Revision in National List of Essential Medicines to help save up to 20%

MUMBAI: The revision in the National List of Essential Medicines (NLEM) by the government last week is expected to translate into savings of 10-20 per cent for patients at the therapy level on widely used antibiotics, anti-infectives, cardiac and respiratory medicines. The overall coverage of new medicines being added to the NLEM will be nearly Rs 8,000 crore in the organized pharma retail market, valued at Rs 95,000 crore (moving annual total), say initial estimates shared exclusively with TOI by market research firm AIOCD.

The revision in the list will lead to a loss of around Rs 600 crore for companies, with Cipla, Pfizer, Sun Pharma, Zydus and Lupin to be among those impacted the most. Savings to patients may be more substantial in terms of the drugs being prescribed, and the length of treatment (chronic therapy), industry experts point out.

In terms of therapies, anti-infectives is the largest in terms of savings for patients, followed by cardiac, neuro and respiratory medicines. Other therapies impacted by the revision will be analgesic, anti-diabetic gastro-intestinal, derma and gynaecological medicines.


The government revised the NLEM to add drugs prescribed for critical illnesses like cancer, HIV and diabetes, and added molecules which are widely used, while those not prescribed frequently or where better alternatives are available have been taken off the list. Last week, the Union health ministry revised the NLEM, raising the total number reportedly to 384 from the existing 348 drugs, following recommendations from a core committee formed by the health ministry.

The new list will be operational with immediate effect once the drug pricing regulator, National Pharmaceutical Pricing Authority, fixes their prices. At present, only 348 drugs are in the NLEM-2011 which are subject to price control according to the National Pharmaceutical Pricing Policy 2012.

Over the years, it has been felt that key life-saving medicines, including anti-cancer drugs and other expensive antibiotics and chronic drugs like anti-diabetics and cardiac, were left out of price control, making treatment costs unaffordable for patients. Not only have prices of medicines gone up since the new DPCO came into effect, the market value and share of medicines covered by it is only about 20 per cent of the pharma market. Also, different brands of the same drug formulation are identical in terms of active ingredients, strength, dosage, but vary significantly in terms of price. Also, most fixed dose combinations have largely escaped price control till now.