Whereas, it was brought to the notice of the State Government that high profits in pharmaceutical industry has led to a large number of drugs and medicinal products under various brand names and number of them have been reported to be irrational combinations as per WHO criteria. As a first step towards promotion of rational use of drugs on the basis of efficacy, safety, suitability and cost effectiveness, the State Government had constituted an Essential drug List Committee (EDLC) comprising of highly qualified professionals and clinical specialists of various disciplines to prepare an Essential Drug List (EDL) for the State of Rajasthan.
And, whereas this EDLC circulated the National Essential Drug List along with WHO criteria for selection of Essential drugs amongst all the principal user-institutions viz. Principals & Controllers of all six Medical Colleges of the state, all Directors of Medical health Services, Rajasthan running different national programmes with a request to examine the National Essential Drug List in their respective institutions looking into the health needs of the people providing treatment facilities at different levels of State health care institutions and send their suggestions and comments in this regard. After receiving the observations and comments of these Principal use institutions, the Essential Drug List committee deliberated and finalised the Essential Drug List (EDL) for the State of Rajasthan availing the expertise of a WHO representative as the member of the EDLC and submitted to the Government.
The State Government is pleased to accept the report of the EDLC and hereby declare it as Rajasthan State Essential List (RSEDL-2000) for the State of Rajasthan (Annexure-I) with the following Guidelines.
1. The doctors of the state working under Government shall prescribe and use medicines out of the RSEDL only as far as possible. Deviations in prescription outside the RSEDL would be subject to scrutiny by an “Authorised Medical Authority” to be constituted by the Government.
2. The EDL would serve as a positive list for the public servants and pensioners. Therefore, medicines to these categories would be reimbursable only from EDL. Medicare Relief Card holders would also be prescribed medicines only out of this list claiming reimbursement of Medicare care. This would prevent unnecessary prescribing and save money to Government exchequer. However, in case of severe/chronic illness and life threatening situations supported by the recommendations of “ Authorised medical Authority” to be notified separately, the reimbursement to these categories outside the RSEDL could be considered by the Government.
3. Procurement of drugs and medicines in government hospitals and institutions would continue to be on the basis of existing drug list of the government as this is reported to be sufficient to take care of 90-95% cases of illness. Broadly, 75% of the budget of a hospital should be spent for procuring medicines from the list. Remaining 25% budget should be spent to procure medicines from EDL. This ratio of expenditure could be relaxed by the government on receipt of specific proposals from an institution through HOD with this recommendation. Store Purchase Organization of Medical & Health Department would circulate the approved rate contract for all medicines in the EDL on the basis of which the CM&HO’s. PMO’s and Suptds, Medical Collage Hospitals would procure medicines as per their demand.
4. After the approved rate contract is circulated to all concerned. It would be the responsibility of the in-charge of the medical institution to ensure that medicines in the approved rate contract are available in the hospital and dispensed on priority. To the following categories free of cost:
I. Medicare Relief Card holders
I. Emergency cases
I. Other extreme poor categories like destitute, beggars, orphans, senior citizens and widows unable to afford treatment costs. Decision on this would be taken discretely by in-charge of the hospital and in this absence by another doctor authorised by him for this purpose. Since budget is limited it is expected to use the discretion with utmost caution.
A separate account of drug dispensation to each of the above category would be maintained Separate Drug dispensation counters be opened in each Hospital.
5. The RSEDL is not static and would be periodically revised by EDLC, which may be constituted by the Government from time to time to cope up with the changed environment and rational need of the prescribing.
6. Principals & Superintendents of Medical Collages would ensure that teaching of the Essential Drug List is included in the curriculum of graduate and post graduate Medical students and adequate time is provided for its teaching.
7. All in-charge of the Government hospitals. Principals and Superintendents of Medical Collages. Directors of Medical Health Services would take immediate steps to ensure compliance of the EDL in their hospitals. They should convene meeting of the doctors and sensitise them on use of EDL. Similarly, they should also take steps to sensitise the Private Medical Practitioners on the use of this list for the general benefit of the public.
This order issues with the concurrence of FD vide ID No. 684/Fs/2000 dated 24.2.2000
1. Drugs marked with an asterisk (*) are to be considered as complimentary drugs, i.e.Those that are used if the other drugs there are not available or they are required for specific patients, situations or locations for valid reasons.
