Lucknow – A fresh audit conducted by the Uttar Pradesh Food Safety and Drug Administration (FSDA) has brought to light an alarming mismatch between the actual amount hospitals spend on medicines and the Maximum Retail Price (MRP) displayed on the packaging. In many cases, the MRP is dozens of times higher than the price paid by hospital pharmacies.

Extent of the investigation

The study scrutinised purchase ledgers from 214 pharmacy units operating inside medical colleges and private hospitals. Among the 130 medicines examined, 36 products carried an MRP that was more than ten times their procurement cost. The most extreme example showed an MRP roughly 67 times the purchase price.

Polymyxin‑B injection tops the list

The largest disparity involved a Polymyxin‑B injection, a drug employed against severe bacterial infections. Hospitals acquired the vial for ₹74.09, yet the label advertised an MRP of ₹4,980.94 – a gap of almost 67 ×.

Broad gaps in high‑impact injectables

Other critical injectables also displayed stark differences. A medication for advanced liver disease was bought for about ₹56 but bore an MRP of ₹3,050. Similar mismatches were observed in drugs targeting serious bacterial and fungal infections.

Meropenem and Caspofungin price spreads

For Meropenem 1 g, a work‑horse against hard‑to‑treat bacterial infections, the MRP varied from roughly 5.3 to 10 times the purchase price, depending on the brand.

Caspofungin 70 mg, an antifungal agent, exhibited the widest gap in this group. One formulation cost the hospital ₹800 but was marked at ₹21,230 (about 26.5 ×). Another batch was bought for ₹897.75 and labeled at ₹19,892.

Oncology and life‑saving drugs under the microscope

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

Medical devices echo the pattern

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

Scarcity curtails patient bargaining power

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 costs.

Implications for transparency and regulation

The FSDA’s revelations have amplified calls for greater pricing transparency, tighter 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.