Thursday, July 28, 2011

What AYUSH report - 2010 means to homoeopathy?

Similimateam presents the abstract  – read and analyse this report
Department of AYUSH has released its annual report 'AYUSH in India - 2010' recently.
What it means to homoeopathy? 
Whether the department gives importance to homoeopathy or not? 
These are the questions this author tried to explore from the report.

Registered practitioners, hospitals and education
Number registered homoeopathy practitioners has gone up to 246,772 from 239,285 in 2008. In 2007 it was 217,860). Compounded annual growth rate for the period 1993-2010 is 2-5%. Homoeopathic doctors contribute approximately 31.4% of total AYUSH doctors. As far as Government Hospitals are concerned, homoeopathic hospitals contribute close to 7.5% of total number of AYUSH hospitals. In respect to number of beds, Homoeopathy constitutes 15.4%. Whereas ayurveda hospitals constitute around 75% and number of beds constitute 71.5%. Homoeopathic CGHS dispensaries are 35, more than any other AYUSH system. Homoeopathic dispensaries under national institutes and research councils are 30, more than any other AYUSH system. Gujarat (6.7%), Karnataka (8.8%), Kerala (13.3%), MP (8.3%), Maharashtra (18.8%) and West Bengal (5.0%) contribute 60.9% of the total homoeopathy hospitals by state governments in India.

It is interesting to know that India has got 2102 homoeopaths per crore population. This figure is much lower than other systems. But among the AYUSH systems, homoeopathy has got highest number of admission for under-graduation with 12371 capacity of candidates. Though the capacity is more, we all know that there are many seats unfilled every year. One can hope that the new measures taken by the department of AYUSH by sending direction to CCH to act on poor institutes will effect in this respect. 

States with capacity more than 500 under-graduate candidates admission are Maharashtra - 3560, MP - 1755, Gujarat - 1525, Karnataka  - 840, Bihar - 810, West Bengal - 693, Rajastan - 515, Tamil Nadu - 500. Academic experts' concerns are not the seat capacity, but the quality of education. 

Homoeopathic manufacturing units
Number of homoeopathic manufacturing units  has drastically reduced to 398 from 571 in 2009, 637 in 2008 and 685 in 2007. The  reason may the implementation of GMP, which is not affordable to small manufacturers. But the quality of medicines have improved. Out of 398 homoeopathic manufacturing units, 199 are GMP compliant units and 199 are non-GMP compliant units, exactly 50% each. I wonder how there are still 50% non-GMP complied units exist when the GMP is mandatory for every single homoeopathic manufacturing unit. It will encourage others too and result in poor quality of medicines. West Bengal has got highest number of homoeopathic manufacturing units - 105, amounting to 26.38% of total HMU.

Expenditure on homoeopathy
Department of AYUSH has invested Rs. 678.97 crore (actual expenditure of the department) in 2009-10. The provisional actual expenditure for 2010-11 is 844.53 crore. There is no differentiation between the systems in the expenditure. However, the expenditure of major institutes helps comparing the spending on homoeopathy with the counterpart institute of other systems. Government has spent 0.09 crores for CCH, whereas 0.34 crores for CCIM (Central Council for Indian Medicine - for all other systems). For Homoeopathic Pharmacopoeia Laboratory it has spent 0.9 crores, whereas for PLIM (Pharmacopoeia Laboratory for Indian Medicines) it has spent 1.76 crores. 

Expenditure for running National Institute of Homoeopathy is 20 crores, what as for National Institute of Ayurveda and National Institute of Siddha is 23 crore. In case of National Institute of Unani Medicine, it is 8.76 crore and, Morarji Desai National Institute of Yoga and National Institute of Naturopathy put together, it is 12.5 crore. It is obvious that NIH has utilised the fund properly. In respect to research councils, expenditure for CCRH is 29.85 crore, for CCRAS (ayurveda and siddha) is 59 crores, for CCRUM (unani medicine) is 30.95 and for CCRYN (yoga and naturopathy) is 12.5 crores. Homoeopathy has got its due share. 

Exports and imports
Foreign export of AYUSH medicines in the year 2009-10 amounts to Rs. 2887.01 crore. Total import of AYUSH medicines is 346.22 crore. Compounded annual growth rate of export of total AYUSH medicines from 1995-96 to 2009-10 is 12.63%. Rs. 5.58 crores of homoeopathic medicines and Rs. 2.83 crores of biochemic medicines have been exported in 2009-10.

Though the department can give more importance to homoeopathy in respect to hospitals and dispensaries, the expenditure on homoeopathic institutes show that homoeopathy is getting its due share of attention from the government.

The fragmented report can be accessed from the link  http://indianmedicine.nic.in/index2.asp?lang=1&slid=632&sublinkid=225 

www.similima.com has compiled all the sections in one pdf file.

