The National Pharmaceutical Pricing Authority (NPPA) has said that the Fortis hospital at Gurgaon charged as high as 1,700 per cent margin on consumables and medicines used for the treatment of a seven-year-old dengue patient, Adya, who subsequently died of the illness.
Interestingly, the hospital deliberately used expensive medicines despite cheaper versions were available in the hospital pharmacy, according to documents possessed by Outlook.
Fortis Memorial Research Institute, Gurgaon, charged a margin of up to 1,737 per cent on procurement price on a three-way stop cock, the regulator said.
The procurement price of the consumable per unit stood at Rs 5.77 while the hospital charged Rs 106 per unit for the product, it added.
The consumables listed by the NPPA included items such as syringes, gloves and towels among others.
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Last month, the NPPA had asked Fortis Healthcare to provide copies of bills in relation to allegations that its Gurgaon-based hospital overcharged the family of the girl.
The findings of an expert committee also suggest, amongst other things, that Fortis medical hospital offered Adya's father, Jayant Singh, an amount of Rs 25 lakh for an out-of-court settlement which Singh refused. When Outlook contacted Singh over the issue, he said the hospital was yet to get in touch with him since he had made the bribe allegation.
“A hospital representative offered me the money of the November 24 and after I refused, no one has gotten in touch with me”, Singh told Outlook.
The committee report also details how Adya was issued Meropenum injections, a third line anti-biotic, from two different brands which had a huge gap in the MRP. The brand Merocrit, manufactured by Cipla had an MRP of Rs 3112.50 per unit, while another brand, Merolan of the same drug was priced at Rs 499 per dose, a difference of Rs 2,613 per dose.
According to the itemised bill given by Fortis to Singh, the hospital used 21 units of Merocrit, while cost them Rs 65,362, while only 9 units of the cheaper version, Merocrat were used.
While Meropenum is not currently under the list of essential medicines and, hence, not under the price control, organisations such as All India Drug Action Network have been fighting for its inclusion under the national list of essential medicines for the last several years.
“Meropenum is a drug used very often for patients in the ICU and, thus, needs to come under price control. We have been fighting a case with the government for several years to expand the scope of the DPCO to avoid over changing as in the case of Adya,” said Malini Aisola of AIDAN.
Similarly, two different brands of another drug, Human Albumin 5% were issued to the child. The first one manufactured by the name BIOTEST had an MRP of Rs 6350 per unit, while a competing drug by the name BAXALTA had an MRP of Rs 2777 per unit.
As an explanation to this, the registered pharmacist of the Fortis pharmacy said they had issued the same drug which was indented to the pharmacy online from the IPD and only the prescribing doctor can explain the reason for prescribing two different brands with different MRPs with a huge gap, according to the report.
The report also supports the NPPA’s findings about profit margins as high as 1737% which were posted on its website on Saturday. It also mentions that the total bill was charged at a profit margin of 108%.
Regarding the non-scheduled formulations, the NPPA had said the hospital charged the family a margin as high as 914 per cent.
Elaborating, the NPPA said the hospital charged Rs 287.50 for Dotamin 200 mg whose procurement price per unit stood at Rs 28.35, a margin of 914 per cent.
Fortis also charged Rs 3,112.50 for Merocrit 1 GM thus charging a margin of 670 per cent. The hospital had procured the formulation at Rs 404.32 per unit, the regulator said.
Regarding the scheduled formulations which are under the ambit of price control, the NPPA said the hospital charged up to 343 per cent from the family of Adya.
The per unit procurement price of Tranemic by the hospital stood at Rs 15.75 while it was billed at Rs 69.77 per unit to the family.
The regulator gave a list of 39 scheduled formulations, 41 non-scheduled formulations and 96 consumables that were used for the treatment of Adya.
"NPPA shall be taking necessary follow up the action as per existing law and within its jurisdiction," the regulator said.
The reply of Fortis Healthcare could not be obtained at the time of filing the story.
The drug authority's action came after the Union health ministry asked all states to issue strict warnings and take action against hospitals, including private ones, which indulge in malpractices such as overcharging and do not follow standard treatment protocols.
(With inputs from Arushi Bedi)
