Online Sale of Medicines



Online Sale of Medicines 


In accordance with the provisions of the Drugs & Cosmetics Act, 1940 and Rules made thereunder, the sale of drugs in the country is regulated by State Licensing Authorities. Accordingly, drugs specified in Schedule H, H1 or Schedule X cannot be sold except on and in accordance with the prescription of a Registered Medical Practitioner. The supply of prescription drugs can be effected only by or under the personal supervision of a registered pharmacist from a licensed premises. 


Food and Drug Administration, Maharashtra has taken regulatory action against Snapdeal, Amazon and Flipkart which were found to be selling/distributing medicines to consumers through internet without valid sales bill and requisite licenses. 

A number of representations have been received from Chemists and Druggist associations against online sale of prescription drugs. Similarly, a number of representations have also been received to permit such sales. 

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today. 

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Sustainable Development Goal 

As per the resolution of UN General Assembly in September, 2015 the Sustainable Development Goals (SDGs) have been adopted by 193 member nations. The Ministry of Statistics and Programme Implementation is in the process of developing indicators for the SDGs which are applicable to India.7 

The Government of India has been implementing several Central Sector/Centrally Sponsored Schemes including the Flagships Programs for sustainable development of the country and its people in three dimensions viz. economic, social and environmental. These developmental schemes are mostly addressing the Sustainable Development Goals (SDGs) which are targeted to be achieved by 2030. The Development Monitoring and Evaluation Office (DMEO), an attached office under NITI Aayog has been nominated as the nodal organization for the implementation of the SDGs. 

A Working Group (WG) has been constituted for dealing with the matters relating to Sustainable Development Goals (SDGs), such as: examining the data sheet prepared by DMEO on mapping of Central Sector/Centrally Sponsored Schemes (‘Core of the Core’ and ‘Core’ indicator) and other initiatives (eg. Pradhan Mantri Jan Dhan Yojana, etc.) on the basis of which the MOSPI will frame the National level Indicators. 

The Development Monitoring and Evaluation Office (DMEO), an attached office under NITI Aayog has prepared a draft road map for the concerned implementing Ministries of the Govt. of India which are implementing the Central Sector/Centrally Sponsored Schemes and the same have been circulated among the concerned Ministries for their comments. 

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today. 

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Wrong Treatment of Diseases 

Health is a State subject. It is the responsibility of the respective State Government to take cognizance of such instances and take action to prevent and control such practices. Therefore, such complaints, as and when these are received, are forwarded to the concerned States. Details of such complaints are, however, not maintained centrally.

Since, health is a State subject, only State Governments can regulate treatment charges. However, the Government of India has notified Clinical Establishments Rules 2012 under Clinical Establishments (Registration and Regulation) Act, 2010. In accordance with the said rules, one of the conditions for registration and continuation of the clinical establishments (in the States/UTs where the Clinical Establishments Act, 2010 is applicable) is that the clinical establishments shall ensure compliance of the Standard Treatment Guidelines (STG) as may be determined and issued by the Central Government or State Government from time to time. So far, Standard Treatment Guidelines for 21 therapeutic categories of Allopathy and one category of Ayurveda have been prepared and are available on the website of Ministry of Health and Family Welfare viz., www.clinicalestablishments.nic.in. Further, in accordance with the said rules, one of the conditions for registration and continuation of clinical establishments is that the clinical establishments (in the States / Union Territories where the said Act is applicable) shall charge the rates for each type of procedure and services within the range of rates determined by the Central Government from time to time in consultation with the State Governments. The National Council for Clinical Establishments, as provided under the Act, has approved a standard list of medical procedures and a standard template for costing of medical procedures for facilitating States for determination of “standard procedure cost” by them for regulation of medical treatment charges in their respective State/Union Territory which is also available on the aforementioned website of this Ministry.  The said standard list of medical procedures and standard template for costing of procedures has been shared with the States and the States will take appropriate decision in the matter.



The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today.


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Healthcare Services 


As per the National Health Profile 2015, the number of beds in rural hospitals is 183602 as against 492177 beds in urban hospitals. The State/UT wise details of number of beds are given below:









