PGIMER DOES not regulate the prices of medicines sold at the outlets on its premises. There are more than 10 chemists on the campus.
Each medicine has many brands, and each brand has a different MRP, even though the medicine “salt” and its quantity are identical across brands. The National Pharmaceutical Pricing Authority fixes a ceiling price for hundreds of medicines. Its latest “essential list”, which came out on April 2, contains 869 medicines, and more are added to it with every update.
Amarpal Singh Sawhney, director (pricing) at National Pharmaceutical Pricing Authority in New Delhi, told Chandigarh Newsline that there is a ceiling on the prices of medicines in the essential list. “On April 2, we issued a fresh list for 869 formulations under Drugs (Prices Control) Order,” he said. However, manufacturers are free to fix their MRPs within this ceiling. Sawhney said that all drugs in the market are not in the NPPA list. For drugs not on the list, there is no price control.
Out of four medicines which Newsline purchased from the chemists in PGI, Labetalol and Atorvastatin and Amoxicillin and Clavulanate Potassium are in the NPPA list. Meropenem is not on the list. PGI officials said that the price of a medicine at each of the on-campus outlets also depends on the rent being paid by the pharmacy to the institute. Details provided by the PGIMER’s Public Relations Office show that the chemist shop at the Nehru Emergency is paying a rent of Rs 86,14,231 plus 18 per cent GST every month to PGI. The chemist shop at Advance Trauma Centre has to pay a rent of Rs 21,21,000 plus 18 per cent GST. The AMRIT outlet is paying Rs 99,250. “It is true that there is a difference of rates, but at our level, we have been making it mandatory for the chemists to provide a minimum of 15 per cent discount and they have been providing it as well. We have no control over the MRP,” said a senior PGIMER administration official.
When contacted, PGIMER director Jagat Ram said that “wide difference between the costs of the medicine sold within campus shouldn’t happen”. “We will look into the matter and find why there is a difference in the cost of medicines,” he said. He added that the PGIMER was planning to start its own pharmacy at the institute “in a few months”. According to the plan, at least 50 per cent discount would be provided to the patients. Official sources said that PGI was planning to open an AMRIT outlet in Trauma centre as well.
Ram Kumar, whose cousin was admitted to PGI’s Emergency last week, told Chandigarh Newsline that the doctor who was seeing his patient asked him to get medicines from any chemist shop. “We went to the nearest one. We don’t know if there is any other chemist shop at PGI. We have been purchasing medicine from this shop only,” said Kumar, pointing to the private chemist shop at Nehru Emergency, the most expensive of the five outlets in the CNL investigation.
Association of Resident Doctors (ARD) president Dr Sombir Singh said resident doctors do not tell patients to purchase the medicine from one or another chemist. “It is the choice of the family member or the attendant to purchase the medicine from any chemists in or outside PGI,” he said. Some doctors, however, do at times point patients towards the less expensive outlets, but it is not a regular practice.
Dr Rajesh Chhabra, president, PGI Faculty Association, told Chandigarh Newsline that the only way to provide relief to the patients who purchase the medicines at the hospital is that the institute should increase the efforts to open its own pharmacy. “The best way is for PGI to procure the medicines and sell without profit. That is the only option in sight if you want to provide medicines at cheaper costs,” he said.
Dr Chhabra adds, “If a doctor is prescribing a particular brand, it is the doctor’s trust and reliability on that particular brand of medicine. What’s happening is that if we prescribe salt of the medicine only, branding happens at chemist’s level. Then the chemist provides the medicine on which he makes maximum profit. All the medicines are not available at Janaushadhi store. It is the duty of the government to ensure the quality and availability of generic drugs in the market.”
Dr G S Grewal, former president of the Punjab Medical Council, who has been raising voice against the medical corruption, told Chandigarh Newsline that despite NPPA stating that there is a high level of margins on the medicines sold by the chemists, there has been no action by the Central government. “The government is not acting and the general public is bearing the brunt after paying a huge amount of money by purchasing the medicines,” he said. He also said that all the medicines should be included in the essential list because anything, which is called a “medicine”, is essential for human beings.
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