ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
This article is part of the Research TopicIntegrating Economics into Population Health: Assessing Policies and OutcomesView all 18 articles
Medicine Affordability and Access in India: Lessons from Generic–Branded Price Variation under the Jan Aushadhi Scheme
Provisionally accepted
- 1Economics and Finance, RMIT University Vietnam, Ho Chi Minh City, Vietnam
- 2Asian Development Bank Institute (ADBI), Tokyo, Japan
- 3Clarivate Analytics, Bengaluru, India
- 4Accuscript Consultancy, Ludhiana, India
- 5Manipal Academy of Higher Education (MAHE), Manipal, India
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Abstract Background: High out-of-pocket expenditure (OOPE) on medicines continues to be a major driver of health-related financial hardship in India. The Jan Aushadhi Scheme (JAS), launched by the Government of India, seeks to improve affordability and access to essential medicines through generic substitution. However, systematic evidence on its pricing dynamics, affordability, and equity implications remains limited. Methods: We conducted an observational analysis of 696 branded formulations for Eye and Ear, Nose, and Throat (ENT) conditions, comparing their prices with Jan Aushadhi generics listed in the Pharmaceuticals and Medical Devices Bureau of India (PMBI). Data were drawn from the Current Index of Medical Specialties (CIMS, 2021) and PMBI catalogs. Cost ratios and price variation percentages were calculated, alongside affordability assessment using the WHO/HAI one-day wage benchmark. Correlation and regression models assessed the relationship between brand proliferation and price dispersion. Supplementary analyses included chronic disease medicines (diabetes, hypertension, insulin), distribution trends of Jan Aushadhi Kendras (2018– 2022), and global benchmarking using WHO indicators. Results: Branded formulations exhibited wide cost variation, with correlation analysis showing that greater brand numbers were associated with higher—not lower—price dispersion. While most JAS medicines met the WHO affordability threshold, chronic therapies such as glaucoma drugs remained financially burdensome for low-income households. Supplementary analyses demonstrated that dosage form, packaging, and storage requirements contribute to persistent price gaps. Geographic analysis revealed strong growth in Kendras (3,200 in 2018 to 9,000 in 2022), but significant inequities persisted, with large states such as Uttar Pradesh and Bihar showing low per-capita availability. Global benchmarking highlighted India's paradox: despite being a global leader in generic production, domestic uptake of generics remains far below comparator countries. Conclusion: The Jan Aushadhi Scheme has made measurable progress in improving medicine affordability, but inequities in access, persistent price variation, and limited uptake constrain its full potential. Strengthening regulatory oversight, improving geographic distribution, and addressing physician and patient perceptions of generics are essential to maximize policy impact. Future research should apply quasi-experimental methods and integrate patient perception data to better capture the affordability–access–adherence pathway.
Keywords: medicine affordability, Drug price variation, Generic medicines, Branded medicines, Jan Aushadhi Scheme (JAS), out-of-pocket expenditure
Received: 16 May 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Behera, Rahut, Dhanal, Tasneem and Rajendhran. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Deepak Kumar Behera, deepakkumar.behera59@gmail.com
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