India’s Problem of Overtreatment and Overmedication

15 Oct 2026

Tags: Social Justice   Social Services   Health sector issues

Source: The Hindu

Context: Advances in medical technology have improved diagnosis and treatment, but overtreatment and overmedication are rising concerns. India faces a dual burden: unnecessary medical interventions for some and inadequate access to essential healthcare for others.

Major Causes of Overtreatment

• Excessive testing: Unnecessary screening and diagnostic tests can produce false positives, anxiety, incidental findings, further investigations and treatment for conditions that may never cause harm.
• Fragmented healthcare: Excessive dependence on specialists and superspecialists can lead to multiple prescriptions, duplication and inadequate coordination of care, especially among patients with multiple chronic conditions.
• Polypharmacy among older adults: A 2021 systematic review and meta-analysis reported polypharmacy in about 49% of older Indians; a 2025 study found roughly one-third of older adults took five or more prescribed medicines, with potentially inappropriate medicines identified in 28.8% of cases.
• Commercialisation of healthcare: The sale of laboratory tests, scans, procedures, supplements and monitoring devices, combined with the fee-for-service model, can incentivise greater service utilisation rather than clinically necessary care.
• Health insurance-related moral hazard: Insurance may encourage patients and hospitals to favour costlier interventions because the immediate financial burden is partly borne by insurers, even when procedures offer limited clinical benefit.
• Patient expectations: Patients may perceive prescriptions, scans and investigations as evidence of effective treatment, while reassurance, observation and lifestyle advice may appear inadequate.
• Defensive medicine: Doctors may order additional tests or procedures to avoid missing rare diagnoses or facing litigation, overlooking the risks of testing and the discovery of harmless abnormalities.

Consequences of Overtreatment

• Diagnostic and treatment cascades: An incidental finding may trigger repeated investigations, a diagnosis, long-term medication or surgery, even when intervention is unnecessary.
• Patient harm: Unnecessary interventions can cause adverse drug reactions, drug interactions, anxiety, complications and avoidable financial expenditure.
• Polypharmacy and inappropriate medication: Multiple prescriptions increase the risk of interactions, duplication and medicines whose benefits no longer justify their risks.
• Misallocation of resources: Excessive spending on low-value care can divert healthcare resources from essential primary care, affordable medicines and timely treatment.

Global Initiative: Choosing Wisely

• The Choosing Wisely movement promotes informed discussions between doctors and patients about unnecessary or low-value medical interventions.
• Between 2012 and 2023, nearly 80 specialty societies worldwide published close to 700 recommendations identifying tests and treatments that clinicians and patients should question.
• The movement emphasises evidence-based decision-making, patient participation and avoiding interventions whose potential harms outweigh their benefits.

Measures to Address Overtreatment in India

• Strengthen primary healthcare: Make functional primary care and family physicians the first point of contact for non-emergency needs, ensuring appropriate referrals, coordinated prescriptions and continuity of care.
• Institutionalise medication reviews: Prescriptions should carry review dates and, where appropriate, stop dates. Older adults and patients taking five or more medicines should undergo periodic reviews to assess indications, benefits, duplication, interactions and opportunities for deprescribing—the supervised reduction or discontinuation of unnecessary medicines.
• Develop India-specific guidelines: Professional medical societies and the Indian Council of Medical Research (ICMR) should prepare lists of low-value tests, treatments and procedures, integrating them into medical education, accreditation and quality-improvement programmes.
• Measure avoidance of unnecessary care: Hospitals should assess not only whether recommended treatments were provided but also whether unnecessary investigations, medicines and procedures were avoided.
• Promote informed patient participation: Before undergoing a test or treatment, patients should ask:
  • Why do I need it?
  • What happens if I wait?
  • What are its potential benefits and risks?
  • What are the alternatives?
• Reform payment and insurance systems: Incentivise clinical outcomes, appropriate care and continuity rather than the volume of tests and procedures performed.

Key Concepts for UPSC

• Overdiagnosis: Identifying a condition that would never have caused symptoms or harm during a person's lifetime.
• Overtreatment: Providing medical interventions that offer little or no net benefit compared with their potential harms.
• Polypharmacy: The concurrent use of multiple medicines, commonly defined in research as five or more medicines; it is not inherently inappropriate when every medicine is necessary.
• Deprescribing: A planned, supervised process of reducing or stopping medicines when their potential harms outweigh their benefits or their original indications no longer apply.
• Moral hazard in health insurance: Changes in the behaviour of insured patients or providers that may increase healthcare utilisation or costs because the direct financial consequences are partly transferred to another party.

Conclusion

• Medical progress requires not only better diagnostic tools, medicines and procedures but also clinical restraint. Strengthening primary care, improving prescription reviews, reducing financial incentives for unnecessary interventions and promoting shared decision-making can help India achieve more appropriate, equitable and patient-centred healthcare.