Nutshell
No. of registered practitioners of homoeopathy - 246,772 (in 2007-217,860; in 2008-239,285). Average annual growth rate for the period 1993-2010 is 2-5%. Current figure contributes 31.4% of total AYUSH doctors.
•No. of manufacturing units 398, whereas in 2007 it was 685, in 2008 it was 637 and in 2009 it was 571. As you know, WSI had lobbied in the past for GMP through various means. We have even interacted with media people emphasising on GMP. Subsequent to the enforcement, there is a definite improvement in terms of quality of products by other other manufacturers. Small manufacturers who could not afford the cost involved in upgradation, are forced to discontinue their licence.
•As far as Government Hospitals are concerned, Ayurveda hospitals contribute to 75% and Homoeopathic hospitals contribute to 7.5% of total no. hospitals. In respect to no. of beds, Ayurveda 71.5% and Homoeopathy 15.4%.
•But it is interesting to note that homoeopathic CGHS dispensaries are more than ayurveda. Homoeopathy - 35, ayurveda - 33. It is true with homoeopathic dispensaries under national institutes and research councils also. Homoeopathy - 30, ayurveda - 8.
•Gujarat, Karnataka, Kerala, MP, Maharashtra and West Bengal have got highest contribution to the total number of homoeopathy hospitals by state governments with 6.7%, 8.8%, 13.3%, 8.3%, 18.8% and 5.0% respectively.
•Homoeopathy has got highest no. of admission for under-graduation. Homoeopathy - 12371, ayurveda 11927
•States with capacity more than 500 candidates - Maharashtra - 3560, MP - 1755, Gujarat - 1525, Karnataka  - 840, Bihar - 810, West Bengal - 693, Rajastan - 515, Tamil Nadu 500. We may give priority to these states inn future.
•It is surprising to know that out of 398 homoeopathic manufacturing units (HMU), 199 are GMP compliant units and 199 are non-GMP compliant units. As GMP is mandatory now, I can't understand how non-GMP units exist.
•As we know the highest percentage of HMUs are from West Bengal, amounting to 26.38%.
•Since 2005-06 every year no. of HMU is declining except in 2006-07.
•Department of AYUSH has invested Rs. 678.97 crore (actual expenditure of the department) in 2009-10. The provisional actual expenditure for 2010-11 is 844.53 crore.
•There is no differentiation between the systems in the expenditure. However, we can differentiate between the institutes of these systems. Below table compares the expenditures to the institutes.
•Foreign export of AYUSH medicines in the year 2009-10 amounts to Rs. 2887.01 crore.
•Total import is 346.22 crore.
•Cumulative annual growth rate of export from 1995-96 to 2009-10 is 12.63%.
•Rs. 5.58 crores of homoeopathic medicines and Rs. 2.83 crores of biochemic medicines have been exported in 2009-10.
•Cumulative annual growth rate of export from 1995-96 to 2009-10 is 12.63%.


Compiled by Dr R Valavan
Manager - Scientific Affairs, Dr. Willmar Schwabe India Pvt. Ltd.

Wednesday, July 27, 2011

Homoeopathy, Ayurveda and other alternative systems of medicine get mediclaim cover

New India Assurance ,Cholamandalam MS General,ICICI Lombard General and many others now offering comprehensive health insurance plans.
  
Till some time back, health insurance policies used to cover only allopathy treatment while ayurveda, homeopathy, naturopathy and unani treatments were left out of the ambit. Despite having a comprehensive health insurance plan, individuals who preferred such systems had to pay out of their own pockets.  

These policyholders can now breathe easy as some insurance companies have started including alternative forms of treatment under their cover, especially ayurveda and Homoeopathy. “Ayurveda being the most prevalent of the alternate systems, we have designed a product to cover treatments under ayurvedic hospitalization,” says S S Gopalarathnam, MD, Cholamandalam MS General Insurance. 
  
While some insurers only offer it under their group policies, others have started offering it to individual health insurance seekers. PSU insurer New India Assurance and standalone health insurance provider Star Health and Allied Insurance are other insurance firms that have started covering ayurvedic treatments under individual policies. ICICI Lombard General Insurance covers it under government scheme and Future Generali Insurance offers it to corporate group insurance buyers. 

“Our policies as such do not cover any other line of treatment besides allopathy. However, in group policies, we do offer tailor-made packages to corporate clients to cover ayurvedic treatment subject to certain conditions,” says Shreeraj Deshpande, head of health insurance at Future Generali. Few insurance policies cover unani treatment. 

How did the need to cover alternative forms of medicine in health insurance arise? According to S S Gopalarathnam, managing director, Cholamandalam MS General Insurance, “During various focus group discussions with customers and agents, we found that for chronic ailments like spondilytis, arthritis and epilepsy, many people preferred alternate streams of treatment such as ayurveda, siddha and homeopathy, etc.” 
  
Though the coverage has been expanded, there are curbs on the amount and situations under which it can be claimed. 

New India Assurance’s extends cover to individuals undergoing treatment with the help of Ayurvedic, homeopathic and Unani systems of medicine. “Such claims will be covered only to the extent of 25% of sum insured. Also, they need to have availed of the treatment at a government hospital to be eligible for the claim,” informs Segar Sampathkumar, deputy general manager, New India Assurance. 

Similarly, Star Health also covers non-allopathic treatment, except Naturopathy, costs under its Unique Health Insurance Policy, “up to 25% of sum assured or a maximum of Rs 25,000 per occurrence, per year.” 

Chola Individual Health line Insurance policy provides coverage for ayurveda during hospitalization, prior and post hospitalization. A policy holder can get treated in any of the government registered ayurveda hospitals across the country and claim if hospitalized for more than 24 hours. 

Naturopathy treatments are excluded in all policies, while few cover unani and homeopathic. This is because other forms of treatments have no standard treatment protocols and highly varied costs thus making it difficult to actuarially compute the cost to be covered. 

Even under ayurveda, select procedures are covered to ensure people do not misuse a policy for a basic rejuvenation procedure. 

“We do not cover the unani system of medicine. Under ayurveda, hospitalization for panchkarma (five actions) meant to purify the whole body by eliminating accumulated toxins, is covered on a case to case basis,” explains Deshpande. 

It is important to note that there is no standalone cover available for covering alternative treatments. You will have to buy a standard health insurance cover from these select insurers and others who start offering the non-allopathic coverage. 

Before you head for alternative treatment and make a claim, see whether the treatment is listed in the insurance policy document. 
  
Source: Times of India, 25-07-2011, Delhi edition 

Saturday, July 16, 2011

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