Steep medicine markups came under the scrutiny of the Supreme Court again on Tuesday with the centre being questioned on the same. The Supreme Court has asked the government about steep markups asking how hospitals could justify charging patients several times the procurement cost of life-saving drugs. A case was cited in which a hospital allegedly charged Rs 1.3 lakh for a cancer injection that was available to a medical distributor for Rs 11,000. A bench of Justices Vikram Nath and Sandeep Mehta questioned the justification for such a massive price difference, saying hospitals must find other ways to sustain their operations rather than burdening patients with excessive medicine costs. The court was hearing two petitions concerning medicine pricing, trade margins and the regulation of drug prices in India.
The bench referred to the case of a medical distributor whose wife was undergoing cancer treatment at a private hospital. The distributor reportedly informed the hospital that the injection being used during chemotherapy was available to him at a dealer price of Rs 11,000. However, the hospital allegedly refused to administer the injection supplied by him and charged Rs 1.3 lakh for it. “The government is allowing this to happen. It is under the government's own eyes that it is happening,” the bench told Centre.
The distributor told the court, "Sir I am myself a dealer and to me the injection comes at Rs. 11,000 dealer price. The hospital refused to administer that injection and charged Rs. 1,30,000 for that injection"
The court also observed that cancer patients and their families are particularly vulnerable because they have little room to negotiate medicine prices when treatment is at stake. The Supreme Court also asked of the existing regulatory framework was controlling medicine prices and asked why the government was allowing such wide differences between the prices at which medicines are supplied to retailers and the amounts ultimately charged to patients.
The centre, represented by Additional Solicitor General Aishwarya Bhati, submitted that medicine prices in India were among the lowest in the world. It also said the government's policy was not to control the entire pharmaceutical ecosystem.
"India already has one of the lowest prices in the world. The dichotomy is there which we are addressing from time to time", the Centre told the Court. The hearing also saw the court deliberate on the centre's decision to regulate trade margins on anti-cancer medicines by capping them at 30% of their maximum retail price for the drugs covered under the policy.
The court was hearing a public interest litigation (PIL) filed by advocate Kishan Chand Jain seeking mandatory generic drug prescriptions, strict initial price controls on non-scheduled medicines, and statutory margin caps on medical devices under the Drug Price Control Order (DPCO). The bench questioned why similar restrictions could not be extended to other medicines and raised concerns about the gap between the price to retailer and the MRP.
Senior advocate Mukul Rohatgi, appearing for private hospitals, argued that private healthcare providers were necessary because the public healthcare system was overstretched. He said hospitals had substantial infrastructure and operational expenses and raised concerns about patients bringing medicines purchased outside the hospital, including the risk of spurious drugs.
Speaking to NDTV, Dr. Ashish Joshi Co-Founder, MOC Cancer Care Centre spoke on the most important component of critical care - Affordability. He says, "While advancements in oncology have significantly improved treatment outcomes, the high cost of certain cancer drugs continues to be a major challenge for patients and their families. The proposed trade margin caps are a positive step towards reducing out-of-pocket expenditure and making essential cancer medicines more accessible. For patients requiring prolonged treatment, even a modest reduction in drug prices can translate into meaningful cumulative savings. The focus must remain on ensuring that every patient has access to the right treatment at the right time, without financial constraints becoming a barrier to care." he said. The Supreme Court reserved its order after hearing the submissions
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