Patients made to overpay for life-saving medicines

Anand Kumar Patel        Last Updated: July 14, 2017  | 09:25 IST
Patients made to overpay for life-saving medicines

Every day, crowds throng the chemist shops opposite the country's premier hospital the All India Institute of Medical Sciences (AIIMS). And easy availability of medicines is not the only reason for the rush.

The chemists here offer 5%-10% discount on drugs to lure customers. But India Today TV has exclusive access to price quotations from reputed pharmaceutical companies to hospitals and stockists that reveal a shocking nexus of pharma companies and hospitals to fleece patients. For instance, Emcure Pharmaceuticals was offering its drug Temcure 250 mg to an Amritsar-based cancer hospital at just Rs 1,950 while  patients have to pay about nine times more at  Rs 18,647.

While a vial of Pemcure 500 mg from the same company costs patients Rs 16,500, a hospital can get it for just Rs 3,190. 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 a hospital but a patient will pay Rs 58,602 for it. Another drug, RituxiRel 500 mg has a maximum retail price (MRP) of Rs 36,916, which is more than twice what the hospital pays: Rs 14,970.

Even drugs for heart ailments come at puffed-up prices. A quotation from healthcare major Abbott shows it offering branded drugs to hospitals at a third of the MRP. Retelex 18mg, an anti-coagulant used during heart surgery, is offered at just Rs 18,000 while the MRP is Rs 32,700. Also, Eptifab100ml that is used to treat heart diseases goes to hospitals at Rs 3,500 while patients have to pay up to Rs 12,331.

The National Health Policy 2017 document says that out-of-pocket expenditure on health pushes nearly 6.3 crore people below the poverty line every year. According to a World Health Organisation study, 89.2% of the expenses of medical treatment is borne by the patients in the country. India Today TV contacted some of these pharmaceutical companies to understand the huge price gap, but none of them came back with responses.

Industry sources, however, say hospitals are offered drugs cheaper since they buy in bulk. But a visit to the crowded oncology OPD at AIIMS revealed sales representatives of pharma firms attempting to pull patients with prescriptions for expensive drugs offering them higher discounts than those available at chemists.

"Patients suffering from serious diseases like cancer, cardiac or kidney ailments are fleeced by touts of pharma companies who roam about freely in hospitals," health activist Raj Narain said. "At times, doctors are also hand in glove."

According to industry figures, the business of pharma companies in the country is worth over Rs 1 lakh crore. The All India Drug Action Network, a group of several NGOs, alleges that 25 per cent of this amount is earmarked for medical corruption, which goes to doctors, bureaucrats and politicians.

The Narendra Modi government has asked doctors to prescribe generic drugs that are relatively cheaper. But even these medicines have different prices for patients, stockists and retailers. "The industry says it will stop our R&D, it will stop our production when you are giving me a medicine at Rs 200 for which MRP is Rs 690," said Dr GS Grewal of the Alliance of Doctors for Ethical Healthcare.

"The company has covered everything including the stockist and retailer margins... Why should the government allow this arbitrary MRP? Just because the patient is in need? This is a massive scandal ... We are happy that this Prime Minister has   started talking about it. Earlier, no one was even speaking on the matter." The Alliance of Doctors for Ethical Healthcare (ADEH) has given a memorandum to the Prime Minister, saying: "An unsuspecting patient has no reason to pay the MRP mentioned on the drugs/implants which is highly inflated and exorbitant. The MRP on drugs be meticulously monitored, regulated and strictly enforced."

The All India Drug Action Network (AIDAN) too has demanded auditing of costs for all medical procedures, implants, stents, etc, by an independent team to maintain transparency. Dr Mira Shiva, who's a member of the network, said, "Nobody consumes medicines by choice. The clause of bringing only the drugs in the National List of Essential Medicines under drug price control is flawed and is an escape route for the pharma companies."

The ADEH and AIDAN have demanded that all medicines be brought under the ambit of "essential drugs". Following a nod from the Modi government, the National Pharmaceutical Pricing Authority reduced rates of stents. The NPPA recently held meetings to discuss capping prices of medical devices such as orthopaedic implants and intraocular lenses. But capping of drugs prices is still a far cry. NPPA chairman Bhupendra Singh told India Today TV, "NPPA keeps on monitoring the prices of drugs and notified devices on a regular basis. About 20 to 22% drugs are under price control."

 In Association with Mail Today

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