When I first joined MGIMS, our “medical store” was really just a humble dispensary. It sat quietly in a corner of the hospital, functional but unassuming. The wooden shelves held loose tablets—aspirin, chlorpheniramine, Nilpyrine—and a few familiar glass bottles: cough sedatives, expectorants, throat paints, ear drops, glycerine magsulf, and zinc oxide ointment. If a doctor wanted something unusual, they had to write a prescription for an outside shop.
The dispensary didn’t run on software; it ran on experience and memory. It was anchored by two dependable compounders, Sudhakar Mitkar and Ambulkar. They knew every bottle, every drawer, and every patient’s face by heart. When both of them retired in 2006, the dispensary lost its soul. Within two years, it shut down for good.
What replaced it was not just a bigger room. It was a completely different way of thinking—about medicines, money, and the dignity of the patients who had to buy them.
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A Dispensary, Not a Pharmacy
In those early years, we stocked what we could and managed shortages the way small hospitals always do: by improvising. The concepts of an organized inventory, batch tracking, expiry alerts, and systematic procurement felt like science fiction. Most of us could not even imagine that a rural teaching hospital could run a modern pharmacy with the discipline of a corporate chain. We were too busy treating patients and making do with what we had.
The change began slowly in 2004, when C-DAC arrived with the ambitious plan of computerising hospital services. A year later, Ajay Gupta built a small part of the pharmacy module. At first, the system hobbled along on two legs—paper and computer—because no one trusted the new method completely. The old registers stayed open, and the new screens flickered beside them, waiting to be believed.
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The Man Who Feared the Mouse
The medical store staff had every reason to feel anxious. For years, their competence had been measured by manual speed—how fast they could decipher a scrawled prescription, find the medicine, and keep accounts in thick registers. Suddenly, a machine arrived and demanded a new, alien vocabulary: clicking, typing, saving, searching.
Mr. Chhagani—who later became our Chief Pharmacist—would often remember those early days with a smile. He confessed he was initially so intimidated that he didn’t even have the courage to touch the mouse. It looked harmless, but to him, it represented the terror of making mistakes in public, of slowing down the queue, of being judged by younger people who seemed to learn faster.
Tragically, Chhagani’s story was cut short. In 2025, just two years before his retirement, he was killed in a road accident when his car collided with a truck. But before he left us, he had transformed from the man who feared the mouse into the man who mastered the machine.
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The Great Migration (2009)
Ritesh, who joined the medical store as a clerk in 2007, remembers the old procurement system as a relic of a slower age. It functioned like a dusty file in a government office. Doctors recommended branded drugs. The medical store had to type letters to companies and send them by post. Companies forwarded lists to distributors. Distributors took their own sweet time. Supplies arrived late—or not at all. Stock-outs were common, and as always, the patients paid the price.
When C-DAC began computerising hospital services, the medical store saw a chance to upgrade properly. We decided to migrate from the old FoxPro program to the newer Oracle-based system. That shift happened on a day I still remember clearly—not because it was dramatic, but because it was symbolic.
It was Maha Shivratri—Monday, February 23, 2009. While the rest of the town was celebrating, the pharmacy staff stayed behind, working through the holiday to migrate every single item of inventory from FoxPro into Oracle. The next morning, the store opened with the new software. It was not just a technical switch. It was a declaration that we were done with half-measures.
Bhavana’s role in this transition remains one of my favourite ironies. She had helped create and run the FoxPro system earlier. Yet she was the one who insisted we replace it with the C-DAC module and integrate it fully with the hospital’s electronic ecosystem. She approached it the way a good cook approaches change: she was willing to retire her own signature dish if she found a better recipe.
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Tenders, Generics, and the Real Meaning of “Affordable”
Technology improved tracking, but the real revolution came from a deeper question: What medicines should we stock—and at what price?
