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Access to Free Medicines Extension of use of APeRx App in respect of Anti-Hypertensive & Anti- Diabetic Drugs G.O.Rt.No 96

G.O.Rt.No. 96 Dated: 08.02.2019 Health Medical & Family Welfare Department- ACCESS TO FREE MEDICINES- Extension of use of APeRx App in respect of Anti-Hypertensive & Anti- Diabetic Drugs

HEALTH, MEDICAL & FAMILY WELFARE( I.1) DEPARTMENT

 G.O.Rt.No. 96                                                          Dated: 08.02.2019
                                                 
Read:
Govt. Memo No.19021/8/2018/I1/HM&FW, HM& FW(I1)Department,  
       dt.24.08.2018
• ప్రైవేటు రిటైల్ మెడికల్ షాపులలోనూ నెలకు సరిపడా BP, షుగర్ మందులను రోగులకు ఉచితంగా అందజేయుటకు గానూ ఉత్తర్వులు విడుదల చేసిన ఏపీ వైద్య, ఆరోగ్య శాఖ కమీషనర్ పూనం మాలకొండయ్య గారు.
• అందజేయబడు మందుల జాబితా జతచేయబడినది.
ORDER:
In the Govt. Memo read above, Government have issued orders dispensing of Anti TB drugs through Registered mobile App- APeRx creating by Govt. of AP.  
2. Non-communicable diseases like diabetes and hypertension lead to a significant amount of morbidity and mortality, a majority of which happens in low and middle-income groups. Due to the chronic nature of these diseases, out of pocket spending by poor to purchase these drugs aggravates the problem leading to low compliance to dosage schedule and also economic impoverishment. In this context, an economic study has been concluded by Kalam Institute of Health Technology (Health Technology Assessment Regional Hub, under ICMR, Dept. of Health Research, Govt. of India) which suggests marked improvement in clinical indicators for the patient as well as economic welfare to the patient’s families, if access to Hypertensive and Diabetes Drugs be given to all patients.
3. Government after careful consideration of the matter, the Govt. of Andhra Pradesh has decided to extend the use of APeRx App, for Anti-Hypertensive & Anti- Diabetic drugs. Accordingly, the citizens can avail a set of drugs approved for hypertension and diabetes any free of cost from private chemists/pharmacy in the state of Andhra Pradesh.  The cost of these drugs shall be reimbursed to the registered Pharmacist/Chemist/Druggist at rate at which APSMIDC procures the corresponding drugs for Government Hospitals.  The reimbursement to private chemists will be done directly by the e-Rx App into the registered bank account.  
4. The free drugs in private Registered Pharmacies shall be made available after case evaluation by Physician/Specialist in all Government Hospitals (PHCs, CHCs, AHs, DHs and THs) and Government run PPP centers (eUPHC), based on the diagnostic test results done in these  Hospitals and centers, either through NTR Vaidya Pariskha or in-house diagnostics program. Similar benefit shall be available to employees subsequent to their diagnostic check-up in empanelled hospitals of government hospitals. It would be mandatory to have the tests done once every six months whereas private pharmacies would be enabled to prescribe drugs for one month at the time subsequent to APeRx based prescription by Doctors at Government health facilities or Urban Health Centres (eUPHC) that are operating in PPP mode. For Hypertension, the Blood Pressure shall be recorded and for Diabetes Mellitus, HbA1C shall be recorded after from fasting and post-meal blood sugar values as may be clinically indicated.

5. The following procedure shall be followed scrupulously during the use of APeRx App : 
(i)                APeRx Process flow for drug prescription and Dispensing
  • Patient Visiting the Public Health Facility
  • Diagnostic Test to be done, based on the recommendation of the Medical officer
  • Uploading of the test results by the Medical Officer into the app.
  • Patients receive SMS with an alphanumeric code
 (ii)               Pharmacy: 
·         Entering the code received by the patient through SMS
·         Dispensing of drugs and generating the sales bill. 
·         Generation of Weekly consolidated payment details pharmacy  
      wise.
 ·       Validation & approval of the Payment details by the SPIU with the        
      support of DCA & APMSIDC. 
·         Weekly online payment through CFMS.
 (iii)  The Free Drugs Scheme is applicable to all citizens who have been diagnosed as Chronic Hypertension and/or Diabetic case, irrespective of their economic category; provided the diagnosis has been done in a Govt. Health Facility/e-UPHCs. It is completely Voluntary for the pharmacists to participate in this program. It is also completely Voluntary for patients to avail this scheme. However, the patient identification has been linked to Praja Sadhikarta Survey (PSS) and Aadhar. Citizens diagnosed with Hypertension and/or Diabetes are requested to approach the nearest Mee-Seva Counter for inclusion to PSS database if they have any difficult in accessing the free drug scheme.
 (iv) Combination Drugs shall not be included in this scheme. The Chemists/Druggists/Pharmacists are expected to follow stringent quality control for drugs that would be given to public. Drug Control Administration shall devise adequate inspections for facilitate and monitor the quality of drugs.

(v)    Payment Process:
 The drugs so supplied will be procured by individual private pharmacies, and the reimbursement on submission of copies of prescriptions and the details of drugs dispensed shall be made by the Government. The pharmacies will be reimbursed once in a week through bank accounts registered on the APeRx App.  The expenditure of this project is to be met from e-Ausadhi scheme/free drug scheme of National Health Mission/external aided project financing and the payment will be through CFMS.


   (vi) The following are the list of identified drugs along with the cost to be        dispensed for Hypertension & Diabetes through APeRx App:

S.No.
Item Name
Unit
Rate in INR
                           DIABETES
1
Glibenclamide Tablets IP 5mg
100
9.90
2
Glimepride Tablets IP 1mg
100
11.09
3
Glimepride Tablets IP2mg
100
14.70
4
Metformin Tablets IP 500 mg
100
21.19
                      HYPERTENSION
1
Amlodipine Tablets IP5mg
100
8.60
2
Atenolol Tablets IP 50mg
140
23.45
3
Enalapril Maleate Tablets IP 5mg
100
16.61
4
Enalapril Tab 10mg
100
33.59
5
Losartan Potassium   Tablets IP 50 mg (film coated)
100
25.00
6
MetoprololTablets IP   25mg
100
19.98
7
MetoprololTartarateTablets                                    IP 50mg
100
43.43
8
Propranolol Hcl Tablets IP 40 mg
100
18.81
9
Ramipril Tablets IP 5mg
100
44.79
10
Telmisartan Tablets BP 40mg
100
39.39

Note: The prices of drugs mentioned here are subject to modifications as per APMSIDC procurement rate(s). 
6. Such a Scheme of providing for Free Drugs through private pharmacies for Hypertension and Diabetes is being planned and implemented for the first time in the Country, and citizens are requested to share their satisfaction/comments/concerns on 1100 –toll free number for service improvement/extension to other drug categories/quality check as may be required from time to time.
7. The Director General, Drugs Control Administration, AP, Guntur, the Managing Director, A.P. Medical Services & Infrastructure Development Corporation,(APMSIDC) Mangalagiri, the  Director, Strategic Planning Innovations Unit (SPIU), the Commissioner, AP Vaidya Vidhana Parishad (APVVP), Vijayawada, the Director, Public Health & Family Welfare (DPH&FW), Vijayawada, the Director of Medical Education (DME), Vijayawada   shall take necessary action in the matter.  
8. This order issues with the concurrence of the Finance (FMU - HM&FW -II) Department vide their U.O. No.FIN01-60030/2/2018, Dated: 16.1.2019.

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