The National Pharmaceutical Pricing Authority (NPPA) has started issuing show cause notices to managements of hospitals, nursing homes and other institutions for recovery of overcharged amounts, along with pre-prosecution notices under Essential Commodities Act, 1955 to those hospitals, nursing homes and institutions which have not abided by the instructions of NPPA for compliance of price fixation of coronary stents.

Earlier, vide its Gazette Notification S.O. No. 412 (E), dated 13.02.2017, the NPPA had notified the ceiling prices of coronary stents. As per the notification, the NPPA had put a cap on the prices of bare metal stents - the basic category – at Rs. 7,260 and that of more advanced drug-eluting and bioresorbable stents at Rs. 29,600. Besides, the NPPA had also issued subsequent clarifications issued through Office Memoranda (OM). As per the notification and clarificatory OM, the hospitals are required to comply with the notified ceiling price of stents and to adhere to instructions in letter and spirit.

As per the notification, hospitals are also required to issue detailed bills to the patients clearly mentioning the brand name, name of the manufacturer/importer/batch no., category of the stent (BMS/DES) and other details of stent, if any. In this connection, the NPPA had received a large number of complaints against hospitals for overcharging and in all the cases, the concerned hospitals, nursing homes or institutions were directed to submit list of all angioplasty cases done and billed on or after 14th February, 2017 till 15th March, 2017; certified copies of invoices/ bills of all cases and other concerned documents.  

However, on perusal of the documents specially the bills issued to the patients in case of nine hospitals, it is revealed that, none of these hospitals has fully complied with the instructions contained in the Gazette notification and subsequent OMs issued by NPPA on the subject.

During the examination of the complaints, the NPPA found several non-compliances by the hospitals and nursing homes. Bills issued to the patients by various hospitals, nursing homes or institutions merely indicate the brand name of the stent used, other essential details such as name of the manufacture/importer/batch no/expiry date etc., have not been mentioned.  The type of stent used, whether it is a Bare Metal Stent or Drug Eluting Stent (DES) is also not mentioned in the Bills. Therefore, the hospitals, nursing homes or institutions have not adhered to the order S.O, 4I2(E), dated 13th February, 2017 issued by NPPA in letter and spirit. Besides, in the lump sum billing, there has been no separate mention of the price of stent.  Hospitals have not submitted the bills or submitted the bills after the deadline was over.

“Therefore, all the hospitals/nursing homes/institutions are once again directed to follow all instructions of NPPA which have been issued so far, with regard to the price fixation of coronary stents,” the NPPA warned.