Don’t succumb to hospital-chemist nexus

Pushpa Girimaji

Can hospitals insist on patients or their relatives buying the medicine only from the hospital’s in-house dispensary? I have often found their rates to be higher than the chemists outside, but they insist on buying from their own store on the ground that they are not sure of the quality of medicines from elsewhere. I would like to mention that I buy medicines from my local chemist all the time and have never had any problem.

Putting restrictions on where you buy the medicine or tying up the hospital services with the purchase of medicines from their store constitutes restrictive trade practice, which is obviously against the interest of the consumer. It takes away your right to choice and can cause you financial loss. It is also an unfair trade practice.

There is often a wide difference in the price of the same drug, manufactured by different pharmaceutical companies. By exercising your choice, you can buy the cheapest brand. Or you can buy a generic drug, which is cheaper than the branded drug. If you are buying from a local neighbourhood chemist regularly, he may be giving you a discount. So when a hospital insists on your buying the medicine from their in-house chemist, it is taking away your right to choice and fair deal. The hospital may prescribe the most expensive of brands by taking a hefty cut from the manufacturer for doing so. You will obviously become the victim of an unholy nexus and unnecessarily pay a much higher price.

Recently , a friend told me about how they had to spend lakhs of rupees more on a relative’s cancer treatment only because the hospital would not allow them buy the medicine anywhere else except at their store and it was far more expensive than outside. This is not only unethical, but unfair, and such practices must stop. Relatives of patients, already under mental stress, usually avoid having any argument with the hospital or the doctor for fear of such disagreement affecting the treatment. And hospitals exploit this sentiment fully.

Can one file a case against such a hospital? Can you quote any for reference?

You can do so, but you must retain your receipts and also have adequate proof to show that the same medicine was available elsewhere at a lower price. You will also have to show that the hospital insisted on purchases from their chemist.

In Fortis Health Management (North) Ltd , Lucknow, Vs Meenu Jain and another (RP NO 2448 of 2014, order dated July 22, 2014), the central issue was about the hospital charging much more than the market rate for a life-saving drug, Iviglobex, administered to Jain at the hospital; five doses for five days. According to her husband, even though he said that he could get the injections at a much lower rate which would be 30-40 per cent less than the market, the hospital did not permit him to buy the medicine from outside.

After his wife got better and was discharged from the hospital, he wrote to the hospital asking for information on the batch number, expiry date and the bill of the supplier, but the hospital refused to reveal this information. He then sought a refund of Rs 1,56,167 as the excess amount charged for the drug. When this was refused by the hospital, he filed a complaint before the District Consumer Disputes Redressal Forum. Holding it to be an unfair trade practice, the Forum awarded a compensation of Rs 1 lakh and also asked the hospital to discontinue such practice and pay Rs 1 lakh towards the State Consumer Welfare Fund. This was upheld by the State Consumer Commission.

The National Consumer Disputes Redressal Commission too upheld the view of the lower courts. Said the Commission: “… we are of the opinion that the hospital authorities exercised undue influence and compelled the complainants to pay excess price. This amounts to unfair trade practice. The right of the complainant/patient cannot be curtailed by preventing the complainants to exercise their option to purchase the medicines or injections from the market.”

However, on the ground that the patient’s husband had not produced any cogent evidence to show the discounted price of injections outside the hospital, the Commission asked the hospital to refund Rs 78,000, which was 50 per cent of the amount calculated as excess price paid by the patient.