisgarh, NPCC Meeting -

6thApril 2011, New Delhi)

14) ICMR – Medical Research Council Workshop on Chronic Diseases 2009 ; The Burden of

Cardiovascular Disease in India

15) ICMR – Medical Research Council Workshop on Chronic Diseases 2009 ; The Burden of

Diabetes in India

Report


Chhattisgarh 118

-----End of Document-----

Report


Chhattisgarh 119

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