Indian regulators this week flagged the country’s hospitals for “unethical profiteering” from “exorbitant” markups – some as much as 2,000% – for commonly used medical devices.
India’s National Pharmaceutical Pricing Authority – which has already slapped price caps on stents and other devices and is auditing alleged hospital overpricing on stenting procedures – cited the markups on syringes, cannulae and catheters.
“The profit margins in the non-scheduled devices used in the three cases (syringes, cannula and catheters) are exorbitant and clearly a case of unethical profiteering in a failed market system,” the agency wrote in a Feb. 20 report, noting that “the major beneficiaries of profits in all these cases because of inflated MRPs have been hospitals rather than drugs and devices’ manufacturers.”
The report was prompted by complaints from the relatives of patients who died at “four reputed private hospitals” in New Delhi.
“In each case, NPPA got complaints of overpricing and inflated bills,” according to the report.
Here’s a look at some of the NPPA report’s findings, factoring in the amount of product involved in each example:
| Device | Distributor [INR (USD)] | Purchase [INR (USD)] | MRP [INR (USD)] | Billed to patient* [INR (USD)] | Procurement margin (%) | Distributor margin (%) |
| IV Infusion Set | 5.20 ($0.08) | 8.39 ($0.13) | 115.00 ($1.77) | 2,070.00 ($31.91) | 1271% | 2112% |
| IV Set Vented | 9.50 ($0.15) | 8.46 ($0.13) | 115.00 ($1.77) | 2,070.00 ($31.91) | 1259% | 1111% |
| Syringe Disposable Without Needle | 13.60 ($0.21) | 15.29 ($0.24) | 200.00 ($3.08) | 13,400.00 ($206.54) | 1208% | 1371% |
| Syringe Disposable | 13.60 ($0.21) | 15.29 ($0.24) | 200.00 ($3.08) | 12,000.00 ($184.96) | 1208% | 1371% |
| Syringe Disposable | 13.60 ($0.21) | 15.90 ($0.25) | 205.00 ($3.16) | 4,100.00 ($63.19) | 1189% | 1407% |
| Syringe Disposable Luer Lock | 1.12 ($0.02) | 1.61 ($0.02) | 19.00 ($0.29) | 1,140.00 ($17.57) | 1080% | 1596% |
| Syringe Disposable | 1.20 ($0.02) | 1.61 ($0.02) | 19.00 ($0.29) | 665.00 ($10.25) | 1080% | 1483% |
| Syringe Disposable | 2.57 ($0.04) | 3.26 ($0.05) | 37.00 ($0.57) | 37.00 ($0.57) | 1035% | 1340% |
| Syringe Disposable With Needle | 1.66 ($0.03) | 2.07 ($0.03) | 23.00 ($0.35) | 483.00 ($7.44) | 1011% | 1286% |
| Syringe Disposable | 1.28 ($0.02) | 2.07 ($0.03) | 23.00 ($0.35) | 1,564.00 ($24.11) | 1011% | 1697% |
| Syringe Disposable | 1.51 ($0.02) | 2.08 ($0.03) | 23.00 ($0.35) | 1,545.00 ($23.81) | 1006% | 1423% |
| Syringe Disposable With Needle | 2.21 ($0.03) | 3.21 ($0.05) | 35.00 ($0.54) | 35.00 ($0.54) | 990% | 1484% |
| Suction Cath Tc 12F | 9.50 ($0.15) | 6.63 ($0.10) | 64.00 ($0.99) | 64.00 ($0.99) | 865% | 574% |
| Suction Cath Plain 12F | 6.40 ($0.10) | 5.79 ($0.09) | 52.00 ($0.80) | 676.00 ($10.42) | 798% | 713% |
