Hos can’t force patients to buy medicines from its store Hospitals usually have an attached pharmacy. Patients are compelled to buy medicines from the in-house store and are prevented from purchasing it in the open market. In a landmark ruling, the National Commission has held this to be an unfair trade practice.
Case Study: Meenu Jain was admitted to Fortis Escort Hospital in Jaipur on May 25, 2009 for treatment of Guillain Barre Syndrome. At the time of admission, her husband Prem Chand was made to sign a form giving general consent for admission and counselling. It also contained a declaration agreeing to the administration of treatment in accordance with the advice of the doctors and to pay the rates charged by the hospital.
Meenu was put on ventilator and had to be administered a lifesaving drug, Injection Iviglobex, five doses daily, for five days. The cost of this injection was Rs 18,990 as per the MRP. The injections had to be purchased from the hospital’s pharmacy. Meenu was successfully treated and discharged on June 13, 2009. The total amount billed by the hospital was Rs 6,82,965, which was paid without any protest.
After discharge, Prem Chand wrote to the hospital seeking information about the batch number, expiry date, and the supplier’s bill for these injections, but the hospital refused to furnish these details. Prem Chand then filed a complaint before the Jaipur District Forum against the hospital through Fortis Health Management (North) Ltd. He claimed that the same injection was available in the market at 30% to 40% discount, but he was compelled to purchase them from the hospital pharmacy at the printed MRP. He claimed that this had resulted in his having to pay an excess amount of Rs 1,56,167, and he sought to recover this amount by filing the complaint. The forum held the hospital guilty and ordered it to discontinue the unfair trade practice. It directed the hospital to pay a compensation of Rs 1 lakh and costs of Rs 5,000 to the Jain couple, and another Rs 1 lakh to the State Consumer Welfare Fund.
The hospital’s appeal to the state commission was dismissed. The dispute was carried in revision to the National Commission, where the hospital argued that the complaint was not maintainable since the patient had been successfully treated and discharged, and there was no allegation of medical negligence. The entire bill had also been paid without any objection. The dispute about being overcharged was raised after discharge. The hospital attempted to justify the compulsion to purchase all drugs from its own pharmacy as those available outside in chemists shops may be spurious. An example was cited where drug control officials had conducted a raid on a medical store outside the hospital and seized 15 Iviglobex injections that were suspected to be spurious. Also, Prem Chand had agreed to purchase medicines from the hospital as per the consent form signed by him at the time of his wife’s admission.
The commission observed that the hospital was in a dominating position and had exercised undue influence as the family members would be anxious to get over with the formalities so that treatment would commence, especially when the patient is in serious condition. The argument that purchase from the hospital’s pharmacy was made compulsory to ensure quality and genuineness of the drugs was considered to be an excuse. The commission concluded that insistence on purchase from the hospital pharmacy imposed an unjustified and unreasonable restriction on the consumer.
The commission pointed out that corporate hospitals should not be commercial / business centres for profiteering from the exploitation of critical patients, who have to pay skyrocketing hospital bills.
Accordingly, by its order of July 22, 2014 delivered by Dr S M Kantikar for the bench along with Justice JM Malik, the commission held the hospital guilty of indulging in unfair trade practice. It observed that the right of the consumer to purchase medicines from the open market cannot be curtailed by the hospital. Since there was no evidence to show the discounted price of the injection, the commission ordered 50% of the excess charge to be refunded amounting to Rs 78,000. Ninety days was given for compliance, and if delayed, amount would carry interest at 9% pa.
Impact: Hospitals cannot profiteer by exploiting captive consumers. In view of the increasing number of complaints against hospitals indulging in such malpractices, the state government’s Food and Drug Administration recently issued a circular dated January 18, directing hospitals to conspicuously put up a notice informing patients that they are free to purchase medicines from any authorized chemist and not necessarily from the hospital pharmacy.