After 15 days of treatment for dengue, 7-year-old Adya Singh was declared dead on September 15, 2017, at Fortis Memorial Research Institute [FMRI] in Gurugram. The hospital billed the family nearly ₹16 lakh for the fortnight, charging ₹1,564 for a syringe available at the pharmacist for ₹1.28.
Adya’s case became emblematic of the practice of overcharging by corporate hospitals across India.
On Tuesday, an investigation by the National Pharmaceutical Pricing Authority (NPPA) revealed that hospitals were forcing patients to buy non-scheduled drugs from in-house pharmacies after increasing price margins by nearly 2000% in some cases.
Medical bills
Adya’s father Jayant Singh, who supplied the NPPA with his daughter’s medical bills, said he will not stop till the sector is reformed. He will address a press conference on the issue on Thursday.
Mr. Singh said, “This is extortion. I have filed a writ petition in the Supreme Court demanding that corrective measures [be taken]. The NPPA can only highlight the issue. It cannot correct it because it does not have the authority.”
Adya was admitted to Rockland Hospital on August 27, 2017, and referred to FMRI on August 31, 2017 (Thursday). The family said she was immediately put on ventilator support and remained sedated for the next three days. Her father claimed that doctors were not available on the weekend (September 1 and 2, 2017). The family was billed ₹17,142 for 2,700 surgical gloves, while medical investigations, including blood tests, cost another ₹2.17 lakh.
The case came to light after Union Health Minister J.P. Nadda asked for bill details on Twitter, setting off an investigation by the NPPA.
Over the past six months, NPPA investigated FMRI, Medanta - The Medicity in Gurugram, Max Hospital in New Delhi’s Shalimar Bagh and B.L.K. Super Speciality Hospital in Delhi’s Rajinder Nagar.
The investigation found that dengue patients who died at these four corporate paid a staggering ₹17,79,898 for branded medicines. Branded medicines comprised 25% of their bill against generic medicines which amounted to 4% of the bill at ₹2,84,296.
‘Branded medicines’
“It is amply clear that for claiming higher margins, doctors and hospitals prefer prescribing and dispensing non-scheduled branded medicines instead of scheduled medicines while scheduled medicines under NLEM [National List of Essential Medicines] are supposed to cover all essential medicines,” reads the 14-page report.
Further, most drugs, devices and consumables were used and sold from private hospital’s in-house pharmacy and patients were given no choice.
“This report shines light on a fundamental lie private hospitals routinely say — that they charge as per maximum retail prices [MRPs] as per market requirements. The report reveals that they bulk purchase and print inflated MRPs. This is pure and simple extortion as patients are not allowed to buy the same drugs from outside the hospital, where they are affordable,” said Mr. Singh.
Diagnostic services
The investigation revealed that private hospitals charged more for consumables like surgical masks and gloves, and higher for diagnostic tests like MRIs, CT scans and X-rays than independently run diagnostic centres. Neither diagnostic services nor consumables are under the purview of NPPA and therefore the cost is unregulated.
