Lucknow – A recent audit carried out by the Uttar Pradesh Food Safety and Drug Administration (FSDA) has highlighted a pronounced mismatch between the amounts hospitals actually pay for medicines and the maximum retail prices (MRP) displayed on the packaging. In many cases, the MRP is dozens of times higher than the price paid by hospital pharmacies.

Scope of the investigation

The study examined purchase ledgers from 214 pharmacy units attached to medical colleges and private hospitals. Out of the 130 drugs that were scrutinised, 36 showed an MRP exceeding ten‑fold their procurement cost, with the most extreme example reaching roughly 67 times the purchase price.

Polymyxin‑B injection tops the list

The widest gap was observed for a Polymyxin‑B injection, a medication used against severe bacterial infections. While hospitals acquired the vial for ₹74.09, the label listed an MRP of ₹4,980.94 – a disparity of almost 67 ×.

Significant variations in essential injectables

Other high‑impact injectables also displayed stark differences. A drug for advanced liver disease was bought for about ₹56 but carried an MRP of ₹3,050. Similar mismatches were noted for medicines targeting serious bacterial and fungal infections.

Meropenem and Caspofungin price spreads

For Meropenem 1 g, a cornerstone therapy for resistant bacterial infections, the MRP ranged from roughly 5.3 to 10 times the purchase price, varying by brand.

Caspofungin 70 mg, an antifungal agent, exhibited the most pronounced gap among the group. One formulation cost the hospital ₹800 yet was marked at ₹21,230 (about 26.5 ×). Another batch was procured for ₹897.75 and labeled at ₹19,892.

Cancer and life‑saving drugs under the microscope

The audit also flagged several oncology and other life‑saving medicines with inflated MRPs. While high printed prices can allow manufacturers room for discounts, the findings raise questions about how these figures are determined and communicated to patients.

Medical devices reflect the same trend

Price inflation was not limited to pharmaceuticals. A three‑way stopcock was purchased for just ₹6.40 but bore an MRP of ₹163. Another piece of equipment cost the hospital ₹20.95 yet carried a retail label of ₹500.

Limited availability squeezes patient choice

When a drug is stocked only in a particular hospital pharmacy—or is scarce in the open market—patients have little ability to compare prices. Consequently, they may be forced to accept the inflated hospital‑pharmacy rate, potentially driving up overall treatment expenses.

Implications for transparency and regulation

The FSDA’s findings have amplified calls for greater pricing transparency, stricter procurement oversight, and continuous monitoring of MRPs for both medicines and medical consumables. Better insight into the relationship between purchase costs and retail prices could help curb excessive mark‑ups and shield patients from undue financial strain.