S. No.
State/UT/Division
  Rural Hospitals (Govt.)
Urban Hospitals (Govt.)
Total Hospitals (Govt.)


No.
Beds
No.
Beds
No.
Beds









India
16816
183602
3490
492177
20306
675779
1
Andhra Pradesh
222
7380
56
12468
278
19848
2
Arunachal Pradesh
204
2095
8
218
212
2313
3
Assam
1088
7504
49
5877
1137
13381
4
Bihar
1325
5250
111
6302
1436
11552
5
Chattisgarh
416
1522
221
10490
637
12012
6
Goa
16
1684
15
1434
31
3118
7
Gujarat 
296
8945
89
18983
385
27928
8
Haryana
80
2454
79
5210
159
7664
9
Himachal Pradesh
107
3328
53
5448
160
8776
10
Jammu & Kashmir
2368
5867
444
3893
2812
9760
11
Jharkhand
545
4879
4
535
549
5414
12
Karnataka
439
9884
215
43138
654
53022
13
Kerala
1135
18082
143
20318
1278
38400
14
Madhya Pradesh
334
10020
117
18167
451
28187
15
Maharashtra
450
12420
135
151445
585
163865
16
Manipur
23
730
7
697
30
1427
17
Meghalaya
28
840
12
2287
40
3127
18
Mizoram
29
1420
7
210
36
1630
19
Nagaland
21
630
32
1797
53
2427
20
Odisha
1659
7099
91
9584
1750
16683
21
Punjab
94
2900
146
8904
240
11804
22
Rajasthan
2656
33038
489
13631
3145
46669
23
Sikkim
30
730
3
830
33
1560
24
Tamil Nadu
407
9150
381
55093
788
64243
25
Tripura
101
1022
21
3115
122
4137
26
Uttar Pradesh 
737
NA
94
NA
831

27
Uttarakhand
666
3746
29
4219
695
7965
28
West Bengal
1272
19684
294
58882
1566
78566
30
A&N Island
31
625
1
450
32
1075
29
Chandigarh
0
0
4
700
4
700
31
D&N Haveli
1
100
1
272
2
372
32
Daman & Diu
0
0
4
200
4
200
33
Delhi
0
0
109
24383
109
24383
34
Lakshadweep
9
300
0
0
9
300
35
Puducherry
27
274
26
2997
53
3271








Notes:
Government hospitals includes central government, state government and local govt. bodies


Source: Directorate General of State Health Services

Public Health being a State subject, the primary responsibility to provide health care services to all the citizens, lies with the State Governments. The Government of India launched the National Rural Health Mission, now subsumed as a Sub Mission of the National Health Mission (NHM) in 2005 to improve the healthcare services, particularly in rural areas. To improve the availability of critical manpower to provide services in public health facilities, financial support is provided to States under NHM, inter-alia for giving hard area allowance to doctors for serving in rural and remote areas and for their residential quarters, so that doctors find it attractive to join public health facilities in such areas. States have also been advised to have transparent policies of posting and transfer, and adopt rational deployment of doctors.
In order to encourage the doctors to work in remote and difficult areas, the Post Graduate Medical Education Regulations, 2000 has also been amended to provide:

(i)       50% reservation in Post Graduate Diploma Courses for Medical Officers in the Government service who have served for at least three years in remote and difficult areas; and,

(ii)     Incentive at the rate of 10% of the marks obtained for each year in service in remote or difficult areas up to the maximum of 30% of the marks obtained in the entrance test for admissions in Post Graduate Medical Courses.

The implementation and progress of the National Health Mission (NHM) is monitored/ reviewed at the national level through Annual Common Review Missions (CRM) which comprise of government officials from different Ministries and NITI Aayog, public health experts and representatives of development partners and civil society. At the District Level, the "District Level Vigilance & Monitoring Committees” are constituted to monitor the progress of implementation of National Rural Health Mission under the overall Framework for Implementation. Other mechanisms include external surveys such as Sample Registration Survey (SRS), the District Level Household Survey (DLHS) and National Family Health Survey (NFHS) besides regular monitoring visits from National Program Management Units to States & districts and from States to districts & blocks. The Health Management Information Systems (HMIS) helps to monitor the performance of public health facilities.

The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.

*****

Cancer Prevalence 


National Cancer Registry Programme (NCRP) is being implemented by Indian Council of Medical Research (ICMR) based on 29 Population Based and 29 Hospital Based Registries.  The estimated prevalence and mortality in the past three years, State/UT wise is given below:

Estimated Prevalence Cancer cases in India by State/UT -All sites- (2012 to 2014)- Both sexes
States
2012
2013
2014
Andaman & Nicobar Islands
880
894
905
Andhra Pradesh*
202229
209366
216901
Arunachal Pradesh
3061
3132
3204
Assam
67820
68556
69290
Bihar
247647
256449
265535
Chandigarh
2470
2530
2593
Chhattisgarh
60936
62980
65084
Dadra & Nagar Haveli
837
886
941
Daman & Diu
627
700
778
Delhi
39196
40055
40932
Goa
3419
3494
3568
Gujarat
142885
147064
151366
Haryana
59729
61346
63007
Himachal Pradesh
16107
16462
16822
Jammu & Kashmir
29841
30855
31899
Jharkhand
78481
81070
83733
Karnataka
144385
148192
152092
Kerala
79473
82004
84779
Lakshadweep
156
164
171
Madhya Pradesh
172299
177649
183143
Maharashtra
263719
269652
275672
Manipur
5722
5649
5578
Meghalaya
6515
6639
6768
Mizoram
2390
2430
2469
Nagaland
4307
4353
4401
Odisha
98817
101190
103612
Pondicherry
3007
3132
3263
Punjab
64815
66182
67570
Rajasthan
162176
166706
171340
Sikkim
1384
1456
1541
Tamil Nadu
167533
169641
171744
Tripura
8198
8480
8798
Uttar Pradesh
473592
488554
503924
Uttaranchal
24027
24767
25529
West Bengal
215771
221635
227676
Total
2854451
2934314
3016628
Prevalence (10 years of duration) is assumed to be 2.7 times of Incidence cases (2009-2011 PBCR report).
* The data is not segregated for Andhra Pradesh and Telangana.


