Editorial- April 2019

With Ayushman Bharat or Pradhan Mantri Jan Arogya Yojana (PM-JAY), PM Modi has rolled out the biggest government funded healthcare plan anywhere in the world. The scheme which became operational on Sep 25, 2018 in a short span of five months is already reporting an impressive beginning. Details on pmjay.gov.in website shows that twenty states have signed MoUs with the centre for the scheme, 14,865 hospitals have been empanelled, 24,832,493 E-cards have been issued, and 1,527,053 patients have availed the services.

This programme is aimed at benefitting over 10.74 crore vulnerable families translating into 50 crore beneficiaries. The government sponsored healthcare insurance scheme will provide free coverage of up to Rs 5 lakh per family per year, for secondary and tertiary care hospitalization, in cashless and paperless manner, at public and empanelled private hospitals. All the services that a private insurer offers to a premium client will be offered to a poor person under the PM-JAY. The states will foot 40 per cent of the expenses, while special category states (J&K, Himachal Pradesh, Uttarakhand and Northeast states) will have to share just 10 per cent. The rest of the expenses will be provided by the centre. Incase of UTs with no legislature, 100 per cent funding will be provided by the centre.

Price caps on drugs, stents, promotion of generics, cash support to expectant mothers from underprivileged backgrounds and a commitment in the National Health Policy, 2017, for increasing public healthcare expenditure to 2.5 per cent of GDP are among the uplifting news coming from the health sector.

One would have thought that the social infrastructure is finally getting fixed and those with health vulnerabilities would not be at the mercy of greedy private hospitals or profiteering MNC brands. So, we turned our gaze to one of the most fragile affected populations: The Haemophilia patients. Our investigations reveal how three MNC companies Baxalta, Novo Nordisk, and Pfizer in nexus with doctors, procurement bodies and certain patient group organizations are working together to obstruct competition from domestic pharma companies. All haemophilia patients are provided free treatment in the designated hospitals, as per government norms, the procurement being done by state governments. The manufacturing ability of domestic pharma companies had brought about substantial price reductions in the medicine Plasma Derived Factor (pdF-8), so now the MNCs have devised a strategy for pushing the expensive option, Recombinant Factor VIII (rF-8), for which there is no domestic production and is solely imported. And they are succeeding. This is contrary to scientific principles as the World Federation of Haemophilia (WFH) treats both at par. Read our cover story for complete details.