Banning Compulsory Purchase From Hospital In-House Pharmacies: SC notice To Centre, State
New Delhi: Seeking a permanent ban on the policy of compulsory purchase form In House hospital pharmacies for patients admitted to the private hospitals in the country, a PIL has been filed in the Supreme Court by a law student and his advocate father. Responding to the petition Supreme Court today issued notice to Union Health Ministry, all states and union territories.
The PIL sought direction to the various governments to ban the Hospitals and hospital pharmacies from compelling the patients to mandatorily buy medicines from hospitals and the hospital pharmacies. This the petitioner alleged happened only at MRP or manipulated and artificially inflated prices for profiteering also from sale of medicines, when the medicines are available at lesser and heavily discounted prices in the open market from the medical shops, retailers, dealers and distributors duly licensed and regulated by the Drug Control Department of state and central governments.
The petitioner added that hospitals take advantage of the ignorance, plight and adverse circumstances of the patients in the Hospitals all over India, and the Respondents (various governments) despite knowing all these malpractices adopted by the Hospitals all over India, have shut their eyes and totally ignored the intetest of the patients, which they are bound to protect as over the Hospitals the Respondents have complete authority over the hospitals.
The petition came, after the mother of the law student, and wife of the advocate, who was diagnosed with breast cancer went through six chemotherapies, 20 sessions of radiotherapy, and 17 adjuvant chemotherapies which are continuing for which she will be required to be given Biceltis (Trastuzumab (440mg)) injunctions every 21 days. During the treatment, the petitioners found that the said medicine, named Biceltis (Trastuzumab (440mg)) was purchased from the hospital pharmacy at MRP of about Rs. 61,132/-, whereas the said medicine manufactured and marketed by the same company (EMCURE) is being sold in the open market at a discounted rate of Rs.50,000/- for each injection, and on completion of purchase of four injections, one injection is being given free of cost to the patient towards the patient’s support programme by the company, thereby bringing the effective cost to Rs.41,000/- for each injection having MRP of approx.. Rs.61,132/-.
It was submitted that first seven injections out of which insurance covered six, were given to the mother of the Petitioner no.1 at the cost of Rs,.61,132/- for each injection by the hospital. No free injection was given. On immense persuasion involving 3 visits and threats of legal action the permission was granted by the hospital for purchase of injection from the open market, despite the fact that the treating doctor had made the recommendation to allow purchase from the open market. On making further inquiries, it was also revealed to the Petitioners that even the MRP of this medicine in the open market was less. Therefore, there was at least a total difference of Rs.21,000/- in the price of each Biceltis injection.
This prompted the petitioners to approach the Supreme Court in the interest of the people of India, who are suffering at the hands of the Hospitals and are a victim of the apathy of the Respondents without any legal recourse.
The petitioners alleged that Hospitals compel the patients to mandatorily buy medicines, medical devices and implants and consumables from their own pharmacies in the Hospitals and Hospitals itself, without giving any choice or opportunity to the patients, or explaining or disclosing the prices of medicines, medical implants and consumables, including MRP to the patients, and offering them an option to buy medicines, medical implants and consumables from any other pharmacy or medical store of their choice at the same price or at a discounted price.
The petitioners referred to an NPPA report in this regard that mentions that
The petitioners demanded that the court issue order or direction under Article 32 of the Constitution of India, for the following
The PIL sought direction to the various governments to ban the Hospitals and hospital pharmacies from compelling the patients to mandatorily buy medicines from hospitals and the hospital pharmacies. This the petitioner alleged happened only at MRP or manipulated and artificially inflated prices for profiteering also from sale of medicines, when the medicines are available at lesser and heavily discounted prices in the open market from the medical shops, retailers, dealers and distributors duly licensed and regulated by the Drug Control Department of state and central governments.
