NEW DELHI: Gurugram-based Fortis Memorial Research Institute marked up the prices of consumables billed to the family of a seven-year-old severe dengue patient by over 1,700%, shows a new report released by the Indian drug pricing watchdog. The hospital also charged the family as much as 900% for some of the medicines it used in the patient’s treatment.
At the same time, Fortis has said that these prices do not violate the country’s drug pricing laws.
“Fortis Healthcare does not charge any drug or consumables above the printed MRP and there is no violation…It should also be noted that our end price to the patient us very much in line with what other private hospitals in India charge,” said a Fortis Healthcare spokesperson.
Following allegations that Fortis overcharged and was medically negligent in the patient’s treatment, the National Pharmaceutical Pricing Authority (NPPA) last month asked the hospital for details of the medicines and consumables it used in this case.
The family was billed nearly Rs 16 lakh for a fortnight’s treatment for dengue shock syndrome earlier this year, which involved admitting the patient into the paediatric ICU and keeping her on ventilator support.
In an office memorandum released late on Friday, NPPA displayed the prices at which Fortis procured the medicines from distributors, the maximum retail prices at which the hospital billed the family and how much each medicine and consumable was marked up. These revelations come a week after the Haryana health minister’s expert committee found several irregularities and “unethical” practices in the hospital’s treatment of the patient.
NPPA’s latest notification said it has analysed and classified the information received from Fortis into three categories–medicines under price control, medicines not under price control and consumables that were neither under price control nor under the country’s list of essential medicines.
The mark-ups were the highest in consumables at as much as 1,737%. Around 96 types of consumables were used on the patient.
For medicines under price control, Fortis marked up the prices between 5% and 350%. For those not under price control, the family was billed anywhere between 10-200% more than what the hospital had paid distributors for the products.
Consumables like some brands of disposable syringes were billed at a maximum retail price of Rs 200 even while Fortis had procured the product for around Rs 15.29. The family was charged around Rs350 for bed bath towels and wipes, which the hospital had bought for Rs33.60—a 942% mark-up.
Oxygen facemasks bought for Rs 24.68 were billed to the family at an MRP of Rs 190, certain sterile surgical gloves procured for Rs 9.86 were sold for Rs 75 and unsterile examination gloves bought for Rs 1.34 were marked up 609% to Rs 9.50.
“NPPA shall be taking necessary follow up action as per existing law and within its jurisdiction,” stated NPPA in its notification. It did not specify whether the hospital was guilty of overcharging and NPPA chairman Bhupendra Singh could not be reached for comment.
According to the DPCO 2013, the markups for retailers for scheduled drugs are 16% and Fortis, acting as the point of sale to the family in this case, has completely violated this, said Malini Aisola of patient group All India Drug Action Network (AIDAN).
“In the cases of non-scheduled and consumables also, Fortis has kept obscene margins above the procurement prices,” she told ET. According to her, excessive markups charged by private hospitals have become the norm and this called for “immediate” price control on medical devices deemed as drugs.
Fortis’ spokesperson said that looking at individual prices of any single item on the list takes the hospital’s margin or profit “out of context”, as the hospital’s business reported operating profit of 5%-6% over the last four quarters. Fortis also reported a negative profit after tax for the same period, the spokesperson added.