How hospitals in collusion with pharma firms are burning a hole in your pocket

If you thought easy availability and discounted prices of medicines were why people flocked to chemist shops opposite India’s topmost hospital – the All India Institute of Medical Sciences (AIIMS), think again.

India Today has exclusive access to quotations from reputed pharmaceutical companies to hospitals and stockists that show how pharma firms are hand-in-glove with hospitals to fleece cancer patients. While hospitals receive a particular life-saving drug from pharma firms for a nominal cost, the former charge the patients many times that cost for the same.

This nexus explains why most poor patients can’t afford the proper treatment they need and queue up outside chemist shops opposite AIIMS.

Sample this. Emcure oncology pharma quotation offers Temecure 250 mg to an Amritsar-based cancer hospital at just Rs 1,950 while patients have to shell out Rs 18,647 for treatment. While one vial of Pemcure 500 mg costs patients Rs 16,500, the hospital has to pay a meagre Rs 3,190 for it.

PATIENTS PAYING MANY TIMES OVER COST OF DRUGS AT HOSPITALS

Now take a look at the margins offered to the hospitals by Reliance Life Sciences for cancer drugs. Trasturel 440 mg is offered at Rs 30,875 to the hospital, but the patients will have to pay Rs 58,602 for the same. Another drug Rituxirel 500 mg MRP costs a patient Rs 36,916, which  is more than twice the price the hospital pays for it – Rs 14,970.

Even drugs used for heart ailments are sold to patients at exorbitant prices. A quotation from Abbot, a reputed pharma company shows branded drugs being offered to hospitals at a price three times lower than the MRP.

Retelex 18mg, an anti-coagulant used during heart surgery is offered at just Rs 18,000 while its MRP is Rs 32,700. Eptifab 100ml, which is used to treat heart diseases, is offered at just Rs 3,500 while its MRP is 12,331.

India Today contacted some of these pharma companies to understand the huge price gap, but none got back to us. Industry sources say that hospitals are offered cheaper drugs since they buy in bulk.

But a visit to a crowded oncology department OPD at the country’s premier hospital AIIMS shows that sales representatives of pharma companies are trying to lure patients with prescriptions for expensive drugs, offering them better discounts than those available at chemist shops.

Health Activist Raj Narain says, “Big hospitals, whether government or private, have become centers of loot. Patients suffering from serious diseases like cancer, cardiac or kidney ailments are fleeced by the touts of pharma companies who roam about freely in these hospitals. These patients are offered higher discounts than market price. There is no control of hospitals on these touts of pharma firms. At times, doctors are also hand-in-glove.”

As per industry figures, the business of pharma companies in the country is well over Rs 1 lakh crore. The All India Drug Action Network alleges that 25 per cent of this amount is earmarked for medical corruption which goes to doctors, bureaucrats and politicians. The Modi government has asked doctors to prescribe generic drugs, which are relatively cheaper. But even these generic drugs have different prices from patients, stockists and retailers.

DOCTOR’s ACCOUNT

Dr G S Grewal of Alliance of Doctors for Ethical Healthcare told India Today, “The industry says it will stop our R and D, it will stop our production when you are giving me a medicine at Rs 200 for which the MRP is Rs 690. The company has covered everything including the stockist and retailer margins. Why should the government allow this arbitrary MRP? Just because the patient is helpless, this is a massive scandal. We are happy that the Prime Minister has started talking about this. Earlier nobody was even talking about it.”

The Alliance of Doctors for Ethical Healthcare has given a memorandum to the Prime Minister demanding, “An unsuspecting patient has no reason to pay the MRP mentioned on the drugs or implants, which is highly inflated and exorbitant. The MRP on drugs must be meticulously monitored, regulated and strictly enforced.”

The All India Drug Action Network has demanded auditing of all medical procedures, implants, stents. It wants all the data to be audited by an independent team to maintain transparency. Dr Meera Shiva of the All India Drug Action Network says, “Nobody consumes medicines by choice, the clause of bringing only the drugs in the National List of Essential List of Medicines under the Drug Price Control is flawed and is an escape route for the pharma companies to evade price control.”

The Alliance of Doctors for Ethical Healthcare and All India Drug Action Network have demanded that its high time that all the medicines be brought under the ambit of essential drugs. Following a nod from the Modi government, the National Pharmaceutical Pricing Authority (NPPA) reduced stent prices. Recently, the NPPA held meetings to discuss capping prices of medical devices like orthopaedic implants and intraocular lenses, but capping of drug prices is still a far cry.

MODI GOVERNMENT’s RELIEF FOR HEART PATIENTS

In Februrary, the Modi government gave a huge relief to heart patients by reducing the prices of coronary stents by upto 85 per cent. This came after the government’s decision to include stents in the National List of Essential Medicines and their classification as a scheduled drug. Surprisingly, the National List of Essential Medicines includes only 376 life-saving drugs.

NPPA Chairman Bhupendra Singh told India Today, “NPPA keeps on monitoring the prices of drugs and notified devices on a regular basis. About 20 to 22 per cent drugs are under price control and the rest are not. Government is committed to providing affordable drugs to people and needful intervention is done wherever necessary after due diligence and following the due process as prescribed under the relevant law.”

The National Health Policy 2017 document says that out of the pocket expenditure on health pushes, nearly 6.3 crore people are below the poverty line, out of which the expenditure on drugs was to the tune of 67 per cent.

Source : India Today

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