India's Health System Transformation: Insurance, Primary Care, and Generic Medicines
A government review highlighted the scale of health system expansion over the past twelve years, covering health insurance, primary care infrastructure, and affordable medicines.
Over 44 crore families have been brought under health insurance coverage, with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) serving as the flagship scheme — recognised as the world's largest publicly funded health assurance programme.
More than 1.86 lakh primary care centres (Ayushman Arogya Mandirs, formerly known as Health and Wellness Centres) have been operationalised, shifting India's primary health architecture from a curative to a comprehensive wellness model.
Over 18,000 Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) Kendras now provide generic medicines at prices 50–90% below comparable branded equivalents, with cumulative savings to citizens estimated at approximately Rs 38,000 crore against branded alternatives.
Expansion of AIIMS (All India Institutes of Medical Sciences) and medical college infrastructure has significantly increased the supply of trained health professionals.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)
AB PM-JAY is the health insurance component of the Ayushman Bharat umbrella programme, launched in 2018. It provides cashless, paperless hospitalisation coverage at empanelled public and private hospitals across India.
The figure of 44 crore families insured reflects the cumulative coverage across PMJAY and State Government health insurance schemes layered on top of it — a composite of Central and State schemes working together toward Universal Health Coverage.
Ayushman Arogya Mandirs (Health and Wellness Centres)
Ayushman Arogya Mandirs (AAMs), earlier called Ayushman Bharat Health and Wellness Centres (AB-HWCs), are the primary care infrastructure component of the Ayushman Bharat programme. They were rebranded in 2023.
Key Details
- Over 1.86 lakh AAMs have been operationalised across India as of 2026, serving rural and semi-urban populations.
- They are converted from existing Sub-Health Centres (SHCs), Primary Health Centres (PHCs), and Urban Primary Health Centres (UPHCs).
- Services expanded beyond curative care to include: comprehensive primary health care, non-communicable disease (NCD) management, mental health, oral health, palliative care, and screening for cancers, diabetes, and hypertension.
- The Community Health Officer (CHO) — a mid-level health professional with 6-month training — is the key frontline functionary at each AAM.
- The three-tier primary health structure in India: Sub-Centre (5,000 population) → Primary Health Centre (30,000 population) → Community Health Centre (1,20,000 population).
The 1.86 lakh AAMs represent the largest single expansion of India's primary health infrastructure since the establishment of the PHC network in the 1950s, shifting health delivery from hospitals to community-level comprehensive care.
Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP)
PMBJP is a government scheme that provides quality generic medicines at affordable prices through dedicated retail outlets called Jan Aushadhi Kendras (JAKs). It is implemented by the Bureau of Pharma Public Sector Undertakings of India (BPPI) under the Department of Pharmaceuticals.
The Jan Aushadhi network is the most scalable demand-side medicine access intervention in India's public health toolkit, reducing out-of-pocket expenditure — the dominant driver of medical impoverishment in India.
- AB PM-JAY launched: September 2018.
- Coverage quantum: Rs 5 lakh per family per year.
- Beneficiary base: ~12 crore families / ~55 crore individuals (bottom 40% by SECC 2011).
- Senior citizen extension (70+ years, regardless of income): approved September 2024; additional top-up Rs 5 lakh.
- Cost-sharing ratio (Centre:State): 60:40 (general states); 90:10 (NE and special category states).
- Cumulative PMJAY hospitalisations: 8.59 crore admissions worth Rs 1,19,858 crore.
- Ayushman Arogya Mandirs (AAMs) operationalised: 1.86 lakh (as of 2026).
- Jan Aushadhi Kendras: 80 (2014) → 18,000+ (2026); target: 25,000 by March 2027.
- PMBJP medicine discount range: 50–90% below branded market price.
- Cumulative citizen savings via PMBJP: ~Rs 38,000 crore (estimated, vs branded alternatives).
- BPPI (Bureau of Pharma PSUs of India): nodal agency for PMBJP, under Department of Pharmaceuticals.