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.

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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.                                                        *****