NEW DELHI – Top private hospitals in Delhi and National Capital Region have been clocking profit margins ranging from 200 to over 2000 per cent on drugs, diagnostics and consumables being billed to patients.
In the first-ever analysis of drug, diagnostics and devices procurement and billing data of four private hospitals, the National Pharmaceutical and Pricing Authority (NPPA) revealed that all hospitals prescribed non-scheduled branded medicines to patients instead of scheduled medicines in order to expand their profit margins. Scheduled drugs are much cheaper since these are part of price control under the National List of Essential Medicines.
“The total cost on scheduled medicines is only 4.10 per cent compared to 25.67 per cent on non-scheduled formulations. For higher margins, hospitals preferred prescribing non-scheduled branded medicines though scheduled medicines under NLEM are supposed to cover all essential medicines,” the apex drug pricing authority said, calling for a policy intervention.
The NPPA revealed that all these top hospitals charged patients at shockingly high profit margins on scheduled drugs, branded non-scheduled drugs, consumables and medical devices.
Picture this — 67 units of disposable syringes (without needles) which cost the hospital Rs 15.29 each were billed to patients at Rs 13,400 (a margin of 1208 per cent). Profit margins in 18 intravenous infusion sets were also found to be very high. These cost the distributor Rs 5.20, the hospital Rs 8.39 but the patient was billed Rs 2,070.
A similar story is seen across segments — be it scheduled drugs or branded ones. Scheduled Adrenor injections (12) cost the hospital Rs 13.44; the MRP was Rs 52.35 and the patients were billed Rs 628.
Among non-scheduled formulations, hospitals charged patients Rs 42,476 for 10 EMTIG injections bought for Rs 442 each. The profit margin works out to be 856 per cent.
Hospitals even made profits on three-way stop cocks. While they bought 39 units for Rs 5.77 each, they billed these to patients at Rs 4,134.
The NPPA found diagnostics constituted more than 15 per cent of the total cost to patients in hospitals, which were not named. “Diagnostics services do not come under the NPPA and can only be regulated by states through the Clinical Establishments Regulation Act,” the NPPA said.
The authority also said that profit margins in non-scheduled devices used in syringes, cannula and catheters were exorbitant. The NPPA said that most drugs, devices and disposables were sold by hospitals from in-house pharmacies, making huge profits.
The analysis came after two Delhi-based private hospitals were caught overcharging patients. Fortis Gurugram had charged the family of a dengue death victim exorbitantly. Max Shalimar had recently wrongly declared a newborn dead.
COVID-19: Plasma therapy positive result on critical Corona Virus patient: Max Hospitals
New Delhi: The Max Hospital in Saket has administered plasma therapy on a critical coronavirus patient and it’s showing positive results with the patient being taken off ventilator support, the hospital said on Monday.
The 49-year-old man became the first patient to be administered plasma therapy at the Max Hospital (East Wing) here, the hospital said in a statement.
In convalescent plasma therapy, the antibodies of a person who has recovered from the virus are taken and transfused into a sick person (having the virus) to help boost the person’s immune system.
The patient from Delhi had tested positive for Covid-19 on April 4 and was admitted on the same day to the coronavirus facility at the Max Hospital with moderate symptoms and a history of fever and respiratory issues.
“His condition deteriorated during the next few days and he soon required external oxygen to maintain saturation. He also developed pneumonia with Type I respiratory failure and had to be put on ventilator support on April 8,” the hospital said.
When the patient showed no improvement, his family members requested the hospital to administer plasma therapy on compassionate grounds, a first of its kind treatment modality that is being used for the disease in India.
“The family came forward to arrange a donor for extracting plasma. The donor had recovered from the infection (confirmed by two consecutive negative reports) three weeks ago and again tested Covid-19 negative at the time of donation along with other standard tests to rule out infections like Hep B, Hep C and HIV,” the hospital said.
