For instance, as per the Co-WIN portal on Monday, H N Reliance Hospital in Mumbai is charging Rs 700 per dose for Covishield — Rs 100 more than the price at which the Serum Institute of India (SII) sold the vaccine to private hospitals. However, Nanavati Max Hospital in the city has set a price of Rs 900 for one shot, as per the portal. Other hospitals like BLK Max in Delhi and Max Healthcare in North India which, like Nanavati, are under the management of Max Healthcare, also charge this rate, showed Co-WIN.
Similarly, the rate specified by Apollo Hospitals and Fortis Healthcare for a dose of Covaxin across the country was Rs 1,250 on Co-WIN — Rs 50 more than the price set by Bharat Biotech for the private market. However, those seeking Covaxin at Kolkata’s Woodlands Hospital would have to pay Rs 1,500 per dose, showed Co-WIN.
As of May 5, Bengaluru’s BGS Gleneagles Global Hospital was also charging Rs 1,500 per jab for Covaxin, according to an analysis by the All India Drug Action Network co-convenor Malini Aisola and theoretical physicist Siddhartha Das, who have both been working on vaccine access issues. Aisola and Das analysed private hospital charges on Co-WIN in major cities between May 5 and 8.
Disparity to widen
The different rates are likely to lead to disparity in access to vaccines. Most of the supply is currently with select private hospitals with freedom to set own prices, while states are scrambling to access doses. While this has led to a lack of transparency in the system, prices may stabilise if the supply picks up.
BGS Gleneagles, however, clarified that its Rs 1,500 charge was set for walk-in patients “only for the first two days, before the pricing/delivery mechanisms were optimised pursuant to stock and future deliveries”. It currently administers Covaxin at Rs 1,250 and charges Rs 1,500 “only” when it administers the vaccine in corporate offices or apartment buildings, as they involve additional travel and logistic costs.
The variation in how these shots are priced between hospitals is currently around Rs 200-250. However, all are much higher compared to the earlier price of Rs 250 per dose to priority groups — mostly stemming from insufficient supply as well as lack of transparency over the process followed to fix the prices, according to Aisola.
“The supply of Covid-19 vaccines, even in the private sector, is monopolised by a few prominent and corporate hospital chains. Several states are still scrambling to get vaccines, whereas these players already received some stock before May 1,” she told The Indian Express.
Facilities operating in cities with fewer private Covid-19 vaccination sites have more room to price their services higher. In the earlier phases, hospitals were mandated by the Centre to charge no more than Rs 100 over the price of the vaccine as their service charges.
“There is not much transparency over the hospital margins (now),” said Aisola. “The implications are that private hospitals, the first movers since free pricing was permitted in the private sector, are basically pricing for what they think the market can bear, because we know that the demand is outstripping the supply,” she added.
Industry executives, however, attribute the price difference to various factors, including discounts in procurement negotiations. The Apollo Hospitals Group, which began negotiations for Covid-19 vaccines back in November 2020, managed to get Covaxin from Bharat Biotech at Rs 1,000 a dose, according to Shobana Kamineni, the group’s Executive Vice President.
The group has added a Rs 200 charge for administration and consultation and Rs 50 for GST, “which we can’t absorb”, she had earlier told The Indian Express.
On the other hand, Manipal Hospitals, which also provides Covaxin, paid Bharat Biotech Rs 1,200 per shot, according to Manipal Education and Medical Group chairman Dr Ranjan Pai. It has added Rs 150 for administering the vaccine and GST, bringing the price to Rs 1,350 per dose.
“We are just doing the basic minimum. The whole idea is to get as many people vaccinated as possible,” said Pai.
A spokesperson for Max Healthcare said its Rs 900 for Covishield is inclusive of a Rs 710-715 landed cost per inoculation. Within this, the group has taken into account factors like the GST costs “over and above” the basic cost of the Rs 600 per dose charged by the SII and a 5-6 percent expected wastage.
The hospital chain has also worked out a charge of Rs 170-180 per inoculation to cover other costs, including vaccine administration kits, hand sanitisers, PPEs for staff, standby doctors and bio-medical waste disposal.
Queries sent to Kolkata’s Woodlands Hospital remained unanswered by press time Monday.
A senior doctor at a private hospital in Delhi said the costs of storing the vaccine at the right temperature and humidity, and a severe crunch of manpower and logistics, are also factors.
“Most hospitals including ours do not necessarily have the storage containers or medical refrigerators needed. We are either renting or buying from the open market,” the doctor said.
“We (also) have to take extra precautions that the people who come to get vaccinated don’t catch an infection. We have had to hire nurses at extra cost. No one is willing to work in these circumstances,” the doctor added.