Lok Sabha Question No. 3927 (UNSTARRED), answered on 2018-03-20
Subject: Unethical Practices by Private Hospitals
Ministry: CHEMICALS AND FERTILIZERS
Asked by: DHARMENDRA YADAV, SHRIKANT EKNATH SHINDE, Shrirang Appa Barne, VINAYAK BHAURAO RAUT

## GOVERNMENT OF INDIA MINISTRY OF CHEMICALS & FERTILIZERS DEPARTMENT OF PHARMACEUTICALS

LOK SABHA UNSTARRED QUESTION NO. 3927 TO BE ANSWERED ON 20 th  March, 2018

## Unethical Practices by Private Hospitals

†3927. SHRI DHARMENDRA YADAV: DR. SHRIKANT EKNATH SHINDE: SHRI SHRIRANG APPA BARNE: SHRI VINAYAS BHAURAO RAUT:

Will the Minister of CHEMICALS AND FERTILIZERS be pleased to state:

- (a) whether several patients and the health groups have criticized the excessive and unethical pricing by private hospitals and stressed the need for regulation of healthcare charges;
- (b) whether  a  number  of  other  alarming  revelations  have  been  made  by  the National Pharmaceutical Pricing Authority (NPPA), such as, about 25 per cent of  a  patient's  hospital  bill  is  the  cost  of  non-schedule  formulations,  or  those medicines that are not under price control;
- (c) whether  NPPA  has  recommended  a  policy  intervention  to  address  the unethical practices carried out by private hospitals, thereby making healthcare not just unaffordable but also inaccessible to the common man and if so, the details thereof;
- (d) whether  the profit margin  in non-scheduled  equipments  like catheters, syringes and insertion equipments indicates the unethical profit more explicitly in  a  unsuccessful  market  system  and  if  so,  the  reaction  of  the  Government thereto; and
- (e) the  steps  taken  by  the  Government  to  formulate  a  policy  to  address  the unethical  practices  by  the  private  hospitals  and  the  time  by  which  the  said policy is likely to be formulated and implemented?

## ANSWER

## MINISTER  OF  STATE  IN  THE  MINISTRY  OF  ROAD  TRANSPORT  AND HIGHWAYS;  MINISTRY  OF  SHIPPING  AND  MINISTRY  OF  CHEMICALS  AND FERTILIZERS (SHRI MANSUKH L. MANDAVIYA)

- (a): Yes, Madam.
- (b): National Pharmaceutical Pricing Authority (NPPA) has reported that the total cost on scheduled medicines {specified under National List of Essential Medicines (NLEM) and brought under price control} used in the treatment is only 4.10 % as compared to 25.67% on non-scheduled formulations.
- (c): Diagnostics services along with all other charges by hospitals are beyond the purview of NPPA and the Central Government and can be regulated only through State specific laws whether through adoption of central model 'Clinical Establishment Act, 2010 and corresponding Rules' or otherwise through its own specific legislation by State Government.
- (d): The  profit  margins  in  the  non-scheduled  devices  used  in  the  three  cases (syringes,  cannula  and  catheters)  are  exorbitant  and  clearly  a  case  of  unethical profiteering in a failed market system. NPPA vide its notification No. 639(E), dated

12 th February,  2018  at  para  13(m),  directed  all  healthcare  institutions  performing angioplasty and billing the patient to mention billing cost of cardiac catheters, balloon catheter  and  guide  wire  along  with  the  name  of  the  company,  brand  name,  batch number and specifications in order to bring in greater transparency in the billing and for effective monitoring of the Maximum Retail Prices (MRPs) under Para 20 of the Drugs  (Prices  Control)  Order,  2013  (DPCO,  2013).  Further,  the  Government,  in extra-ordinary circumstances, if it considers necessary to do in public interest, can fix the ceiling price of any formulation/medical device.

(e): Public  Health  being  a  State  subject,  the  primary  responsibility  of  supply  of medicines and management  of  hospitals lies with the State/Union Territory Governments. However, the National Council for Clinical Establishments, Ministry of Health  &  Family  Welfare  (MoH&FW)  has  approved  a  standard  list  of  medical procedures and a standard template for costing of medical procedures and the same have been shared with the States for appropriate action.

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