BMC’s Zero Prescription Policy Faces Delay

The much-anticipated Zero Prescription Policy announced by the Brihanmumbai Municipal Corporation (BMC) on 23 November 2023 remains unrealised, leaving patients at BMC-run medical college hospitals still facing out-of-pocket expenses for their medications. Originally slated for implementation by April, the policy’s roll-out has been hampered by procurement delays and logistical challenges.

The Zero Prescription Policy was designed to alleviate the financial burden on patients by ensuring that all necessary medications would be available free of charge at civic hospitals, thus negating the need for patients to purchase drugs from external pharmacies. The BMC had earmarked INR 500 crore for this initiative, aiming to expand the list of covered medications from approximately 1,200 to 4,000 items. Despite the ambitious plans, there has been little progress in the actual deployment of the policy. The BMC’s Central Purchasing Department is still engaged in the procurement process, with tenders for the required medications either closed or under review.

Hospital officials have indicated that many commonly prescribed drugs remain unavailable within the BMC’s facilities, necessitating purchases from private pharmacies by patients. Critics have also pointed out that the policy’s benefits are currently limited to Mumbai residents, potentially creating a two-tiered system of medication access that excludes patients from neighbouring areas. This restriction has been a significant point of contention, raising concerns about equity and accessibility. The auxiliary municipal commissioner for health has acknowledged the issues, noting that the implementation of the policy will occur in phases.

With tenders for a subset of 4,000 items now under review, it has become apparent that rolling out all 13 schedules simultaneously is impractical. Instead, the BMC plans to introduce the policy gradually, schedule by schedule. The delay in the policy’s implementation highlights the broader challenges associated with large-scale public health initiatives, particularly in terms of logistical coordination and procurement. As patients continue to wait for the full realisation of the Zero Prescription Policy, the BMC faces the dual task of addressing immediate medication needs while working towards the policy’s eventual roll-out.