Lucknow – A fresh audit conducted by the Uttar Pradesh Food Safety and Drug Administration (FSDA) has highlighted a dramatic mismatch between the actual expenditure of hospital pharmacies on medicines and the maximum retail price (MRP) displayed on the product labels. In many cases, the printed MRP is many‑fold higher than the amount paid by the institution.

Scope of the investigation

The study scrutinized purchase logs from 214 pharmacy units attached to medical colleges and private hospitals. Out of the 130 medicines examined, 36 showed an MRP that was at least ten times their procurement price, with the most extreme example reaching almost 67 times the purchase cost.

Polymyxin‑B injection tops the list

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

Wide variations in critical injectable medicines

Other high‑impact injectables displayed similarly stark gaps. A medication used for advanced liver disease was bought for roughly ₹56 but carried 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 in treating resistant bacterial infections, 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 widest gap in this group. One formulation cost the hospital ₹800 but was labeled at ₹21,230 (approximately 26.5 ×). Another batch was bought for ₹897.75 and bore an MRP of ₹19,892.

Cancer and life‑saving drugs also under scrutiny

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

Medical devices mirror the trend

Price inflation was not limited to pharmaceuticals. A three‑way stopcock was purchased for just ₹6.40 yet displayed an MRP of ₹163. Another piece of equipment cost the hospital ₹20.95 but carried 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 lack bargaining power 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 intensified calls for greater price transparency, stricter procurement oversight, and routine 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.