The critically ill patient was administered fresh plasma as a treatment modality as a side-line to the standard treatment protocols on the night of April 14, it said.
“After receiving the treatment, the patient showed progressive improvement and by the fourth day, he was weaned off ventilator support on the morning of April 18 and continued on supplementary oxygen thereafter,” it added.
The hospital said the man has been shifted to a room with round-the-clock monitoring facility.
“He has started taking oral feed since Sunday and is faring well,” it said.
Speaking on the success of the first case administered under plasma therapy at the hospital, Sandeep Budhiraja, Group Medical Director, Max Healthcare, and Senior Director, Institute of Internal Medicine, said the case opened a new treatment opportunity during these challenging times.
“We are delighted that the therapy worked well in his case, opening a new treatment opportunity during these challenging times. But it is important that we also understand that plasma therapy is no magic bullet. During the patient’s treatment at the Max Hospital, other standard treatment protocols were followed and we can say that plasma therapy could have worked as a catalyst in speeding up his recovery,” Budhiraja said.
He also said the recovery cannot be attributed 100 per cent to the therapy.
“We cannot attribute 100 per cent recovery to plasma therapy only, as there are multiple factors which carved his path to recovery,” he said.
He further added that in a country like India, a therapy of such kind has a good potential to help Covid-19 patients who have disease severity, which fits into moderate to severe categories.
“Government regulations should work towards making it more accessible for hospitals across the country to be able to use it. One donor can donate 400 ml of plasma which can save two lives, as 200 ml is sufficient to treat one patient,” Budhiraja said.
So far, 47 people have lost their lives due to coronavirus in Delhi.
This Week In Punjab Was All About Justin Trudeau Visit
For the past few days the visit by Canadian Prime Minister Justin Trudeau and his delegation has been much in the news in the Indian media in general and the Punjabi media in particular. The main emphasis of this visit has been the close links between the two democracies.
The progress made by the Indian Diaspora in general and Sikhs in particular in Canada has been a matter of great pride not only in Canada but also in India. In Canada the proportion of people of Indian origin is 1.4% . This is quite close to the Punjabis in India at 1.9%. The clout of Sikhs in particular in every area in Canada is often the topic of discussion here. This is more so at this time .
It was interesting to note that a prominent Indian journalist Harih Khare wrote a very insightful article in The Tribune as a tribute to Canada on the eve of the current visit by the Canadian Prime Minister. Titled “Welcome Justin Trudeau”, Khare quoted former governor general David Johnston ‘ s treatise: The Idea of Canada. This is a beautiful illustration of Canadian values. Khare also quoted extensively from Justin Trudeau’s Common Ground: Political Life. Both of these works highlight Canada’s diversity, multiculturalism and inclusiveness. All of this makes Trudeau’s visit more relevant and meaningful for the people of India. Incidentally, Canada has become one of the most popular countries in India in general and Punjab in particular.
In this context it was only natural that Justin and his delegation have received A very warm welcome everywhere. His visit to Taj Mahal in Agra, Hamandar Sahib in Amritsa and every other place like Ahmedabad, Bombay and New Delhi have been great success. In a sense this has been a memorable milestone in Canada – India relations.
On another front, my family and friends had an opportunity to visit Rajasthan for a few days. This visit included spending a few days in the Pink City of Jaipur. It is a beautiful city . The Amber Fort is just amazing. It is home to the world’s largest cannon. In addition to that it has great artefacts from the past. Built on steep hillside it is a marvel of engineering. Jaipur is also home to the impressive Jantar Mantar, Jal Mahal City Palace and much more.
From Jaipur it was on to visit Dhanda Bhagat’s Gurdwara about two hours drive from Jaipur. This is a very spacious Gurdwara in the memory of Dhanna Bhagat whose 600 th anniversary was celebrated with great deal of enthusiasm last year. From there we moved on to Ajmer, home of a sacred Dargah. After paying our obeisance at the Dargah , we moved on to nearby Pushkar, one of the holiest places for the Hindus. Pushkar is reported to have 326 temples and has the only temple devoted to Lord Brahma. Also, Pushkar had the honour of visits by Guru Nanak Dev ji and Guru Gobind Singh ji. The Gurdwara here is also very impressive.
