AKCDA urges NPPA to bring all surgical items under DPCO to avoid huge margins given to hospitals by manufacturers

Wednesday, July 26, 2023,

In a step towards forcing the National Pharmaceutical Pricing Authority (NPPA) for fixing a uniform price system for all surgical instruments and products sold through private medical shops and hospital pharmacies, the All Kerala Chemists and Druggists Association (AKCDA) has wanted the Union health ministry to take steps to monitor and regulate the prices of all medical devices and surgical products and to bring them under the purview of Drug Price Control Order (DPCO).

According to the office-bearers of the association, there is a huge difference in the prices of surgical products sold through retails chemist shops and the hospital pharmacies. The hospitals are charging the prices on MRPs, but the same products are sold to the patients by the retail chemists at a price far less than the MRP printed on the packets. This happens because the manufacturers supply the products to a distributor at a comparatively lesser rate than the MRP and they supply to the hospitals on a huge margin. However, the hospitals are charging the MRP prices from the patients without any reduction.
 
ML Jayaraj, general secretary of the association, said because of this huge margin given by the companies, the private healthcare centres are making huge profits out of the sale of decontrolled medical devices and surgical products, so the pharmaceutical pricing authority should seriously consider this aspect of the issue and take steps to regulate the sale of these products by bringing them under DPCO. He said he has written letters to the Union health minister and also to the NPPA chairman asking them to ponder over the issue carefully so as to fix a ceiling price for medical and surgical items which can be done through orders under the Essential Commodities Act 1955.
 
Jayaraj further alleged that certain big distributors supply the products to some discount pharmacies on the same margins as given to the hospitals. So, the association will soon conduct a special meeting for the wholesalers to sensitize them about the seriousness of the problem.
 
Responding to the issue, the joint drug controller of the Jharkhand drug control department, Suman Kumar Tiwari, who is looking after the medical devices industry in the state, has informed that the Union government will shortly discuss the issue in the parliament and there will be two classes of medical devices, controlled and decontrolled, which will include all the surgical instruments and products. He said he has forwarded a list of devices to the NPPA for inclusion in the list and the national pricing authority is thinking of all aspects of the issue.
 
However, Tiwari said this is not the right time to make such a demand that all the products should be brought under the purview of DPCO because the medical devices manufacturing industry in India is fragmented and there are a lot of big players importing the materials from China and the UK. Only 30 per cent of the medical devices used in India are made in the country, the remaining products are imported which are manufactured using sophisticated technologies. The Indian manufacturers cannot compete with the foreign manufacturers in the case of medical devices. So, it is not the right time to include all the devices into the list of national medical devices, but a few of them can be. He said once India reaches a saturation point in the production of quality medical devices, we can raise the demand to bring all the products under NPPA control.
 
Tiwari said the National Institute of Biologicals (NIB) was earlier asked to conduct a study on the issue and the director of the NIB, Dr. Surinder Singh, had submitted the report to the government. Accordingly, the government of India had wanted the NPPA to take proper steps on the matter. As a result, the NPPA is implementing it one by one. Tiwari said he will meet the NPPA chairman next week and bring this issue to his attention.
 
But according to the former state regulator of drugs in Tamil Nadu, M Sivabalan, said it is not practically possible to fix ceiling prices for all medical devices and surgical products because of several technical issues and manufacturing industry problems. He said the traders can demand it, but the industry cannot support it. But he said the hospitals are charging very huge prices on medical devices and surgical items, and some hospitals are not even allowing the patients to buy the products from outside. 
 
Valiyakath Anvar, treasurer of AKCDA said he sells a urine collecting bag for Rs. 20, but the hospital is charging a price of Rs. 150 which is the MRP printed on the packet. Similarly, an IV infusion set is priced at Rs. 120 by the companies, but the retail chemists sell them at less than Rs. 30. While the hospitals are charging an MRP of Rs. 250 for a nebulizer mask, the chemist shops in Kerala sell the product for Rs. 50 only. An IV cannula is available for Rs. 8 from any medical shop in Kerala, whereas it is sold through hospital pharmacies at a price of Rs. 73. The difference in the price of Foley Catheter is very big everywhere as it is sold for Rs. 56 through chemist shops and for Rs. 114 through private hospital pharmacies. Anvar said he is charging a nominal rate for all cotton and bandages but that is also charged highly by the private hospitals in Kerala.  

Sujith Kumar, Kerala drug controller, said the huge margin given by the manufacturers to the hospitals are not beneficial to the patients as the hospitals charge the hundred percent MRPs from the poor patients coming to the hospitals. He said a uniform price system for all medical devices and surgicals are necessary irrespective of hospitals or private enterprises.

PHARMABIZ.com