Upfront payment a roadblock for vaccine availability, small hospitals lag behind

With smaller hospitals in non-metros facing difficulties procuring vaccines, AHPI has facilitated efforts to negotiate with vaccine makers on behalf of some of its members.

Speeding up vaccinations and increasing coverage of the population will happen more effectively when smaller hospitals, clinics and nursing homes are empowered to procure these vaccines that are affordable for them.

4 min readNew DelhiJun 8, 2021 03:00 AM IST First published on: Jun 8, 2021 at 03:00 AM IST

Costs of vaccinations in the private sector may become more affordable with the government’s decision to cap hospital service charges at Rs 150 a dose. However, the accessibility of these vaccines, especially at smaller private facilities and off-site locations, may become more difficult, say some members of the industry.

The problem is not so much the capping of the service charges, but the inability of smaller hospitals, clinics and nursing homes to handle the upfront payment to secure their required supply — an issue earlier raised by healthcare associations like Association of Healthcare Providers India (AHPI) and the NATHEALTH-Healthcare Federation of India.

With smaller hospitals in non-metros facing difficulties procuring vaccines, AHPI has facilitated efforts to negotiate with vaccine makers on behalf of some of its members. However, the association has also been hoping that the government will help ease this burden by assisting in procurement, according to its president, Dr Alexander Thomas.

“We had asked the Centre to buy the vaccines on our behalf, as they would be able to negotiate better prices and our smaller hospitals would be able to afford these vaccines. We will get it faster and we will get it cheaper,” Dr Thomas told The Indian Express.

“However, if smaller private hospitals are still left to fend for themselves, AHPI will continue to negotiate for Sputnik V, Covishield and Covaxin,” he said.

While metro cities have been “overflowing” with vaccines, tier 2 and 3 cities as well as rural and interior areas in India are yet to start, said Dr Thomas. “Our efforts have been to connect vaccine manufacturers to them and we are hoping for some supply in the next couple of weeks,” said Dr Thomas, adding that AHPI has requested its members to provide 10 percent of their supply to those below the poverty line “for free”. The association members had internally decided about 2 weeks ago that its members would not charge more than Rs 150 per dose as service charges as the transportation and cold chain requirements were being taken care of by the vaccine company and inclusive of prices.

“We still request that the purchase of vaccines, even for the private sector, be centralised the way it was previously being done before May,” said NATHEALTH president Dr Harsh Mahajan.

Speeding up vaccinations and increasing coverage of the population will happen more effectively when smaller hospitals, clinics and nursing homes are empowered to procure these vaccines that are affordable for them, he said. “Previously, the government was buying the vaccines at Rs 150 a dose and providing it to the private sector … The private sector did not have to pay money upfront to buy the vaccine,” said Dr Mahajan. “Today, there is a wait of 4-6 weeks after advance payment at a higher price and even costs of vaccine wastage that has to be borne by the private sector. Larger hospitals might be able to absorb these costs, but this might discourage smaller players,” he added.

Some larger hospital chains agree. “We would urge that the vaccine prices for (the) private sector be reviewed downwards as well to enable expansion of access,” said Fortis Healthcare, following the Prime Minister’s address.

While some of the larger private hospitals that The Indian Express spoke to believe that the cap in service charges are manageable within hospitals, it will be difficult to carry out vaccinations outside their facilities. “It will be feasible for on-site vaccinations, because there is now more visibility on the supply that hospitals can expect. With greater volumes in supply, you achieve economies of scale,” said Dr Abhay Soi, chairman and MD, Max Healthcare Institute.

“Vaccinations are more of a social service … we are not looking at making huge profits, so we will be able to manage with a Rs 150 service charge,” said Dr H Sudarshan Ballal, chairman of Manipal Health Enterprises. “It certainly would be a stretch for off-site vaccinations, and we would need more clarity on that from the government,” he added.