After spending a few days in Rajsthan it was time to head home. On our way home we thoroughly enjoyed our visit in Delhi. It was an honour for us to pay our obeisance at the historic Bangla Sahib and Raquab Ganj Gurdwaras. From Delhi we moved on to another historic place called Paunta Sahib in Haryana. There are a number of Gurdwaras here. Guru Gobind Singh ji stayed here for more than four years. Here he successfully turned back the attack by a number of hill chieftains at Bhangani. There are a number of Gurdwaras around here dedicated to Guru Gobind Singh ji ‘s stay in this area.
After taking a short break my family and friends plan to visit a few more places of interest. The weather so far has been great. It is a welcome change from the cold and snow of Metro Vancouver. -Balwant Sanghera .
Balwant Sanghera is a retired School Psychologist and Community Activist. He is currently on a family vacation in India.
Walmart In Talks To Buy Large Stake In Flipkart At $20-23 Billion Valuation
NEW DELHI – American retailer Walmart Inc may end up taking a large stake in Flipkart Ltd at a price that could value India’s largest e-commerce firm between $20 billion and $23 billion, three people close to the development said. If it goes through the deal will pit Walmart against Amazon in India, mirroring the fight between the two companies in the US.
Walmart has expressed an interest in buying Flipkart Ltd but a buyout is unlikely to go through as a key Flipkart investor SoftBank Group is opposed to a sale, the three people added on condition of anonymity. “Softbank is not willing to cash out this early as they see themselves as a long term investor in Flipkart,” one of the three people mentioned above said.
The talks are in the early stages and the companies haven’t finalized the final details, the people said. Walmart is expected to invest fresh capital in Flipkart as well as buy shares from existing investors including Accel Partners and Naspers, they added.
Any deal is likely to make Walmart the largest shareholder in Flipkart, they said.
Walmart is not the only suitor pursuing Flipkart. Search giant Google has also offered to invest in the e-retailer at a valuation of $15-$16 billion, said a fourth person close to the development. Flipkart is also talking to other investors, this person said, without naming the investors.
Flipkart’s biggest backer and key board member Lee Fixel of Tiger Global was in Walmart’s headquarters last week helping put together the deal, this person said.
Flipkart and Walmart declined to comment. Google and Softbank did not respond to emails seeking comment.
The Economic Times newspaper reported on 31 January that Walmart is in talks to buy 15-20% of Flipkart.
In August 2017, Flipkart received a commitment of $1.4 billion in fresh capital from Japan’s Softbank Group valuing the company at about $14 billion.
Launched in 2007, Flipkart has thus far raised more than $6 billion.
The current valuation offered by Walmart includes Flipkart’s fashion businesses Myntra and Jabong, ebay India, as well as mobile payments firm PhonePe.
Walmart has eyed India’s retail sector for years but the existing foreign direct investment (FDI) policy does not allow the retailer to serve have a meaningful presence in the country.
It does operate in India’s B2B (business to business) retail and e-retail segment but has stayed away from direct retail. Walmart has stayed away from joining hands with any other Indian retailer since it’s partnership with Bharti Enterprises ended in 2013.
New potential investors are willing to value the company at a much higher price partly because Flipkart has shown that it is holding its own against Amazon, which has been unable to unseat its local rival as the country’s largest online retailer despite outspending Flipkart, say analysts. Additionally, Flipkart is seen as the one of the most attractive assets in the global Internet economy, benefitting from the long-term potential ascribed to India’s internet market by investors.
Walmart and Google held funding talks with Flipkart in late 2016 but those discussions didn’t lead to deals.
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