State govt fails in maintaining essential medicines: CAG

 Hyderabad: The Comptroller and Auditor General (CAG) has pointed out that the State run government hospitals, PHCs have fallen short of procuring the Essential Medicines List (EML) and Additional Medicines List (AML) during successive years.

The CAG has said that although a Corporation was to get the EML/AML reviewed and updated once in two years, it was observed that the review of EML/AML was done only twice in 2015 and 2019. The CAG has found that as against 530 items required to be procured as per the approved EML list-2015, items procured were 396 in 2017-18, 336 in 2018-19 and 266 during 2019-20.

Similarly, out of 338 items required to be procured as per the approved EML list-2019, items procured were 209 in 2020-21 and 197 during 2021-22. All the health facilities were not implementing e-Aushadhi up to the Medicine Distribution Centre (MDC) level. There were also gaps and inadequate validation controls in eAushadhi application.

Essential drugs and medicines are those which address the priority healthcare requirements of a given population and the scrutiny by CAG in the district hospitals revealed that out of 39 therapeutic medicine groups, medicine related to 20 groups were not available across 11 out of 14 district hospitals.

Out of 16,016 Purchase Orders (Pos) issued by the Corporation, drugs were supplied for 13,950 POs leaving 2,066 POs unsupplied. However, no penalty on the suppliers was levied by the Corporation as per tender conditions. Contrary to the agreement conditions, the Corporation issued 19 POs beyond the agreed Rate Contract (RC) resulting in an excess payment of Rs 1.65 crore to nine suppliers. Drugs and Medicines (706 numbers) worth Rs 17.13 crore having leftover shelf life ranging from 1 to 89 days were issued by Central Medicine Stores to 1,259 health facilities during the period 2016-17 to 2021-22.

As per e-Aushadhi data, expired drugs valued Rs 390.26 crore were not got replaced timely with the suppliers causing huge monetary loss to the Government. Out of the 39,258 batches of drugs/ surgical/ CTS items, the Corporation had not sent 2,392 batches for Quality Check, (6 per cent) not being tested for their quality. CMS issued 32 batches of drugs without the mandatory testing to Health institutions.

Deficiencies in drugs storage facilities were observed in all the three test checked Central Medical Stores., Hyderabad, Mahabubnagar and Warangal making the drugs susceptible to damages, contamination and theft and risk to the patients.

The CAG has recommended the government to ensure implementation of e-Aushadhi application at all levels as envisaged and efforts may be made to strengthen validation controls in e-Aushadhi system. The CAG has asked the government to ensure that rules regarding near expiry drugs and its return to supplier timely for replacement of stock are followed by CMSs strictly. Essential Medicines List (EML) and Additional Medicines List (AML) should be reviewed and updated at least once in two years or more frequently as needed.