Karnataka Flags Massive Markup in Hospital Drug Billing and Calls for Central Intervention

The Karnataka Food Safety and Drug Administration (FSDA) uncovered price disparities between the institutional “landing” cost of high-value medicines, cancer drugs, antibiotics and hospital consumables and the Maximum Retail Prices (MRP) charged to patients. Inspections of hospitals treating cancer patients revealed mark-ups ranging from ten-fold to more than fifty-two-fold the procurement cost. The state government has written to the Union Ministry of Health and Family Welfare seeking national-level action and has launched a phased verification drive to continue probing the issue.

Karnataka Flags Wide Disparity Between Landing Cost And MRP Of High-Cost Drugs And Medical Consumables, Seeks Central Government Intervention The Indian ExpressThe Hindu

India’s Drug Price Control Order (DPCO) of 2013 caps retailer margins at 16 % for scheduled drugs, while non-scheduled drugs have no ceiling, leaving the manufacturer-printed MRP as the sole legal upper limit. Karnataka’s findings show medicines supplied to hospitals at heavily discounted landing prices, yet patients are billed at or near the printed MRP.

The Indian ExpressKarnataka Flags Wide Disparity Between Landing Cost And MRP Of High-Cost Drugs And Medical Consumables, Seeks Central Government Intervention

• Gufipol (Criticare) – landing cost INR80; billed INR4,528; markup ? 52.6 times.

The Hindu

• Cytax 100 mg – landing cost INR342; billed INR3,836; markup ? 11 times.

The Hindu

• Guficycline-50 injection – landing cost INR160; billed INR7,110; markup ? 44 times.

The Hindu

• Adult nebuliser mask – landing cost INR44.50; billed INR950; markup ? 21 times.

The Indian Express

The FSDA’s verification examined more than 768 consumable items and 189 high-cost drugs across wholesale premises, hospitals and other establishments in Bengaluru and district headquarters.

The Hindu

Health and Family Welfare Minister U. T. Khader wrote to the Union Health Minister on September 23 requesting urgent national intervention. He said inspections showed hospitals billing patients up to 52 times the actual procurement cost and urged the Centre to mandate transparency by requiring hospitals to display both landing cost and MRP on patient bills.

Karnataka Flags Wide Disparity Between Landing Cost And MRP Of High-Cost Drugs And Medical Consumables, Seeks Central Government Intervention

The state has also asked for:

The Hindu

• Expansion of the list of drugs under price control in the DPCO.

The Indian Express

• Rationalisation of trade margins on essential high-value medicines and consumables.

The Indian Express

• Creation of an inter-ministerial expert group and a national data study.

The Hindu

• Amendments to the Drugs (Prices Control) Order, 2013, including an expanded National List of Essential Medicines and a dedicated audit mechanism.

The Indian Express

The FSDA announced that the verification drive conducted on September 25 and September 26, 2026 will continue in phases, with the next round focusing on antiretroviral drugs, higher-generation antibiotics, medical devices and other high-impact consumables.

The Hindu

• “Affordability of essential and life-saving healthcare is a matter of serious public importance, and the Government of Karnataka will take all measures available within its jurisdiction to protect patients from unjustified financial burden,” — T. Khader, Family Welfare Minister

The Indian Express

The FSDA indicated that future verification phases will target antiretroviral therapies, critical antibiotics and additional medical devices. Karnataka’s demands for central-government mandates on price transparency and expanded price-control measures remain pending, with the state expecting the Union Ministry’s response following the submission of its findings.

The Indian Express