Recent analysis of bills from four reputed private hospitals in Delhi and NCR by the National Pharmaceutical Pricing Authority (NPPA) has put a question mark on the sincerity of private hospitals. As per the reports of NPPA, these hospitals are making profits of up to 1737 per cent on drugs, consumables and diagnostics and that these three accounts for about 46 per cent of a patient’s bill. The NPPA noted that most drugs, devices and disposables were used and sold by the hospitals from their in-house pharmacies and patients didn’t have the choice of buying them from outside where prices could be lower. Institutional bulk purchase by private hospitals, in most cases by their own pharmacy, makes it easier for them to indulge in “profiteering on drugs and devices even without the need to violate the MRPs”, since these are already inflated, stated the NPPA. According to the NPPA’s analysis, hospitals were effectively pushing the pharmaceutical companies to print higher MRPs to get bulk supply orders from them. And it is the patients who have to incur huge out-of-pocket expenditure in hospitalisation cases.
The expenditure on drugs, devices and diagnostics, constituting almost half the billed amount, is not part of the ‘estimate’ or ‘package’ (in case of implants) given by hospitals unlike procedures (about 11 per cent of the bill) or room rent (12 per cent), which are “the more visible components”, stated the NPPA. The profit margins for the hospitals were highest on consumables, ranging from almost 350 per cent to over 1,700 per cent. On drugs that are not under price control, the margins ranged from about 160 per cent to 1200 per cent. Margins on drugs under price control were between 115 per cent and 360 per cent. Elaborating on how patients were billed with high margins on medicines, the regulator said, in case of Adrenor 2 ml injection with an MRP of Rs 189.95, the purchase price to the hospital was Rs 14.70 but was charged at Rs 5,318.60, inclusive of taxes, to patients. The margin on procurement price of the drug used in emergency cases for treatment of potentially life-threatening low blood pressure was 1,192 per cent. Likewise, Todaycef 1 gm injection was billed to patients at Rs 860, whereas, the purchase price of the hospital was Rs 40.32 although the MRP was Rs 430. The margin on procurement price was 966 per cent. For consumables such as three-way stop cock, BI valve, GS-3040, the margins were even higher. The purchase price of the device for the hospital was Rs 5.77 and a 1,737 per cent margin on procurement price was charged, it added. For claiming higher margins, doctors/hospitals preferred prescribing and dispensing non-scheduled branded medicines instead of scheduled medicines, NPPA said.
This is what all is happening in the majority of private hospitals across the country. They have put all ethics and morals aside for the want of money. If it is not so, then how they can overcharge an injection worth Rs. 14.70 at a rate (Rs. 5,319) which no one can imagine? Shame on such doctors who are working in such business hubs. They have lost conscience. They have forgotten their basic motto. They perhaps consider their patients as customers who enjoy shopping at big shopping malls or enjoy a night at five star hotel. But, they don’t know the fact that not every patient visiting them comes from a financially sound family. There are patients who come for treatment after selling their land, cows, buffaloes and gold/silver ornaments if any or taking loan from a rich person at higher interest as the banks already seem to close their doors for such families. If the reports of NPPA are true then we can’t deny the fact that these hospitals may put a patient on ventilator even after his death until the same is required by another patient so that it could never be kept idle. It is not so that patients (or his attendants) are unaware of whole episode. They know everything but are helpless as it is the matter of their life. They don’t want to argue with doctors or hospital administration for the fear of being mishandled. As the of these hospitals are very influential people, general public don’t want to waste time for filling complaints against these hospitals as it knows very well that they manage to escape from the back door with the help of money.
(The author is a teacher of GMS Jakhar Tikri, Udhampur)
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