Over 90 million Indians live in households where spending on healthcare accounts for more than 10% of their total expenditure.

Of these, 31 million live in families where the health spend is more than a quarter of household expenditure.

The proportion of households spending over 10% or 25% of their expenditure on healthcare has gone up between 2017-18 and 2022-23.This was revealed in the Sustainable Development Goals National Indicator Framework Progress Report 2023, released recently by the statistics ministry.

Catastrophic health expenditure is defined as health spending exceeding 10% of household consumption expenditure.

The third of the United Nation's Sustainable Development Goals (SDG) is to provide universal health coverage (UHC) and to improve financial protection, thus preventing catastrophic spending.

UHC includes securing access to quality healthcare and safe, affordable medicines and vaccines for everyone.According to the progress report, the proportion of households where more than 10% of expenditure was on health went up from 4.5% to 6.7% while that of those spending over 25% on healthcare went up from 1.6% to 2.3%.In 2022-23, the highest proportion of people spending more than 10% or 25% of household expenditure on health were in Kerala, 16% and 6% respectively, followed by Maharashtra where it was 9% and 3% respectively.

Kerala also saw the biggest jump in this proportion between 2017-18 and 2022-23.

Other states which saw a significant increase are Karnataka, Odisha and Telangana in that order.According to the National Health Accounts 2019-20, out of pocket expenditure (OOPE) as a proportion of the total health expenditure (68%) was the second highest in Kerala, just below Uttar Pradesh where it was 72%.

Uttar Pradesh is among the five states with the highest proportion of households spending more than 10% or 25% of their expenditure on health.

However, in the case of Karnataka, though OOPE as a proportion of total health expenditure is the lowest among the bigger states (31.8%), the state is among those which have witnessed the highest increase in the proportion of households using more than 10% and 25% of the expenditure on healthcare.In June 2021, the Niti Aayog estimated that at least 400 million people or about 30% of the population did not have any financial protection for health, leading to high out-of-pocket expenditure and impoverishment.

It also estimated that the actual uncovered population would be higher due to existing coverage gaps in PMJAY and overlaps between schemes.Govt fixes prices of 53 popular drugsTheNational Pharmaceutical Pricing Authority has fixed the ceiling price of two anti-coagulant and 51 other drug formulations, including medicines used to manage diabetes, in a notification dated June 28.

NPPA has set the retail prices for the Dabigatran formulation — an anti-coagulant used to treat and prevent blood clots — at Rs 35.6 for a 150-gram capsule.

Prices of 24 anti-diabetic formulations containing dapagliflozin, another 14 with vildagliptin and two with sitagliptin molecules have also been set.

Paroxetine controlled release and Clonazepam capsules for the treatment of depression will be priced at Rs 15.8per capsule.

The ceiling price is the amount fixed by the government for ‘Scheduled Formulations’ in accordance with the provisions of the Drugs (Prices Control) Order, 2013.

It is the maximum price for retailers (excluding GST, if any) for a given product.

In case the retail price of any of the above formulations is not complied with, as per instant price notification, then the manufacturer/marketing company shall be liable to deposit the overcharged amount along with interest thereon under the provisions of the DPCO 2013, read with the Essential Commodities Act, 1955, the notification said.

In 2022, the health ministry had notified the inclusion of coronary stents in the National List of Essential Medicines (NLEM), 2022, to make the life-saving medical devices more affordable.

Doctors say the inclusion of stents in NLEM will help reduce the cost of angioplasty — a minimally invasive procedure to open up blocked arteries — and thus make it more accessible.