2. The names of drugs are followed by the letters given below to indicate their need at various levels of medical care:
P- Primary Health Care
S- Secondary Health Care
T- Tertiary Health Care
U- Universal
3. Although the drugs are listed by their peu categories, these are not necessarily meant to be use as prescribing guidelines. A drug that may deserve to be included in a particular category may not be found there, as it may already be included in another category.
|
Drugs Name |
Type |
1. Anaesthetics |
|
|
1.1 Gen. Anaesthetics
& Oxygen |
|
|
|
Ether |
S, T |
1.2 |
Local Anaesthetics |
|
|
Bupivacaine HCl |
U |
1.3 |
Preop. Medication &
Sedation for short term Procedures |
|
|
Atropine Sulphate |
U |
2. |
Analgesics, Antipyretics
& ASAIDS and Drugs used to treat Gout |
|
2.1 |
Non-opioid Analgesics |
|
|
Acetyl Salicylic Acid |
U |
2.2 |
Opioid Analgesics |
|
|
Pethidine (HCl) |
S, T |
3. |
Anti Allergics & Drugs
used in Anaphylaxis |
|
|
Chlorpheniramine |
U |
4. |
Antidotes and other
Substances used in Poisoning |
|
4.1 |
Non specific |
|
|
Activated charcoal |
U |
4.2 |
Specific |
|
|
Anti snake venom |
U |
5. |
Anticonvulsants |
|
|
Carbamazepine |
U |
6. |
Anti-Infective Drugs |
|
6.1.1 |
Intestinal Anthelmintics |
|
|
Albendazole |
U |
6.1.2 |
Antifilarials |
|
|
Diethylcarbamazine |
U |
6.2 |
Antifilarials |
|
6.2.1 |
Penicillin’s |
|
|
Amoxycillin |
U |
6.2.2 |
Other Antibacterial |
|
|
Amikacin* |
S, T |
6.2.3 |
Anti-Leprosy |
|
|
Clofazimine |
T |
6.2.4 |
Anti-Tuberculosis |
|
|
Ethambutol |
U |
6.3 |
Anti-Fungals |
|
|
Amphotericin |
T |
6.4 |
Antiprotozoal Drugs |
|
6.4.1 |
Antiamoebic &
Antigiardiasis |
|
|
Diloxanide Furoate |
S, T |
6.4.2 |
Antileishmaniasis Drugs |
|
|
Pentamidine |
S, T |
6.4.3 |
Antimalarial Drugs |
|
|
Chloroquine |
U |
6.5 |
Anti-Viral Drugs |
|
|
Acyclovir* |
S, T |
7. |
Antimigraine Drugs |
|
7.1 |
For treatment of acute attack |
|
|
Acetyl Salicylic Acid |
U |
7.2 |
For Prophylaxis |
|
|
Propranolol |
U |
8. |
Antineoplastic and
Immunosuppressant, These Drugs are Specialized and
Drugs and Drugs used in Palliative Toxic Drugs be
Purchased only Care when necessary |
|
8.1 |
Immunosuppressant |
|
|
Azathioprine* |
T |
8.2 |
Cytotoxic Drugs |
|
|
Bleomycin* |
T |
8.3 |
Hormones and Antihormones |
|
|
Prednisolone |
S, T |
9. |
Anti-Parkinsonism Drugs |
|
|
Trihexyphenidyl |
U |
10. |
Drugs affecting the Blood |
|
10.1 |
Antianemia drugs |
|
|
Ferrous salt |
U |
10.2 |
Drugs affecting coagulation |
|
|
Heparin Sodium |
S, T |
11. |
Blood Products and Plasma
Substitutes |
|
11.1 |
Plasma substitutes |
|
|
Dextran 70 |
U |
11.2 |
Plasma Fractions |
|
|
Albumin |
S, T |
12. |
Cardiovascular Drugs |
|
12.1 |
Anti-anginals |
|
|
Diltiazem |
S, T |
12.2 |
Antidysarhythmic drugs |
|
|
Amiodarone |
S, T |
12.3 |
Antihypertensive |
|
|
Amlodipine |
S, T |
12.4 |
Cardiac glycosides |
|
|
Digoxin |
S, T |
12.5 |
Vascular shock drugs |
|
|
Dopamine |
S, T S, T |
12.6 |
Antithrombotic drugs |
|
|
Acetyl Salicylic Acid |
U |
13. |
Dermatological (Topical) |
|
13.1 |
Antifungal Drugs |
|
|
Benzoic Acid+ Salicylic Acid |
U |
13.2 |
Anti-infective drugs |
|
|
Flumycetin Sulfate |
U |
13.3 |
Anti-inflammatory and
