Lack of essential and affordable medicines in India revealed

January 25, 2018, Newcastle University

Research has revealed the shocking lack of access to essential medicines in India, despite thousands being approved in an attempt to generate wider availability.

Researchers at Newcastle University, UK and in Mumbai, India publishing in the Journal of Global Health, found that policy to open up the market has generated a large number of brands of medicines, but there are still not enough available in the pharmacies.

This study assessed the rational use - those drugs shown to be safe and effective with good evidence - and availability of six essential medicines in 124 private pharmacies in Maharashtra State, India.

In theory, competition within India's vast market for should ensure that essential medicines are available in private retail outlets at a price people can afford. However, the study found that despite there being multiple approved products listed in India databases, few were available in private pharmacies at a price people could afford.

Lead author, Dr Colin Millard from Newcastle University's Institute of Health and Society said: "What is worrying is that despite efforts to increase availability through market competition there remains inadequate access to essential medicines.

"We found that multiple brands of selected medicines are listed in professional and commercial databases -running into thousands - yet only a small fraction were available in private pharmacies."

Thousands of medicines approved, yet few available

The researchers examined the drugs available for six common needs: artemisinin (malaria), lamivudine (HIV/AIDS), rifampicin (TB control), oxytocin (reproductive health), fluoxetine (mental health) and metformin (diabetes). The study found that for each of the medicines there were multiple approved products listed in Indian databases, 2186 in total.

They found that only metformin was easily available- in 91% of the pharmacies studied- followed by rifampicin which was present in just above half the pharmacies (64.5%). The other four medicines were available in less than half.

In addition, the medicines were also available in fixed dose combinations (FDCs), where two or more drugs are combined in a set ratio in a single dose form, usually a tablet or capsule. There are concerns in India over the safety and effectiveness of these products. In 2007, the Indian regulatory body the Central Drugs Standard Control Organization (CDSCO) banned 294 FDCs which had been approved by state authorities but had never received central authorisation; in 2012 a further 45 FDCs were withdrawn.

Dr Millard adds: "The high level of approved products available on the Indian market also raises questions about rational use, that is are they being used in unsafe combinations?"

The authors call for a review of available brands, taking into consideration levels of sale and grounds for approval, and the setting up of a centralised database of registered pharmaceutical products.

Explore further: Tackling the rising sale of unapproved antibiotics in India

More information: Colin Millard et al, Availability of brands of six essential medicines in 124 pharmacies in Maharashtra, Journal of Global Health (2018). DOI: 10.7189/jogh.08.010402

Related Stories

Tackling the rising sale of unapproved antibiotics in India

October 10, 2017
Indian government needs to do more to tackle rising sale of unapproved antibiotics, according to an analysis by researchers at Newcastle University and Queen Mary University of London.

Many fixed-dose drug combinations in India lack central regulatory approval

May 12, 2015
Fixed-dose drug combinations (FDCs) which have not received central regulatory approval are sold in substantial numbers in India—despite concerns over the safety and efficacy of these combinations—according to new research ...

Canada needs essential medicines list to ensure supply

June 13, 2016
Canada needs to create a list of essential medicines to help protect against drug shortages, argues an analysis in CMAJ (Canadian Medical Association Journal)

Large market share for non-quality-assured malaria medicines in Africa

May 25, 2017
A new study of malaria medicine quality in 8 sub-Saharan African countries has found a large and potentially growing market for non-quality-assured (QA) malaria treatments—medicines not pre-approved by global health organisations ...

Asthma medicines a struggle for many countries

October 16, 2013
(Medical Xpress)—The availability, pricing and affordability of three essential asthma medicines varies greatly according to a new study of 52 low-and middle-income countries

Some WHO-approved malaria drugs fall short: study

July 10, 2012
Up to eight percent of malaria drugs approved by the World Health Organization or other regulators do not contain the right dose and may fuel resistance, researchers said Tuesday.

Recommended for you

Age at which women experience their first period is linked to their sons' age at puberty

October 12, 2018
The age at which young women experience their first menstrual bleeding is linked to the age at which their sons start puberty, according to the largest study to investigate this association in both sons and daughters.

First ever meta-analysis on Indian lead exposure reveals link to devastating intellectual disability in children

October 12, 2018
New Macquarie University research has revealed the devastating disease burden associated with elevated blood lead levels in India. The results of the first ever meta-analysis of Indian blood lead levels found the burden of ...

The long-term effects of maternal high-fat diets

October 12, 2018
If a mother eats a high-fat diet, this can have a negative effect on the health of her offspring—right down to her great-grandchildren. This is the conclusion drawn by researchers at ETH Zurich from a study with mice.

Sit-stand office desks cut daily sitting time and appear to boost job performance

October 11, 2018
Sit-stand workstations that allow employees to stand, as well as sit, while working on a computer reduce daily sitting time and appear to have a positive impact on job performance and psychological health, finds a trial published ...

Molecular link between body weight, early puberty identified

October 11, 2018
Becoming overweight at a young age can trigger a molecular chain reaction that leads some girls to experience puberty early, according to new research published in Nature Communications.

Hearing and visual aids linked to slower age-related memory loss

October 11, 2018
Hearing aids and cataract surgery are strongly linked to a slower rate of age-related cognitive decline, according to new research by University of Manchester academics.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.