Communication Intervention, Chronic Patients and Out of Pocket Expenditure

What is it about?

Chronic diseases are usually managed by patients over a lifetime with the help of medication and regular health checkups. Recurring expenses incurred by chronic patients on medicine to manage their chronic illness adversely affect their household income as well as increase household expenditure. Schemes such as the Prime Minister Generic Medicine Scheme (PMBJP) launched by the Government of India aims to decrease out-of-pocket (OOP) expenditure on medicine, especially for chronic patients who have recurring expenditures on medicine. With a focus on PMBJP scheme which provides cheap generic alternatives to chronic patients, this cohort study has been undertaken to investigate if using the Internet to access to these generic medicines online can reduce OOP expenditure on medicine for chronic patients. The study observed that the out-of-pocket expenditure on medicine for branded consumers is significantly higher than the expenditure on medicine for JAM (Jan Aushadhi Medicine) generic medicine consumers. The study urges that a communication intervention providing awareness about alternative access to JAM (Jan Aushadhi Medicine) generic medicines online lead to a significant shift in consumption behavior of chronic patients towards accessing these medicines online. The study found that although the PMBJP scheme has the potential of decreasing OOP expenditure on medicine for chronic patients, the scheme needs to be expanded towards online platforms run by government to ensure ease of access, increased availability which could play an instrumental role in decreasing the OOP expenditure on medicine for chronic patients.

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Photo by Towfiqu barbhuiya on Unsplash

Photo by Towfiqu barbhuiya on Unsplash

Why is it important?

Health care payments in India create a substantial burden on low- and middle-income households. Various studies have estimated that nearly 39 million people are pushed into poverty every year due to catastrophic health expenditures [10]; [11]. A study conducted by Shahrawat and Rao in 2012 [12] observed that around 3.5% of the Indian population falls below the poverty line, and 5% of households face catastrophic health expenditures due to high out-of-pocket expenditure. To reduce the burden of out-of-pocket expenditure on medicine for patients, the Government of India launched a novel project by the name of “Jan Aushadhi Medicine (JAM generic Medicines)” in the year 2008 with a vision of ‘quality medicine at affordable price for all.’ The Bureau of Pharma PSUs of India (BPPI) is the nodal agency for the scheme. BPPI comes under the Department of Pharmaceuticals, Government of India. The aim of the programme is to provide quality tested generic medicines at affordable prices to the people of India through retail stores known as Offline JAM Generic Medicine Stores. Under this scheme BPPI aims to open a generic medicine store in each district of the country. A medicine under the scheme is priced on the principle of a maximum of 50% of the average price of the top three branded medicines. Therefore, the price of generic medicine is cheaper by at least 50% and in some cases, by 80% to 90% of the market price of the branded medicines. The scheme is operated through various generic medicine stores which are physical stores either operated by the government or by the private individuals. As of September 2021, there were more than 8,000 generic medicine stores across India. The stores are part of a government initiative to provide quality generic medicines at affordable prices to the general public, especially in rural and remote areas. But factors like awareness among patients about the scheme and availability of medicine at the store can become a hurdle for chronic patients in taking full advantage of the scheme and reducing their out-of-pocket expenditure on medicine [1].

Perspectives