Anti-pruritic drugs |
|
|
Betamethasone |
S, T |
13.4 |
Keratoplastic and Keratolytic
drugs |
|
|
Coal Tar |
U |
13.5 |
Scabicides and Pediculocides |
|
|
Benzyl Benzoate |
U |
14. |
Diagnostic Agents |
|
14.1 |
Opthalmic drugs |
|
|
Fluorescein |
S, T |
14.2 |
Radiocontrast media |
|
|
Barium Sulphate |
S, T |
15. |
Disinfectants and Antiseptics |
|
15.1 |
Antiseptics |
|
|
Chlorhexidine |
U |
15.2 |
Disinfectants |
|
|
Bleaching Power |
U |
16. |
Diuretics |
|
|
Frusemide |
U |
17. |
Gastrointestinal Drugs |
|
17.1 |
Antacids and Anti Ulcer Drugs |
|
|
Aluminum Hydroxide +
Magnesium Hydroxide |
|
17.2 |
Anti Emetics |
|
|
Metoclopramide |
U |
17.3 |
Anti-haemorrhoidal drugs |
|
|
Local anaesthetic. Astringent
and anti-inflammatory drugs, e.g. Lidocaine/
Cinchocaine- |
|
|
Hydorcortisone |
U |
17.4 |
Anti Inflammatory Drugs |
|
|
Dulfasalazine |
T |
17.5 |
Anti Spasmodic drugs |
|
|
Dicyclomine HCL |
U |
17.6 |
Cathartics |
|
|
Bisacodyl |
U |
17.7 |
Drugs for Diarrhoea |
|
|
Furazolidone |
S, T |
18. |
Hormones, other Endocrine
Drugs and Contraceptives |
|
18.1 |
Adrenal, Hormones and
Synthetic Analogues |
|
|
Dexamethasone |
S, T |
18.2 |
Androgens |
|
|
Testosterone Propionate* |
S, T |
18.3 |
Contraceptives |
|
|
Condoms with or without
Spermicide |
U |
18.4 |
Estrogens |
|
|
Ethinylestradiol |
U |
18.5 |
Insulins and Anti Diabetics |
|
|
Glibenclamide |
U |
18.6 |
Progestrogens |
|
|
Norethisterone |
U |
18.7 |
Thyroid and Antithyroid |
|
|
Carbimazole |
S, T |
19. |
Immunologicals |
|
19.1 |
Diagnostic agents |
|
|
Tuberculin, purified protein
derivative |
U |
19.2 |
Sera and Immunoglobulins |
|
|
Anti-Snake venom |
U |
19.3 |
Vaccines |
|
|
B.C.G. Vaccine |
U |
20. |
Muscle Relaxants
(Peripherally Acting) and Cholinesterase
Inhibitors |
|
|
Atracurium* |
S, T |
21. |
ENT and Opthalmological
Preparations |
|
21.1 |
Anti Infective |
|
|
Chloramphenicol |
U |
21.2 |
Anti Inflammatory drugs |
|
|
Prednisolone |
U |
21.3 |
Local Ana esthetics |
|
|
Tetracaine |
U |
21.4 |
Miotics and Antiglaucoma
drugs |
|
|
Acetazolamide |
S, T |
21.5 |
Mydriatics |
|
|
Atropine |
U |
22. |
Oxytocics and Antioxytocics |
|
22.1 |
Oxytocics |
|
|
Methyl Ergometrine |
U |
22.2 |
Antioxytocics |
|
|
Terbutaline |
S, T |
23. |
Peritoneal Dialysis Solutions |
|
|
Intraperitoneal Dialysis
Solution |
|
24 |
Psychotherapeutics |
|
24.1 |
Drugs used in Psychotic
disorders |
|
|
Chlorpromazine |
U |
24.2 |
Drugs used in Mood Disorders |
|
|
Imipramine |
U |
24.3 |
Drugs used for Sedation an
Generalized Anxiety Disorders |
|
|
Diazepam |
U |
24.4 |
Drugs for Obsessive
Compulsive Disorders and Panic Attacks |
|
|
Clomipramine* |
U |
24.5 |
Drugs used for Dead diction |
|
|
Clonidine |
T |
24.6 |
Depot Antipsychotics |
|
|
Fluphenazine Deconate |
S, T |
25. |
Drugs Acting on the
Respiratory Tract |
|
25.1 |
Antiasthmatic |
|
|
Theophylline Compounds |
P, S |
25.2 |
Antitussives |
|
|
Dextromethorphan |
U |
26. |
Solutions Correcting Water,
Electrolyte and Base Disturbances |
|
26.1 |
Oral |
|
|
Oral Rehydration Salts |
U |
26.2 |
Parenteral |
|
|
Glucose |
U |
26.3 |
Miscellaneous |
|
|
Water for Inj. IP |
U |
27 |
Vitamins and Minerals |
|
|
Ascorbic Acid |
U |