23 October 2026 Punjab Khabarnama Bureau : The Central government has flagged significant data gaps and regulatory challenges in efforts to control high mark-ups on medicines, medical devices and consumables sold to patients in hospitals. The issue has come under increased scrutiny as concerns grow over rising healthcare expenses and the financial burden placed on patients and their families.
In its submissions before the Supreme Court, the Centre acknowledged that mark-ups on hospital consumables can range from 100% to 1,000% or even higher in certain cases. However, officials have stressed that comprehensive information on procurement costs and patient billing is necessary before the government can determine the extent of the problem and consider wider price-control measures.
According to government officials, the absence of reliable, nationwide data makes it difficult to assess how much hospitals pay for medicines and medical supplies compared with the amounts charged to patients. The government needs to examine these differences before deciding whether additional regulations or restrictions on margins are justified.
The issue has gained prominence following investigations by state drug regulators that uncovered substantial gaps between procurement prices and maximum retail prices (MRPs) on certain medical products. A Maharashtra government survey, for example, found that an intravenous infusion set purchased at a trade price of ₹11.05 carried a printed MRP of ₹325, representing a mark-up of approximately 2,841%. Other products, including syringes and catheters, also showed substantial price differences.
These findings prompted calls for a national review of the pricing of hospital consumables and medical devices. The Department of Pharmaceuticals has been examining the issue with the National Pharmaceutical Pricing Authority (NPPA), the country’s drug-pricing regulator, and has consulted representatives of private hospitals about procurement practices, billing systems and the costs associated with inpatient care.
However, the Centre faces legal and administrative challenges in extending price controls across the healthcare sector. While the government regulates the prices of specified medicines under the Drugs (Prices Control) Order, 2013, many medical devices and consumables do not fall under the same comprehensive price-control framework.
The division of responsibilities between the Centre and state governments adds another layer of complexity. Public health and hospital administration involve state-level regulatory arrangements, while the Centre has specific powers relating to drug pricing and other areas under applicable legislation. Any broader intervention would therefore require careful consideration of the legal framework and coordination with state authorities.
The Clinical Establishments (Registration and Regulation) Act, 2010, provides for the display of rates charged for services and facilities at covered healthcare establishments. Its provisions also refer to rates or ranges of rates determined by the government in consultation with states. However, implementation is not uniform across the country, and the absence of established rates for many procedures has complicated efforts to standardise hospital charges.
The government has recently asked states and Union territories to ensure that hospitals prominently display their service rates and facilities. The move is intended to improve transparency, help patients make informed decisions and reduce disputes over medical bills. Hospitals covered by the relevant rules are required to display applicable rates in conspicuous locations and in the local language as well as English.
Hospital representatives, meanwhile, have argued that the difference between a product’s printed MRP and its procurement price does not automatically represent the hospital’s actual profit. They point to expenses associated with storage, sterilisation, inventory management, wastage, staffing, infection control and the infrastructure required to provide medical care.
Some hospitals also operate under pre-agreed treatment packages with insurers and government health schemes. Representatives have argued that these arrangements affect how the cost of medicines and consumables is ultimately recovered. They have cautioned that regulating individual items without examining the overall economics of treatment could lead to changes in other charges.
The government must therefore balance the need to protect patients against excessive or opaque billing with the need to maintain the availability of medicines, medical devices and essential healthcare services. Officials have indicated that a clearer picture of procurement costs, billing practices and margins would help determine whether targeted price controls, trade-margin restrictions or other measures are appropriate.
The Supreme Court’s scrutiny has added urgency to the debate, particularly after concerns were raised about substantial mark-ups on essential medicines, including cancer drugs. The court has questioned the wide gap between certain procurement prices and the amounts charged to patients and has asked the Centre to consider possible regulatory measures.
Separately, the government has decided to cap trade margins at 30% on selected expensive, life-saving medicines. Extending similar measures to a wider range of drugs and hospital consumables would require additional analysis, consultation and consideration of potential effects on supply chains.
Consumer groups and patient-rights organisations have called for stronger regulation of hospital charges, transparent billing and greater disclosure of procurement costs. They argue that patients receiving urgent treatment often have little opportunity to compare prices or seek alternatives, making transparency particularly important.
Possible measures under discussion include collecting more detailed pricing data, improving disclosure of costs on patient bills, strengthening audits and reviewing whether additional products should be brought under price monitoring. Any eventual policy would need to define the responsibilities of manufacturers, distributors, hospitals and regulators.
For now, the Centre’s position is that reliable data must form the basis of any broader intervention. The challenge is to establish how pricing differences arise, determine which practices require regulatory action and create an enforceable framework that improves affordability without disrupting access to essential medical supplies.
The debate is expected to continue as the government examines regulatory options amid growing judicial and public scrutiny of hospital billing practices. The outcome could influence how medicines, devices and consumables are priced and disclosed to patients across India’s healthcare system.