Karnataka’s Food and Drug Administration has asked the Centre to intervene against 254 pharmaceutical companies over what it says are extreme gaps between the prices at which medicines are supplied to hospitals and the amounts patients are charged, with some products carrying MRPs more than 70 times their reported landing costs.
The FDA also identified large gaps in the prices of several injectable medicines. Karnataka has also pointed to commercial arrangements between hospitals and suppliers, including rebates, credit notes, free quantities and retrospective discounts. The state has proposed a national framework to determine how much hospitals can charge patients for high value medicines, devices and consumables. It has suggested that an inter-ministerial expert group comprising the Union health ministry, Department of Pharmaceuticals, NPPA, state drug regulators, hospitals, insurers, consumer representatives and clinical experts examine the issue. For expensive cancer and life saving medicines, the state has sought comprehensive limits on trade margins and direct price regulation for a wider range of chemotherapy and targeted therapy drugs.
Among the cases cited by the department, a medicine procured for ₹ 86 was listed with an MRP of ₹ 4,528. Another product bought for ₹ 160 carried an MRP of ₹ 7,110. Cancer drug Cytax 100mg had a reported landing cost of ₹ 342 against an MRP of ₹ 3,836. Nucain 300mcg was listed at ₹ 112 at landing cost and ₹ 1,239 as MRP, while Bivatas 400mg injection had a reported landing cost of ₹ 5,850 and an MRP of ₹ 62,690. Cosate 3 MIU injection was cited at ₹ 340 and ₹ 3,699 respectively.
“The state has argued that the disparity can be particularly burdensome for patients requiring emergency, intensive care, oncology, kidney and AIDS treatment, where medicines, implants and consumables may have to be obtained immediately and patients may have little scope to compare prices or buy elsewhere,” said a senior health department official in the know of the development. Such benefits, it said, can lower the hospital’s actual acquisition cost without being apparent to patients. Karnataka has proposed a national study comparing four figures for selected high value products: the MRP, manufacturer or importer price, hospital’s net acquisition cost and the amount ultimately billed to the patient, according to the officer.
