A statewide review of medicine pricing in Uttar Pradesh has highlighted substantial differences between the prices paid by hospital pharmacies for certain medicines and the maximum retail prices printed on their packaging.
The scrutiny covered purchase and sales records from 214 medical colleges and private hospital pharmacies and examined 130 formulations, according to the report. The review found that the printed MRPs of 36 essential medicines were between 10 and 67 times their reported wholesale purchase prices.
The findings have drawn attention to the way critical medicines are priced and billed in hospital settings, particularly when patients require expensive treatments during serious illness.
Polymyxin-B Shows One of the Largest Price Gaps
One of the most striking examples involved Polymyxin-B, an antibiotic used in treating severe infections.
A 5,00,000-unit injection was reportedly purchased by a hospital pharmacy for ₹74.09, while the printed MRP was ₹4,980.94. Another batch of the same strength reportedly had a purchase price of ₹90 and an MRP of ₹4,528.10.
The difference between procurement and printed retail prices was among the largest identified during the review.
Significant Differences Found in Other Medicines
The investigation also identified wide price differences in medicines used for liver disease, serious infections and cancer treatment.
For example, Terlipressin was reportedly purchased for ₹56 while carrying an MRP of ₹3,050. Another 10-ml product sold under the name Teronim reportedly had the same purchase price but an MRP of ₹2,600.
The report also cited several anti-infective medicines:
- Caspofungin 70 mg: purchase prices of ₹800 and ₹897.75 against MRPs of ₹21,230 and ₹19,892.
- Colistimethate Sodium 4.5 MIU: purchased for ₹210 against an MRP of ₹9,702.31.
- Tigecycline 50 mg: purchased for ₹154.54 against an MRP of ₹7,110.47.
- Meropenem 1 gm: reported retail prices ranged from roughly 5.3 to 10 times the corresponding wholesale invoices.
These figures illustrate why regulators are examining the relationship between institutional procurement prices and patient billing.
Oncology Drugs Also Under Scrutiny
The review reportedly found substantial price differences involving high-value cancer medicines.
Bevacizumab 400 mg, for instance, was reported to have a procurement cost of ₹7,541.10 compared with an MRP of ₹69,995.
Other examples cited in the investigation included Inova 1 mg, reportedly purchased for ₹2,07,504 with an MRP of ₹3,02,610, and Simulect 200 mg, which had a reported purchase cost of ₹72,700.95 and an MRP of ₹95,420.
Such medicines can form a significant part of treatment expenses, making the difference between procurement and billed prices particularly important for patients and their families.
Medical Devices Also Showed Price Differences
The scrutiny was not limited to medicines.
Certain medical consumables were also reported to have substantial differences between procurement prices and printed MRPs. A three-way stopcock was reportedly purchased for ₹6.40 while carrying an MRP of ₹163.
Another medical device cited in the review had a purchase price of ₹20.95 and an MRP of ₹500.
These examples have added to questions about how pricing is determined for products supplied through hospital pharmacies.
Why Hospital Pharmacy Pricing Is Being Examined
Hospital pharmacies can purchase medicines directly from manufacturers or distributors under institutional arrangements. Such arrangements may involve prices substantially below the printed MRP.
The regulatory concern is not simply that a product has a high MRP. The more important question is how the difference between procurement cost, MRP, discounts and the final amount charged to a patient is reflected in actual hospital billing.
Patients may also have limited ability to compare prices when medicines are required urgently during hospital treatment.
In-House Pharmacies and Limited Choice
The issue becomes particularly significant when hospitals maintain in-house pharmacies for specialised medicines.
During critical treatment, patients or their families may have limited practical opportunities to compare prices with other suppliers, particularly when a particular brand or formulation is available primarily through the hospital.
Regulators are therefore examining whether existing pricing practices provide sufficient transparency and competition for patients.
Regulatory Review to Examine Pricing Practices
The Food Safety and Drug Administration is reportedly conducting a further review of the pricing differences identified during the inspection process.
The review is expected to examine purchase prices, printed MRPs and the amounts ultimately charged to patients. It also raises a broader policy question about how institutional discounts and maximum retail prices should operate when medicines are supplied through hospitals.
For healthcare businesses and organisations dealing with procurement, financial controls and compliance, Business Advisory can be relevant when evaluating operational and financial processes.
What Patients Should Know
The reported findings do not mean that every medicine with a large procurement-to-MRP difference represents an unlawful charge. MRP, institutional purchase price and the final billed amount are different pricing components, and the legality of a particular practice depends on the applicable regulatory framework and facts of the case.
However, the scale of the differences identified in some products has increased scrutiny of medicine pricing and patient billing.
The ongoing review could provide greater clarity on how such prices are determined and whether additional measures are required to improve transparency and protect patients from excessive healthcare costs.