| Suction Cath Plain 10F | 6.40 ($0.10) | 5.79 ($0.09) | 52.00 ($0.80) | 1,248.00 ($19.24) | 798% | 713% |
| Suction Catheter Tc 10F | 9.50 ($0.15) | 6.63 ($0.10) | 59.00 ($0.91) | 59.00 ($0.91) | 790% | 521% |
| Photo Fusion IV Set | 20.43 ($0.31) | 25.76 ($0.40) | 215.00 ($3.31) | 1,075.00 ($16.57) | 735% | 952% |
| Syringe Disp W/O Needle 10Ml | 3.90 ($0.06) | 2.60 ($0.04) | 18.50 ($0.29) | 2,645.50 ($40.78) | 612% | 374% |
| Syringe Unolock L/M W/O Needle 2Ml | 1.54 ($0.02) | 1.24 ($0.02) | 8.50 ($0.13) | 1,181.50 ($18.21) | 585% | 452% |
| Syring L.Slip 5Ml W. Needle | 2.52 ($0.04) | 2.42 ($0.04) | 15.50 ($0.24) | 1,271.00 ($19.59) | 540% | 515% |
| Syringe L.Slip 10Ml W.Needle | 3.90 ($0.06) | 3.28 ($0.05) | 21.00 ($0.32) | 735.00 ($11.33) | 540% | 438% |
| Syringe L.Slip 10Ml W.Needle | 3.71 ($0.06) | 3.21 ($0.05) | 20.00 ($0.31) | 3,700.00 ($57.03) | 523% | NA |
| Syringe L.Slip 5Ml W. Needle | 2.05 ($0.03) | 2.42 ($0.04) | 14.50 ($0.22) | 217.50 ($3.35) | 499% | 607% |
| Syring L.Slip 5Ml W. Needle | 2.52 ($0.04) | 2.42 ($0.04) | 14.50 ($0.22) | 1,377.50 ($21.23) | 499% | 475% |
| Syringe L.Slip 10Ml W. Needle | 3.90 ($0.06) | 3.27 ($0.05) | 19.50 ($0.30) | 624.00 ($9.62) | 496% | NA |
| Syringe L.Slip 10Ml W. Needle | 3.71 ($0.06) | 3.21 ($0.05) | 19.00 ($0.29) | 1,900.00 ($29.29) | 492% | 412% |
| Syring L.Slip 2Ml W. Needle 2Ml With Needle | 1.96 ($0.03) | 1.59 ($0.02) | 9.00 ($0.14) | 1,683.00 ($25.94) | 466% | 359% |
| Syringe Unolock L/M W/O Needle 5Ml | 1.96 ($0.03) | 1.70 ($0.03) | 9.50 ($0.15) | 1,387.00 ($21.38) | 459% | NA |
| Syringe Luer Lock 2Ml/3M,L W.Needle 3Ml | 1.96 ($0.03) | 1.62 ($0.02) | 9.00 ($0.14) | 18.00 ($0.28) | 456% | 359% |
| Iv Cannula Adult | 39.05 ($0.60) | 23.84 ($0.37) | 132.00 ($2.03) | 528.00 ($8.14) | 454% | 238% |
| Syringe L.Slip 2Ml W. Needle | 1.96 ($0.03) | 1.59 ($0.02) | 8.50 ($0.13) | 1,003.00 ($15.46) | 435% | 334% |
| Mount Catheter Extendible | NA | 52.56 ($0.81) | 280.00 ($4.32) | 2,240.00 ($34.53) | 433% | NA |
| I.V. Cannula | 76.00 ($1.17) | 50.10 ($0.77) | 265.00 ($4.08) | 530.00 ($8.17) | 429% | 249% |
| I.V. Cannula | 76.00 ($1.17) | 50.10 ($0.77) | 265.00 ($4.08) | 265.00 ($4.08) | 429% | 249% |
| T- Piece With In Line Nebuliser Kit | NA | 68.25 ($1.05) | 350.00 ($5.39) | 350.00 ($5.39) | 413% | NA |
| Iv Cannula 20G | 39.05 ($0.60) | 24.22 ($0.37) | 120.00 ($1.85) | 240.00 ($3.70) | 395% | 207% |
| Mount Catheter Extendible | 49.00 ($0.76) | 59.84 ($0.92) | 289.00 ($4.45) | 4,335.00 ($66.82) | 383% | 490% |
| Trach Vent + Hme | NA | 61.40 ($0.95) | 296.00 ($4.56) | 2,072.00 ($31.94) | 382% | NA |
| Syringe Luer Lock 5Ml W.Needle | 2.39 ($0.04) | 2.10 ($0.03) | 10.00 ($0.15) | 140.00 ($2.16) | 376% | 318% |
| Syring L.Slip 20Ml W/O Needle | 6.73 ($0.10) | 6.57 ($0.10) | 31.00 ($0.48) | 1,674.00 ($25.80) | 372% | 361% |
| *including taxes | $1 = INR 64.87 | |||||
