At the Postgraduate Institute of Medical Education and Research (PGIMER), a patient has the choice to get fleeced or save herself from open wallet surgery. But it all depends on the patient and how well she knows the sprawling campus.
An investigation carried out by Chandigarh Newsline over the last month has revealed that the cost of a medicine can vary widely on the campus, sometimes in a range of Rs 1,500, but the hospital provides no information on or directions to the chemists who charge the least. The two most expensive outlets are located at the Emergency and Trauma centres, where patients and their attenders are at their most vulnerable as the patient needs urgent attention and time is of the essence.
These two outlets are also the most crowded because of the heavy rush of patients arriving in critical condition at Emergency and Trauma Centre. Chandigarh Newsline purchased four different medicines widely prescribed by doctors at the hospital from five chemist outlets located inside the campus, and found a huge discrepancy in the costs. Each chemist stocked a different brand of the identical medicine, that is, the same salt.
The medicines are known by the following salt names: Meropenem 1 gm (antibiotic injection); Labetalol injection 4 ml (for treating high blood pressure); Amoxicillin and Clavulanate Potassium tablets (antibiotic); and Atorvastatin tablets (to improve cholesterol levels). The highest total bill for these four medicines together was Rs 1,954 at the chemist at Nehru Emergency, and the lowest was Rs 400 for the four medicines at Jan Aushadi in OPD block. The two outlets are in two different buildings located at a 10-minute walking distance from each other, but a newcomer to the hospital would not know that. Each of the five outlets sold a different brand of the same medicine, and declared they did not have any other brand.
At the Nehru Emergency, there is only one private chemist. It was at this shop that the bill amount for the four medicines totalled Rs 1,954. The patients here have diverse health problems that need to be attended to immediately, but accident, assault and burn cases are treated separately at the Advanced Trauma Centre located in the same building. PGI’s Nehru emergency remains packed round the clock. When doctors hand over a list of medicines needed for the treatment, the first chemist shop that the family members/attenders see and head towards is this private outlet.
There is no signage or any other information device to tell patients and their families that there are two other chemists in the same building — a second private chemist on the ground floor below the Trauma Centre; and the inexpensive Amrit outlet near the reception at the main entrance of the building, which is, however, not used by either emergency or trauma patients. Only internal patients use this main entrance.
Of the four medicines billed at the private chemist at Nehru Emergency, the highest priced was M-Penem 1 gm injection (Meropenem) at Rs 1,550, that too after a discount of 45 per cent. The MRP for this injection at this shop was Rs 2,850. The total bill amount was Rs 3,348, and after a discount of Rs 1394 on the total bill, it became Rs 1,954. On the ground floor below the Advance Trauma Centre, is the second private outlet. At this shop, the same four medicines came to Rs 905. Here again, it was Meropenem that was the most expensive of the four medicines. But here, the brand name is Acupenem 1 gm injection, priced at Rs 646 (MRP), and after a 15 per cent discount, Rs 549.
In the main block of the same building is the government-controlled Amrit outlet (Affordable Medicines and Reliable Implants for Treatment). Even an increased quantity of the same four medicines cost only Rs 638 altogether. Here too, the most expensive was Meropenem, sold under the brand Meroplan. The MRP was Rs 3,248, but the outlet gave a 93 per cent discount, which brought down the price to just Rs 221.76, including taxes. Based on MRPs of the four medicines, the total bill was Rs 4,030, but after the discount, got slashed to under 16 per cent of that.
There are also two government-run Janaushadhi outlets at PGIMER. Here, only generic medicines are sold under the salt name. One is in New OPD block, and the other at Gol Market. At the OPD Block, this pharmacy had only three of the four medicines, and the total bill of the three was Rs 316. Meropenem, the most expensive of the four medicines, was available for Rs 255.41.
Right next to this is a private outlet at new OPD, where these four medicines together cost Rs 2,607, but after a discount, came to Rs 985. Here, Meropenem was available as Megmacer 1 gm injection, with an MRP of Rs 2,100, but after a discount of 73 per cent, the billed price was Rs 553.35.
The pharmacies are crowded, and customers usually accept the brand that those manning the counters hand out to them. At all the shops, queries about other brands are met with: “Only this one is available with us”.