Directive towards affordable medical care

Supreme Court emphasised pricing regulation, measures against 'compulsion' to buy from hospital pharmacies

The Supreme Court has drawn attention to the problem of unaffordable medical care in hospitals with its observations on a petition that sought action on overpricing of medicines and other medical items in hospitals. The petition noted that private hospitals were compelling patients and their families to buy medicines, implants and other medical care items from in-house pharmacies that imposed exorbitant mark-ups.

It said the central and state governments had failed to take regulatory and correctional measures, and sought a direction to private hospitals to not compel the patients to purchase only from the hospital pharmacies.

The court strongly criticised the states' failure to deliver reasonably priced medicines, particularly in the case of essential drugs, for people from poorer sections of society. It also noted that though it was the duty of the states to deliver proper medical care to citizens, some states had not been able to do so and had “facilitated and promoted private entities.”

The court thought it was not advisable for it to issue mandatory directions, but it was necessary to sensitise state governments on this issue. It told state governments to regulate entities that overpriced medicines and told them to ensure that patients and their families are not compelled to buy from in-house pharmacies, particularly when the same drug or product is available cheaper elsewhere. It also told the Central government to frame guidelines in this respect. The affidavits submitted by the Centre and the state governments in the matter show how serious the problem is. The Central government said there is no compulsion on patients to buy medicines from hospital pharmacies. Several states said they relied on price control orders issued by the Centre, and that prices of essential drugs are fixed to ensure availability at reasonable rates. They even questioned the locus standi of the petitioners in the matter and claimed that fair-price shops had been set up for government-run hospitals.

The claim that there is no compulsion on patients is wrong because most patients and their families do not have another option. They are unable to resist suggestions from the hospital because of various reasons. Governments are also unable to resist pressure from the private medical establishment. The National Medical Commission had to withdraw its 2023 directive to doctors to prescribe generic medicines instead of branded ones under pressure from the medical community. The court reminded the state that the right to fair and reasonable medical treatment derives from Article 21 of the Constitution. But effective measures on the part of the state to ensure fair treatment in all situations, including those pointed out in the petition, may be a long way off.