Essential medicines to get cheaper in India after the release of NLEM

With the release of the latest National List of Essential Medicines (NLEM), several essential medicines are set to get cheaper in India. These include anti-diabetic drugs like insulin glargine, anti-tuberculosis drugs like delamanid, and antiparasite like ivermectin. 

The medicines listed in the NLEM are sold below a price ceiling fixed by the National Pharmaceutical Pricing Authority (NPPA). Price rise for scheduled drugs is linked to the wholesale price index-based inflation. For non-scheduled drugs, companies can hike prices by up to 10 per cent every year. Scheduled drugs roughly constitute 17-18 per cent of the estimated Rs 1.6-trillion domestic pharma market. Around 376 drugs are under price control.

The ceiling price is calculated on the basis of a simple average of the market prices of different brands of medicine. It is done for the medicines that have at least 1 per cent share in the total market. Companies flouting the price cap are penalised.

The NLEM, revised every three years, was last updated in 2015 and a revision was delayed due to Covid-19. The NLEM committee headed by Balram Bhargava, director general of the Indian Council of Medical Research (ICMR), drafted a new NLEM. ICMR last year submitted a draft to the Health Ministry, which then reviewed and reworked the list.

This year, the pricing has been fixed by a different mechanism. Earlier, the health ministry released a list of medicines that must be included in the list, and the department of pharma under the ministry of chemicals and fertilisers included them in the Drug Price Control Order. The NPPA then fixed the prices. 

However, this year, a standing committee was asked to prepare a list of medicines that must be adequately available at lower prices. 

The NLEM was launched for the first time in 1996 in India, along the lines of the World Health Organisation's (WHO) Essential List of Medicines (ELM). The last NLEM was listed in 2015. It was supposed to be launched every three years, however, the process got delayed reportedly due to the Covid-19 pandemic. 

In September 2021, ICMR sent a revised list to the health ministry.