The practice of profiteering by selling expensive Fixed-Dose Combination (FDC) medicines at pharmacies located within private hospital premises continues unabated. Patients are being compelled to purchase medicines prescribed by doctors exclusively from the hospital’s own pharmacy.
Doctors at several private hospitals in the city are prescribing branded multi-combination medicines—containing a mix of two or three drugs—that are not easily available in the open market. Consequently, a medicine that might cost ₹150 in the market is sold for ₹350 to ₹400 at the hospital pharmacy. A survey of various private hospitals and their pharmacies revealed widespread allegations of collusion between doctors and pharmacy operators. When patients attempt to buy medicines from outside shops, pharmacy staff or hospital personnel often stop them, insisting that the prescribed medication is available only at that specific hospital pharmacy.
Many patients reported being discouraged from going elsewhere, with staff claiming the hospital’s responsibility would only be fulfilled if the medicines were purchased on-site. Rakesh Singh, an attendant for a patient named Meera Devi from Ramnagar, recounted that the doctor prescribed a combination of three medicines. No shopkeeper in the market could even identify the drug. Compelled by the situation, he had to buy it from the hospital pharmacy for ₹400, whereas a generic version would have been available much more cheaply. Similar complaints have been received from numerous families.
A look at some medicines sold at hospital pharmacies:
Multi-combination tablets such as ‘Pregalive NTM’ (containing Pregabalin Prolonged-Release, Methylcobalamin, and Nortriptyline Hydrochloride) are being prescribed for neuropathic pain. ‘Calciquick-K2 Forte’ (containing Calcium Carbonate, Calcitriol, Vitamin K2-7, Magnesium, and Zinc) is also available as a branded combination product. In this category, the MRP of Zerodol SP (Aceclofenac, Paracetamol, Serratiopeptidase) is reported to be ₹139, while that of Neurobion Alpha D (Alpha Lipoic Acid, Pyridoxine, Methylcobalamin, Folic Acid, and Vitamin D-3) is ₹207. Since these medicines often fall outside price control regulations, higher profit margins can be applied to them.
**Views from Stakeholders**
The use of multi-combination medicines in private hospitals is rising because they yield significantly higher profits compared to single-drug formulations. If prescribed by their generic names, patients could purchase cheaper medicines from the open market; however, prescribing branded combinations ensures a monopoly for the hospital store. Many hospital pharmacies offer commissions or other perks to doctors, who, in return, prioritize prescribing these branded medicines. This directly impacts the patients’ pockets. The common man is already burdened by the high cost of healthcare services; imposing expensive medicines within the hospital premises exploits their vulnerable situation. — Sanjay Singh, Secretary, Medicine Sellers’ Association, Varanasi.
In a city like Varanasi, where private healthcare services are expanding rapidly, strict monitoring is essential to safeguard patients’ interests. The administration must take proactive steps to curb this profiteering game involving multi-combination medicines; otherwise, the pockets of ordinary patients will continue to be drained. — Sandeep Chaturvedi, State President, Chemists and Druggists Federation, Uttar Pradesh.
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The practice of making exorbitant profits under the guise of Fixed-Dose Combination (FDC) medicines continues unabated in private hospitals and medical stores. Despite the DCGI banning several irrational FDC drugs, many licensed operators continue to sell them openly. There is a massive disparity—exceeding 2,000 percent—between the actual manufacturing cost of medicines and medical devices and their printed MRP. A demand has been made for the National Pharmaceutical Pricing Authority (NPPA) to immediately formulate a transparent pricing policy to protect the general public from this financial exploitation. – Dr. Arvind Singh, Former President, IMA Banaras.
Official’s Statement
Action is taken upon receiving a complaint, but most cases do not come to light because patients remain silent out of fear or compulsion. – Chandresh Dwivedi, Drug Inspector, District Food and Drug Administration, Varanasi.
