Karnataka Mandates Landing Price, MRP Disclosure on Medicine, Medical Device Bills From November 1
A recent circular was issued by the Office of the Commissioner, Food Safety and Drugs Administration, Palace Road, Bengaluru-01. It cites the Drugs (Prices Control) Order, 2013; the Clinical Establishments (Registration and Regulation) Act, 2010, and rules framed thereunder, described in the circular as adopted by Karnataka; and the Karnataka Private Medical Establishment Act, 2007, and its updated rules.
Explaining the background, the department said a significant gap had been observed between the landing or base price—the actual procurement cost to hospitals or hospital pharmacies—and the MRP printed on medicines, medical devices and consumables. In several cases, patients were being billed at or near MRP without transparency about the actual acquisition cost.
To ensure price transparency, protect patient interests, and prevent unfair trade practices, the department has instructed hospitals, healthcare institutions and entities supplied by C&F operators, distributors, wholesalers, and retailers in the state to clearly display landing or base prices and MRPs on all bills for these products, including bills issued in patients’ names.
Setting out the statutory framework, the circular states that the Clinical Establishments (Registration and Regulation) Act, 2010, as described as adopted by Karnataka, requires every clinical establishment to be registered and comply with the prescribed conditions for registration and continuation.
It refers to Rule 9 of the Clinical Establishments (Central Government) Rules, 2012.
Under Rule 9(i), establishments must prominently display the rates charged for each type of service and the facilities available, in both the local language and English, for patients’ benefit.
Under Rule 9(ii), establishments must charge for procedures and services within the range of rates determined and issued by the Central Government from time to time, in consultation with state governments.
According to the circular, the Supreme Court and various High Courts have recognized that these provisions are intended to curb excessive pricing and ensure transparency in hospital charges, with responsibility for enforcement resting with state governments.
The circular further states that rules framed under the Act impose additional obligations, including prominently displaying rates and charges and publishing them on websites where available; providing itemized bills and clear information about charges; and complying with directions issued by the Registering Authority and authorized officers. It also refers to liability for penalties, suspension, or cancellation of registration.
The instructions apply to all government, private, and trust hospitals, nursing homes, clinics, day-care centers, and diagnostic centers. They cover inpatient and outpatient services where medicines, medical devices, implants, stents, consumables, and disposables are supplied and billed to patients.
The scope also extends to all C&F operators, stockists, distributors, wholesalers, and retailers holding licenses issued by the Food Safety and Drugs Administration Department.
The circular stated that with effect from 1.11.2026, all hospitals and healthcare institutions shall:
(a) Itemized Billing
- Issue an itemised bill for every patient, showing each medicine, device, implant and consumable separately.
(b) Display of Prices on Bill
For each line-item relating to medicines, medical devices and consumables, the bill must clearly show:
i. Name of the product (generic and brand, wherever applicable along with batch number, date of manufacturing and date of expiry);
ii. Landing / Base Price – i.e. actual procurement cost to the hospital (exclusive of taxes); and in case to C and F to wholesaler / distributor and wholesaler / distributor to retailer and retailer to the end user.
iii. MRP (Manufacture Retail Price) – as printed on the pack / as notified by NPPA, where applicable;
iv. Price Charged to Patient – which shall not exceed MRP;
v. Applicable Taxes, if any (if not already included in MRP as per law).
A specimen format is given in the Annexure to this circular.
(c) Display at Counters and Website
- Display a notice at billing counters, pharmacy counters, and admission desks informing patients of their right to see landing price and MRP on the bill.
- Publish this information and a summary of the policy on the hospital’s website, if available.
(d) Record Maintenance
- Maintain records of purchase invoices, landing prices, and billing details for at least Three (3) years for inspection by authorized officers.
(e) Prohibition on Overcharging
- No hospital or institution shall charge the patient above the MRP printed on the pack or above the ceiling price notified by the National Pharmaceutical Pricing Authority (NPPA), as applicable.
(f) Monitoring and Enforcement
- The District Health Officer / Chief Medical Officer / Drug Control Authority of each district shall be the nodal officer for implementation and monitoring of this circular.
- Random checks and audits of hospital bills and purchase records may be conducted.
- Violations may attract action under:
- KPME Act and Rules thereunder updated,
- Drugs and Cosmetics Act, 1940 and Rules thereunder,
- Drugs (Price Control) Order, 2013 under The Essential Commodities Act, 1955,
- Consumer Protection Act, 2019, and
- Any other applicable law.
(g) Compliance Timeline
All hospitals and healthcare institutions are directed to comply with this circular with effect from 01.11.2026. Hospitals are advised to update their billing software, train staff, and display requisite notices immediately.
Annexure-I provides a specimen bill with columns for serial number, product details—including batch number, manufacturing date and expiry date—quantity, landing or base price, MRP, price charged, tax and total amount. Its illustrative entries are:
| S. No. | Illustrative item | Quantity | Landing/base price (₹) | MRP (₹) | Price charged (₹) | Tax (₹) | Total (₹) |
|---|---|---|---|---|---|---|---|
| 1 | Tab. XYZ 500 mg | 10 | 18.00 | 50.00 | 50.00 | 0.00 | 500.00 |
| 2 | IV Infusion Set (Brand A) | 1 | 11.05 | 325.00 | 325.00 | 0.00 | 325.00 |
| 3 | Cardiac Stent (Model PQR) | 1 | 22,000 | 28,000 | 28,000 | 0.00 | 28,000.00 |
Each illustrative item includes placeholders for its batch number, manufacturing date and expiry date.
Annexure-II contains a model patient-facing notice for private corporate hospitals, titled “Transparent Billing for Medicines and Medical Devices.” With a placeholder for the hospital’s name, it states that the institution provides full price transparency for medicines, medical devices, implants and consumables in compliance with the Commissioner’s October 1 circular.
Also Read:Karnataka Seeks Central Action Over Huge Gap Between Hospital Drug Costs and Patient Bills
The model notice informs patients that their bills will clearly show the landing or base price representing the actual cost to the hospital, the MRP printed by the manufacturer, and the price charged to them, which will not exceed MRP.
It also outlines patients’ rights to request landing-price and MRP details for any item, verify the MRP on the original pack, and lodge a complaint through a QR code if they are charged above MRP or are not provided with an itemized bill.
To view the circular, click the link below:
