The Post-Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh is a beacon of hope for thousands of patients who throng its corridors to get life-saving treatment from internationally and nationally known faculty. But, in a bid to rake in the moolah from the chemist shops on the campus, authorities of the PGI have put in place a system whereby countless patients buying prescribed medicines and surgical instruments have been put at the mercy of unscrupulous businessmen.
The PGI auctions the shops on its campus to the highest bidder. Given the immense scope for business and hence profit, big chemists have jumped into the arena to make a killing. So, while the PGI and chemists make a good profit, unwary patients, particularly the poor, pay a heavy price, literally speaking.
HT set out to unearth a system which seems insensitive to the situation most patients are put into due to PGI's own making. We focused on three most widely used medical items that account for the bulk of sales at medical stores on the campus: blood transfusion (BT) sets, infusion/intravenous (IV) sets and IV cannulae (see box).
Starting with drug stores on the PGI campus, we also picked up pharmacies in neighbouring Sectors 11, 16 and Khudda Lahora village behind Punjab Engin-eering College for a comparative study of prices. Surprisingly, none of these items are sold at the maximum retail price (MRP). After buying these items at "huge discounts", buyers end up with a false sense of a 'benevolent' healthcare system.
At PGI drug shops, a BT set is sold between Rs. 45 and Rs. 50, after nearly 50% discount on the MRP. Surprisingly, the same set is available at only Rs. 20 at the government multi-specialty hospital at Sector 16, 3 kms from PGI. HT bought the same blood transfusion set at Shubh Sidh Store in Khudda Lahora village, 2 km from PGI, for the same price of Rs. 20.
On the other hand, an IV set available for Rs. 50 at PGI shops was sold for Rs. 18 only at GMSH-16 shop; in Khudda Lahora, the set was retailed for Rs10. PGI shops either sell the brands that carry the highest MRP, or the commonly retailed brands at a relatively higher price.
A cannula available at the PGI shops for Rs. 50 was bought for Rs. 36 at the GMSH-16 shop. At the Khudda Lahora shop, the retail price was just Rs. 15! Other chemists retail it for anything between Rs. 25 and Rs. 40. The chemist shop at the SAS Nagar civil hospital did not have a cannula, when approached.
PGI officials seem to be aware of this price difference. "I know that as one goes away from the PGI, medicines and other items come cheaper," remarked PGI spokesperson ManjuWadwalkar.
Another issue was that a shop at the PGI advanced trauma centre sold products of a particular brand 'Umaflow', which carries a higher MRP than the most commonly found 'Romsons' products. It could be argued that products of a particular brand are better and thus priced higher than products of a rival company. However, a PGI doctor said, "An IV or a BT set is just an anc-illary, yet a common component of any treatment. We just put our demand in terms of numbers because all are equally good."
Even within PGI, there is a stark difference between prices quoted by different medical stores. AAR Medicos in the new OPD block sells lower MRP items for the same price compared to higher priced items sold at other PGI shops. 'Romsons' IV set (MRP Rs70) is sold for Rs. 50 at AAR Medicos, whereas Trilok Medicals sells 'Umaflow' items (MRP Rs. 90) for the same price; AAR Medicos offers 'Romsons' BT set for Rs. 43, whereas Trilok Medicals sells 'Umaflow' brand (MRP Rs110) item for Rs. 50.
Commenting on the price differential issue, Sanjeev Kumar, the owner of a Khudda Lahora-based drug store, said, "PGI shops are auctioned for exorbitantly high rentals. Shop owners have to earn profits to pay the high monthly rentals; so they sell items at high prices. Apart from these surgical items, their real margin lies in high-end antibiotics, which they retail for an extremely high profit."
But why and how did a welfare measure aimed at ensuring ready availability of medicines and medical equipment/instruments on the campus turn anti-people? "Earlier, the shops did not have such high rentals. But, over a period of time, traders realised the profit potentials of campus shops, owing to the high volume of patient traffic at the hospital. This led to the present situation," remarked a PGIMER source.
The iron curtain
When HT tried to contact PGIMER director YK Chawla, he chose to remain hidden behind an iron curtain of "bureaucratic protocol". His office staff said that an appointment was needed to meet him, but denied giving any, citing a 'packed-to-the-rafters' schedule. Even spokesperson Manju Wadwalkar said, "I can't fix an appointment with him. He does not meet people."