KOCHI: Recently, during the Question Hour at the Lok Sabha, the Union Health Minister produced data showing the per capita expenditure on medicines in the country.

The data showed that the per capita Out of Pocket Expenditure for both prescribed and over-the-counter medicines was very high in Kerala compared to other states. As per the National Healthy Accounts (NHA) estimates, the per capita Out of Pocket Expenditure for prescribed medicines stood at Rs 2,270 and for over-the-counter medicines, it was Rs 297.

But what’s the reason? According to Dr Samuel Koshy, state president of, the Indian Medical Association (IMA), there are many reasons. “The very first one is that the Keralites are very health conscious. We tend to rush to the hospital even if we sneeze,” he said.

When it comes to health, Keralites never take chances, he added. “If education and health are taken together, it can be seen that the Keralites will easily place health first and then education. Education also plays a part. People here are more aware of the consequences of dilly-dallying when it comes to their health. We prioritise health,” he said. According to him, another reason might be the preference among Keralites for specialist treatment.

“In the past, people might have tried to solve their health issues by first trying out the traditional medicines and then opting for the allopathic treatment. However, today, people have the tendency to directly seek out specialists and they are not bothered about the cost,” said Dr Samuel. He cited an increase in lifestyle diseases in the state as another reason for the increased expenditure on medicines.

“Diseases like diabetes and obesity have become very common. It should be noted that in the case of diabetes the patient has to be on medicines for his entire life. Then comes the associated health issues that too need the help of medicines,” said Dr Samuel. According to Dr N K Sanil Kumar, Department of Urology, Lisie Hospital, another reason behind the increased expenditure is the easy accessibility to healthcare facilities.

“Unlike in the North Indian states, people living in the rural areas too have access to very good modern healthcare facilities. For example, a person visiting a nearby town might drop in at a clinic to get their health checked. Once that happens, medicines, if prescribed, would be bought and so will an unplanned expenditure happen,” he added.

According to Dr Samuel, another factor is the easy availability of drugs. “We have medical stores nearly everywhere. People don’t have to go very far to buy medicines, be they prescribed or over-the-counter ones,” he said.

This reasoning was backed by O R Murugan, a wholesale dealer of medicines in Ernakulam. “In the past two years, the number of medical shops in the state has doubled,” he said. COVID also played a big part, he added.

According to him, even as other sectors suffered huge losses, the pharmacy was safe and stable.