Maharashtra Food and Drug Administration (FDA) Commissioner Tukaram Munde has initiated action to focus on the drug part of FDA as he has written to the Department of Pharmaceuticals and National Pharmaceutical Pricing Authority (NPPA), recommending guidelines on the permissible gap between trade procurement and MRP. 

Calling the gap a core public health issue, Mr. Munde said, “The most expensive part of a hospital bill may never touch the hospital at all. A patient admitted for care has no way of knowing whether the price on a medical consumable reflects its actual cost or a markup fixed long before it ever reached the ward.“ 

Mr. Munde pointed out that the review of the findings of the survey and clear guidelines on the permissible gap between trade procurement price and declared MRP have been recommended to the Department of Pharmaceuticals and the NPPA, and this is not just to close a pricing gap, but also the information gap patients have. 

A survey of hospital consumables in Maharashtra found an IV infusion set with a trade price of ₹11.05 carrying a printed MRP of ₹325, a markup of 2,841%. A syringe procured at ₹6.75 carried an MRP of ₹57.20. A catheter procured at ₹29.41 carried an MRP of ₹310.

Explaining the gap and need for transparency, he said on X that as they are not elective purchases, patients cannot compare prices, seek alternatives, or question the MRP while receiving care. 

“The MRP itself is often fixed upstream by manufacturers and distributors, disconnected from the trade price by a wide, unexplained margin. The result is a system where the party bearing the cost has the least information to evaluate it,” he added. 

The regulatory gap is structural: scheduled medicines are capped under the Drugs (Prices Control) Order, 2013. Most medical devices and consumables are not covered, leaving both the pricing and the information around it almost entirely unmonitored, he added on X.