The petitioner added that hospitals take advantage of the ignorance, plight and adverse circumstances of the patients in the Hospitals all over India, and the Respondents (various governments) despite knowing all these malpractices adopted by the Hospitals all over India, have shut their eyes and totally ignored the intetest of the patients, which they are bound to protect as over the Hospitals the Respondents have complete authority over the hospitals.
The petition came, after the mother of the law student, and wife of the advocate, who was diagnosed with breast cancer went through six chemotherapies, 20 sessions of radiotherapy, and 17 adjuvant chemotherapies which are continuing for which she will be required to be given Biceltis (Trastuzumab (440mg)) injunctions every 21 days. During the treatment, the petitioners found that the said medicine, named Biceltis (Trastuzumab (440mg)) was purchased from the hospital pharmacy at MRP of about Rs. 61,132/-, whereas the said medicine manufactured and marketed by the same company (EMCURE) is being sold in the open market at a discounted rate of Rs.50,000/- for each injection, and on completion of purchase of four injections, one injection is being given free of cost to the patient towards the patient’s support programme by the company, thereby bringing the effective cost to Rs.41,000/- for each injection having MRP of approx.. Rs.61,132/-.
It was submitted that first seven injections out of which insurance covered six, were given to the mother of the Petitioner no.1 at the cost of Rs,.61,132/- for each injection by the hospital. No free injection was given. On immense persuasion involving 3 visits and threats of legal action the permission was granted by the hospital for purchase of injection from the open market, despite the fact that the treating doctor had made the recommendation to allow purchase from the open market. On making further inquiries, it was also revealed to the Petitioners that even the MRP of this medicine in the open market was less. Therefore, there was at least a total difference of Rs.21,000/- in the price of each Biceltis injection.
This prompted the petitioners to approach the Supreme Court in the interest of the people of India, who are suffering at the hands of the Hospitals and are a victim of the apathy of the Respondents without any legal recourse.
The petitioners alleged that Hospitals compel the patients to mandatorily buy medicines, medical devices and implants and consumables from their own pharmacies in the Hospitals and Hospitals itself, without giving any choice or opportunity to the patients, or explaining or disclosing the prices of medicines, medical implants and consumables, including MRP to the patients, and offering them an option to buy medicines, medical implants and consumables from any other pharmacy or medical store of their choice at the same price or at a discounted price.
The petitioners referred to an NPPA report in this regard that mentions that
“institutional bulk purchase by private Hospitals, which in most cases keep a pharmacy of its own, makes it easier for them to get very high profit margins and indulge into profiteering on drugs and devices even without need to violate the MRPs which is already enough inflated. Industry, to get bulk supply orders, is in a way 'forced' to print higher MRPs as per the ‘market requirements’. This is a clear case of market distortion where manufacturers after accounting for their profits print inflated MRPs to meet out the demands of a distorted trade channel without getting any benefits from this 'artificial inflation' and patients have to incur huge out of pocket expenditure in hospitalization cases and also otherwise where they are not allowed to buy drugs from outside or go by the physician’s branded prescription”.
The petitioners demanded that the court issue order or direction under Article 32 of the Constitution of India, for the following
- Banning the Hospitals from compelling and forcing the patients and their attendants to mandatorily purchase medicines, medical devices and implants, and medical consumables from the Hospitals or hospital pharmacies only, and further declare and direct that the patients and their attendants shall be free and have the choice to purchase medicines, medical devices and implants and medical consumables from the vendor of their choice and the Hospitals cannot compel the patients their attendants to buy medicines, medical devices and implants and medical consumables from Hospitals or hospital pharmacy, and give appropriate directions to the Respondents ban the above mal practices and protect the interests of the buyers of the medicines, medical devices and implants and medical consumables;
- Directing the respective governments to ensure that appropriate notice boards are put at appropriate and prominent places in the Hospitals and the hospital pharmacis that patients and their attendants are free and have the choice to purchase medicines, medical devices and implants and medical consumables from the vendor of their choice including the hospital pharmacy;
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