Lucknow – A fresh audit carried out by the Uttar Pradesh Food Safety and Drug Administration (FSDA) has spotlighted a worrying mismatch between what hospitals actually pay for medicines and the maximum retail price (MRP) displayed on the packaging. In numerous cases, the printed MRP is dozens of times higher than the amount spent 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 medicines scrutinised, 36 carried an MRP that exceeded their procurement cost by at least ten‑fold. The most extreme example showed an MRP nearly 67 times the buying price.

Polymyxin‑B injection tops the list

The widest disparity involved a Polymyxin‑B injection, a drug reserved for severe bacterial infections. Hospitals acquired the vial for ₹74.09, yet the label listed an MRP of ₹4,980.94 – a difference of almost 67 times.

Broad gaps in high‑impact injectables

Other critical injectables displayed similarly stark contrasts. A medication used for advanced liver disease was bought for roughly ₹56 but bore an MRP of ₹3,050. Comparable mismatches were observed in drugs targeting serious bacterial and fungal infections.

Meropenem and Caspofungin price spreads

For Meropenem 1 g, a cornerstone therapy against resistant bacterial strains, the MRP varied from about 5.3 to 10 times the purchase price, depending on the brand.

Caspofungin 70 mg, an antifungal agent, exhibited the most pronounced gap in its category. One formulation cost the hospital ₹800 yet was marked at ₹21,230 (≈ 26.5 ×). Another batch was purchased 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 give manufacturers room for discounts, the findings raise questions about how these figures are set and communicated to patients.

Medical devices echo the trend

The price inflation is not limited to pharmaceuticals. A three‑way stopcock was bought for just ₹6.40 but carried an MRP of ₹163. Another piece of equipment cost the hospital ₹20.95 yet displayed 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 bargaining power to compare prices. Consequently, they may be forced to purchase the medication at the inflated hospital‑pharmacy rate, potentially raising overall treatment expenses.

Implications for transparency and regulation

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