Government have issued the New Procurement Policy of Andhra Pradesh (2009) including the procedure to be adopted to make available essential medicines of good quality, at all health facilities in the State at all times, procured at competitive prices in a transparent manner and to promote rational use of medicines.
Government of Andhra Pradesh have issued orders approving a list of Essential Medicine List 2010 and requested the M.D., A.P.M.S.I.D.C., Hyd. and other HODs, to procure only those medicines included in the AML/EML list duly following the procedure laid down
M.D., A.P.M.S.I.D.C., Hyderabad, has informed that as per the above orders Standing Expert Committee was constituted for preparation of Essential Medicines List (EML). The Expert Committee, Chaired by the Director of Medical Education, has carefully reviewed the burden of various diseases in the state; existing protocols for treatments of various diseases; the medicines required for the management of emergency medical problems and life saving treatment; and cost-effectiveness and efficacy of various medicines available in the market and also held extensive consultations with pharmacologists, clinicians, super-specialists, etc. and recommended a list of “Essential Medicines” that satisfy the medical care needs of the majority of the population that are safe, effective and to be made available in adequate quantity, dosage, form and fair price, for use by all Government Hospitals, Health Facilities and allied health institutions. The Director of Medical Education and Chairman of the Standing Expert Committee convened a workshop with members of Standing Expert Committee to review and to update the EML 2010 and AML 2010 . After detailed discussions, the committee prepared a revised list of new EML/AML of 2013. Further, the list needs to be updated periodically once in 2 years in view of the rapid developments taking place in the pharmaceutical research and new medicines being introduced in the market on a continuous basis. He has, therefore, requested the Govt. to approve a New EML and AML consisting of 509 items, i.e. U-139, S-112 T-87 and AML-171 and issue orders in the matter.
The Government, after careful examination of the above, has decided to accept the recommendations of the Standing ExpertCommittee and hereby order that all Hospitals, Health Facilities, and other Health Institutions under the control of HM & FW Dept., and the programmes assisted by the Government of Andhra Pradesh (HMRI and EMRI etc.) shall use only those Medicines listed in the ‘Essential Medicines List 2013’ (EML 2013), which is Annexed to this Order
Further, to address the specific requirements of the advanced specialties and the super-specialties , the Government also approve the ‘Additional Medicines List’ 2013 (AML 2013), which is Annexed.
The medicines included in the EML2013 have been selected through an evidence based process with due regard to relevance, quality, safety, efficacy and comparative cost-effectiveness. These medicines will be made available at all health facilities under the control of the Health, Medical and Family Welfare Department. Supply of medicines to the primary health centres (PHCs), Urban Health Centres (UHCs) and other primary health facilities shall be limited to those listed as ‘Universal’ (U) in the EML 2013. The secondary health facilities (CHCs, Area Hospitals and Urban Dispensaries) shall utilise those medicines listed as Universal (U) and Secondary (S). Whereas, the tertiary hospitals (teaching, district and super-speciality hospitals) will have access to all drugs included in the EML 2013. The medicines included in AML 2013 will be for the exclusive use of super-specialty and advanced specialty institutions and are for both centralized and decentralized procurement. The medicines other than the EML for National Disease Control Programmes, like RNTCP, NLEP, and other requirements of state departments like Rural Development, ICDS etc., shall be procured by APMSIDC based on the requirement of HOD’s
The Managing Director of Andhra Pradesh Health, Medical Services and Infrastructure Development Corporation (APMSIDC) and all Head of the Departments under the overall charge of Health, Medical and Family Welfare Department shall henceforth procure, store and dispense only those medicines included in the EML 2013/ AML 2013 based on the need under Centralized and decentralized Procurements . All medicines included in the lists contain International Non-proprietary Names (INN) or Generic Names. The medicines included in the list shall be procured in their generic form, strictly adhering to the Pharmacopeia standards, Route of Administration, Unit Pack, Strength and Specifications mentioned in this order.
All Heads of Department shall issue detailed instructions to all facilities and functionaries under their control regarding rational and effective use of medicines included in the EML and AML. The MD of APHMHIDC shall publish and distribute copies of the EML and AML to all health facilities and disseminate information regarding their use amongst all health functionaries of the state. The Commissioner of Health and Family Welfare shall organize workshops for all medical professionals of the Health, Medical and Family Welfare Department regarding the rational use of medicines and strict adherence to the use of medicines listed in this Order.
By implementing the essential medicines concept, the Government of Andhra Pradesh expects to improve the efficiency of drug management in all health facilities. The Government instructed all HODs to ensure strict compliance with the Government Orders issued in G.O.Ms No. 1357 HM&FW Department,dated 19 October 2009. All measures shall be taken by all HODs to ensure that:
(i) All essential drugs shall be available at all health facilities in the state at all times of the year.
(ii) Stocks required for at least three months should be maintained at all times.
(iii) Every effort shall be made to completely eliminate expired drugs, drug wastage, pilferage and stock-outs.
(iv) High standards of quality control and quality assurance measures shall maintained and monitored.
(V) All drugs in the EML and AML shall be purchased only from pharmaceutical companies who follow good manufacturing practices (GMP) stipulated by the drugs control authorities and APMSIDC, in Generic form, and custom packed in strips and blister packets for Government of AP duly following
(vi) No doctor of the HM&FW Department shall procure, prescribe, dispense, or recommend any medicine that is not included in the EML / AML without prior approval of the Government. Any violation of these instructions shall attract disciplinary action.
(vii) A comprehensive monitoring system to ensure that the above stipulations are fully implemented, shall be designed and operationalized by M.D., APMISDC within three months, duly involving the concerned Heads of Departments.
The M.D., A.P.M.S.I.D.C., Hyderabad and other Heads of Department shall procure only those medicines included in the AML / EML list duly following the procedure laid down in the reference first read above. All hospitals under other departments of Government of Andhra Pradesh and the private sector hospitals, especially those included in Rajiv Arogyasri Network, are also strongly encouraged to use the medicines notified in this Order