Under the 2013 revisions to Schedule I of the Drugs (Prices Control) Order, the National Pharmaceutical Pricing Authority (NPPA) has released the draught version of the ceiling price calculation for 20 formulations, including specific strengths of paracetamol, povidone iodine, risperidone injection, and Japanese encephalitis vaccines. The pricing authority replaced Schedule I of the DPCO, 2013 with the National List of Essential Medicines (NLEM), 2022, in the second half of last year. This is the 15th set of draught calculation sheets that have been provided by the pricing authority since that time.
The latest lot of draft calculation sheet include proposals to fix the price of newly added formulations of risperidone injection (long acting) 25 mg at Rs. 1,930.19 per ml, and risperidone injection (long acting) 37.5 mg at Rs. 2649.26 per ml. The calculation sheet suggests prices of Rs. 2.90 per unit, Rs. 2.57 per unit, and Rs. 1.60 per unit, respectively, for the formulations of gentamicin injection 40 mg/ml, dexamethasone injection 4 mg/ml, and paracetamol injection 150 mg/ml, for which prices were not previously determined.
Fluconazole capsules 100 mg have a suggested ceiling price drop of 31.96% to Rs. 21.40 per unit, efavirenz capsules 200 mg have a cut of 26.67% to Rs. 21.98 per unit, and fluoxetine tablets 20 mg have a cut of 15.85% to Rs. 4.15 per unit. Even though the prices were permitted to increase by about 12.12% in line with the Wholesale Price Index (WPI) increase effective April 1, 2023, the Authority claimed at the start of the current fiscal year that the price reduction caused by the inclusion of NLEM 2022 into the DPCO, 2013, has resulted in a price cut of about 6.73 percent on about 651 formulations.
The Authority made it clear that starting on April 1, 2023, prices for scheduled formulations were permitted to increase by 12.12% in accordance with the WPI increase. The prices of 870 formulations are being adjusted or fixed based on NLEM, 2022, however this is done in accordance with the updated Schedule I of the DPCO, 2023. Around 16.62 percent less has been deducted from the cost of 651 scheduled formulations so far. The price of these 651 essential drugs is still lower for the customer even after accounting for the 12.12% price rise based on the WPI, according to the Authority.
For instance, the maximum price for a 500 mg paracetamol tablet under the NLEM, 2015, was set at Rs. 1.01 per unit as of April 1, 2022. After the price was revised to reflect the NLEM, 2022, and even after the WPI was added, the maximum price was set at Rs. 0.89 per tablet as of April 1, 2023, which represents a net decrease from the NLEM, 2015, of 11.88% after the WPI increase. Similarly, the price of the diabetes medication metformin 500 mg tablet, which was 2.13 rupees per tablet as of April 1, 2022, was 2.01 rupees per tablet as of April 1, 2023. which is a net decrease of 5.63 percent. The ceiling price for glimepiride tablets, 2 mg, was set at Rs. 6.34 on April 1, 2022, and it was reduced to Rs. 5.79 a year later, representing a net decrease of 8.68 percent from NLEM, 2015, after the WPI increased by 12.12 percent.
The correction was made in light of press reports that claimed that the WPI hike and the addition of drug prices had caused a 12.12% increase in drug costs starting on April 1, 2023. The Authority expressed its opinion that, according to reports, medicine manufacturers frequently maintain their maximum retail prices below the ceiling price due to market pressures and the existence of Jan Aushadhi outlets across the nation.