Between 2007 and 2011, we had a Drug and Therapeutic Committee meant to recommend rational drugs. On paper, it sounded ideal. In practice, it faltered. Opinions clashed, and decisions often remained stuck in the safe middle ground between “what is best” and “what is familiar.”
So we changed the approach. We formed a new drug committee chaired by Dr. Poonam Varma Shivkumar, bringing together department heads, the administrative officer, the chief accountant, and the chief pharmacist. It met annually, but it worked with a seriousness that matched the stakes.
In 2009, the medical store got a adrenaline shot in the form of Dr. Rajnish Joshi. Then an assistant professor of Medicine, Rajnish came armed with an MPH and PhD from UC Berkeley and was asked to look after the ailing store. Rajnish was quick, decisive, and impatient with inefficiency. He knew how to rally a team and get work done. Having already played a key role in building our Hospital Information System (HIS), he brought that same clarity to the pharmacy.
Under his watch, procurement became systematic. Tenders and quotations brought prices crashing down. Although Rajnish left Sevagram a year later—moving to AIIMS Patna, Sikkim, and finally AIIMS Bhopal, where he became the Medcine department head and also a Dean—he laid the foundation. Later, Dr. Ramesh Pande took the baton and has carried the work forward for over a decade, improving the system year after year.
In February 2010, we made a decisive shift: we focused on generic and branded-generic medicines, and we digitised the tender process end-to-end. We also revolutionized the pricing. Earlier, like many hospitals, we deducted a percentage from the MRP. But MRP is often a fantasy number, designed for marketing rather than honesty. We moved to a transparent model: Procurement Cost + 20%.
I often think of the ordinary patient with multiple chronic diseases—heart disease, diabetes, hypertension—who needs a cocktail of tablets every day. Earlier, such a patient would bleed money slowly, month after month. With the new system, many could buy their daily medicines for around five rupees a day. In India, that is less than what people spend on a cup of tea without thinking twice.
Even auditors were stunned. Some would stare at the price list and ask, half-suspiciously, “How can you sell this for ₹24 when the MRP is ₹100?” A few were so impressed they bought medicines for their own parents. That was not part of our plan, but I took it as an unintended certificate of credibility.
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Heena and the Digital Turn
Heena joined the medical store as a pharmacist in 2010, taking to the work like a duck to water. “I still remember those days,” she told me. “We prepared purchase orders by hand, and it would take forever to make even one.”
By 2011, that manual labor was history. The team began using the digital system to procure everything—from tablets and syrups to injections, sutures, mesh, staples, stents, balloons, and implants. The entire lifecycle of a medicine—from the moment we needed it to the moment a patient paid for it—became digital, transparent, and trackable.
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The Counter Where Relief Shows on Faces
Over the years, the medical store moved around like a restless tenant. It started near the Obstetrics wards, moved to the old Surgery OPD, and finally, in 2020, found a proper home: a spacious, newly built complex inside the hospital building.
Today, the new store runs like a small airport. There are separate counters for outpatients, inpatients, senior citizens, emergency cases, and dialysis patients. On an average day, it serves around 1,500 patients and generates nearly two lakh rupees in sales.
Not everyone welcomed the change initially. Some doctors worried that “generic” meant “inferior.” We listened, we discussed, and we tightened our quality checks. But we did not abandon our central philosophy: patients must not be punished for being poor.
The fall in prices has been dramatic. A Paclitaxel injection (260 mg), which cost ₹13,500 in 2015, now costs around ₹550. When you see a reduction like that, it doesn’t look like “policy.” It looks like survival.
The most convincing evidence is not in a spreadsheet. It is at the counter. Patients arrive tired, clutching prescriptions, mentally calculating if they have enough cash. Then they hear the amount. Their faces change—first disbelief, then relief, and sometimes, a smile. They look at the pharmacist as if a small miracle has just occurred.
In those moments, I don’t see a pharmacy module or an inventory system. I see what a hospital is supposed to do: make treatment possible.