Estimated Mortality cancer cases in India by State / UT - All sites- (2012 to 2014) - Both sexes
States
2012
2013
2014
Andaman & Nicobar Islands
143
145
148
Andhra Pradesh*
32956
34119
35347
Arunachal Pradesh
499
510
522
Assam
11052
11172
11292
Bihar
40357
41792
43272
Chandigarh
403
413
423
Chhattisgarh
9930
10263
10606
Dadra & Nagar Haveli
136
144
153
Daman & Diu
102
114
127
Delhi
6387
6529
6670
Goa
557
569
581
Gujarat
23285
23966
24667
Haryana
9734
9998
10268
Himachal Pradesh
2625
2683
2741
Jammu & Kashmir
4863
5028
5198
Jharkhand
12790
13211
13646
Karnataka
23529
24150
24785
Kerala
12951
13363
13816
Lakshadweep
25
27
28
Madhya Pradesh
28078
28951
29846
Maharashtra
42976
43943
44924
Manipur
932
920
909
Meghalaya
1062
1082
1103
Mizoram
389
396
402
Nagaland
702
709
717
Orissa
16103
16490
16885
Pondicherry
490
510
532
Punjab
10563
10785
11011
Rajasthan
26429
27168
27922
Sikkim
226
237
251
Tamil Nadu
27302
27645
27988
Tripura
1336
1382
1434
Uttar Pradesh
77178
79616
82121
Uttaranchal
3916
4037
4160
West Bengal
35163
36118
37103
Total
465169
478185
491598
Based on Cancer incidence cases and Pooled M/I ratio of Mumbai data (2009-2011) report.

            * The data is not segregated for Andhra Pradesh and Telangana.


Crude mortality rate per lakh population as per Mumbai Population Based Cancer Registry for males and females during 2001 to 2011 is as below:
Year
Crude Mortality Rate
Males
Females
2001-2003
34.4
37.1
2004-2005
36.4
40.1
2006-2008
38.3
43.2
2009-2011
33.1
38.0

The increase in the number of cancer cases in the country may be attributed to larger number of ageing population, unhealthy life styles, use of tobacco and tobacco products, unhealthy diet, better diagnostic facilities etc.

The Government of India is currently implementing a scheme for enhancing the tertiary care facilities for Cancer in the country. Under the said scheme, Government of India assists to set up/establish State Cancer Institutes (SCI) and Tertiary Care Cancer Centre (TCCC) in different parts of the country. The maximum assistance inclusive of State share for SCI is uptoRs. 120 crores and for TCCC is uptoRs. 45 crores.

Under the scheme, 47 proposals have been received out of which 16 proposals are for SCI and 31 for TCCCs. After evaluation and examination 6 SCIs and 5 TCCCs have been approved and first installment of Central Government share has been released.

A statement showing the release of funds under the said scheme during the last two years and the current year is given below:

State-wise funds released under TCCC component of National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)*
           
            (1)        Funds released during the financial year 2014-15:
           S No.
State/UTs
Name of the Institute
SCI/
TCCC
Amount Released
(in Crore)
1
Karnataka
Kidwai Memorial Institute of Oncology(RCC), Bangaluru
 SCI
67.50
2
Kerala
Government Medical College, Kozhikode
TCCC
22.24
3
Tripura
Cancer Hospital(RCC), Agartala
 SCI
55.00
4
Gujarat
Gujarat Cancer Research Institute, Ahmedabad
 SCI
67.50
5
West Bengal
Government Medical College, Burdwan
TCCC
25.03
6
Jammu & Kashmir
Sher-i-Kashmir Institute of Medical Sciences, Srinagar
 SCI
47.25
7
Tamil Nadu
Cancer Institute (RCC) Adyar, Chennai
SCI
67.38
Total
351.90


            (2)        Funds released during the financial year 2015-16 (till 4thDecember, 2015):  
S No.
State/UTs
Name of the Institute
SCI/
TCCC
Amount Released
(in Crore)
1
Himachal Pradesh
Indira Gandhi Medical College, Shimla
 TCCC
14.87
2
Bihar
Indira Gandhi Institute of Medical Sciences, Patna
 SCI
33.06
3
Mizoram
Civil Hospital, Aizawl
TCCC
14.64
4
Uttar Pradesh
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
TCCC
11.43
Total
74.00

* The Scheme for Tertiary Care facilities for Cancer was approved in September 2013. No release were made under the Scheme in 2013-14.
Reports regarding a delay in the implementation of the above projects have not been received.

The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.

                                                       *****




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