A Maharashtra government survey has brought a sharp focus on the prices patients pay for basic medical consumables in hospitals. The survey found huge differences between the prices at which some products were procured and their printed maximum retail prices (MRPs), with markups reaching as high as 2,841% in one case.
The issue has now reached the Centre. The government has sought a report from the National Pharmaceutical Pricing Authority (NPPA) after Maharashtra Food and Drug Administration (FDA) Commissioner Tukaram Mundhe flagged the pricing gaps and called for a review of the existing system. The Department of Pharmaceuticals is expected to examine the NPPA’s analysis before deciding on further action.
One example cited by Mundhe involved an intravenous (IV) infusion set. The product was procured at a trade price of Rs 11.05 but carried a printed MRP of Rs 325. The difference works out to a markup of about 2,841%.
Other hospital consumables also showed wide gaps. A syringe purchased for Rs 6.75 carried an MRP of Rs 57.20, while a catheter procured for Rs 29.41 had an MRP of Rs 310. The survey covered hospitals in the Mumbai Metropolitan Region, Pune and Chhatrapati Sambhajinagar.
Mundhe has argued that the problem is not limited to the price of individual products. Patients admitted to hospitals often have little opportunity to compare the prices of medical supplies used during treatment or question the basis of the charges. Unlike elective purchases, many of these items are used as part of routine medical care, leaving patients with limited choice.
The Maharashtra FDA has therefore recommended a review of the pricing structure and clearer rules on the permissible difference between trade procurement prices and declared MRPs. Mundhe has said the issue needs to be examined at the policy level rather than through arbitrary price-setting.
A key part of the debate is the regulatory treatment of medical devices and consumables. Scheduled medicines are subject to price ceilings under the Drugs (Prices Control) Order, 2013. Many medical devices and hospital consumables, however, do not face the same type of price controls. This has raised questions about how large differences between procurement costs and MRPs should be monitored.
The Maharashtra FDA has made clear that it does not have the authority to regulate hospital bills. Its survey was aimed at highlighting the pricing gap and bringing the matter before the appropriate central authorities. The final decision on any price controls or changes to the regulatory framework rests with the Centre and the NPPA.
The issue has also drawn a response from the healthcare industry. Hospitals and healthcare organisations have argued that procurement prices alone cannot be used to determine the final cost of providing a medical product to a patient. They point to additional expenses such as maintaining emergency stocks, ensuring sterile storage, product traceability, trained staff, infrastructure and the risk of unused products expiring.
Industry representatives have also called for a differentiated approach. They argue that simple, routinely used consumables should be examined differently from sophisticated medical technologies that require specialised infrastructure and clinical support. At the same time, healthcare bodies have acknowledged that unusually high margins on basic consumables warrant scrutiny.
The debate is therefore moving beyond a single hospital or product. It raises broader questions about transparency in hospital billing, medical device pricing and the information available to patients.
The figures highlighted by the Maharashtra FDA have also renewed discussion around trade-margin rationalisation. If a product is purchased by a hospital at a fraction of its printed MRP, regulators need to determine how the difference is created, who benefits from it and what portion, if any, is reflected in the final patient bill.
Mundhe has stopped short of suggesting a fixed percentage for permissible margins, saying that such a decision falls within the remit of the NPPA and policymakers. He has instead called for a transparent framework that takes into account manufacturers, distributors, hospitals and patients.
The Centre’s request for an NPPA report is now the next step. The regulator’s analysis could help determine whether the price gaps identified in Maharashtra point to a wider problem requiring changes in medical device pricing rules.
Any new framework will have to balance affordability with the costs involved in safely supplying medical products. The immediate question, however, remains straightforward: when patients are billed for basic hospital consumables, how much of the price should they reasonably be expected to pay, and how clearly should that cost be explained?
The Maharashtra survey has put that question firmly on the healthcare policy agenda, with patients, hospitals, manufacturers and regulators now waiting for the Centre’s next move.