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‘Need clear guidelines to counter profiteering and low-grade kits’.

Date: 02-05-2020
Subject: ‘Need clear guidelines to counter profiteering and low-grade kits’
Mumbai: With the country already reeling under the Covid-19 pandemic, patients and consumers are now raising concerns over unethical practices like price gouging and selling of sub-standard quality N95 masks and personal protective equipment (PPE) kits. Prices of N95 masks have increased by nearly four times, while different prices are being charged for PPEs across the country, with their quality also being suspect. Industry experts have also said that false and fake certification is rampant and fly-by-night manufacturers have surfaced in the absence of clear product specifications and monitoring by government.

Prices of surgical masks were capped by the government in March to plug overcharging, while N95 masks were not included in the notification. 

With the exceptions of masks, there is no clarity or uniform guidelines on the protective gear specification for health workers, police personnel and sanitation workers, resulting in some of them buying sub-standard kits from dubious manufacturers. 

“The Union health ministry in ‘Rational Use of PPEs’ has laid down guidelines only for a few categories of healthcare workers, while other organisations are required to use them as per hospital infection control policy, hence, we request government to provide standard guidelines for each category of workers,” Dr Sanjiiiv, chairman, PWMAI (Preventive Wear Manufacturers’ Association of India) told TOI, adding that this is leading to confusion. 

There is also a demand for clear national standards to be set by Bureau of Indian Standards for specification of each category/ product of PPEs so that MRP can be capped. “In order to protect consumers, MRP of PPE and other Covid-relevant medical devices needs to be capped at a reasonable level. We suggest an MRP of around four times the ex-factory price or import-landed price. It is difficult to cap prices for PPE in the absence of clear BIS standards as these have to be co-related to a defined product specification/ category, so it’s imperative that BIS releases these standards after due consultation with stakeholders,” Rajiv Nath, forum coordinator of AiMeD, industry body of domestic medical devices said. 

“There has been a proliferation of PPE manufacturers, many of which are new entrants trying to take advantage of the situation caused by pandemic and operating without necessary quality compliance. This has also led to a sellers’ market with outrageous quotations for PPE components”, Malini Aisola, co-convenor of All India Drug Action Network told TOI. 

The price of a PPE kit by state-owned HLL Lifecare, which is designated as a single-window procurement agency for Central government hospitals, is around Rs 1,100. However, kits are being sold for as low as Rs 250 in the private sector but these kits are suspected to be substandard and without a proper barrier to protect against microbes and fluids, an industry expert said. In certain cases, patients are being billed as high as Rs 1,500-2,000 for PPE kits, by hospitals. 

“Most private hospitals are billing patients for PPEs and the charges can vary widely, depending on the treatment and hospital. Even the patients, whose treatment is covered under Ayushman Bharat, are being forced to pay for PPEs out of their pockets. For example, if a patient, covered for dialysis under Ayushman Bharat, is asked to pay Rs 170 for PPEs everytime he/she goes for dialysis, as was being done by one private hospital in Jaipur, the patient actually ends up paying Rs 1,360 a month, considering that he/she would need this treatment at least twice a week. Recently, Rajasthan released an order warning private hospitals to refrain from charging extra from patients, apart from what they are entitled to as per the package rates fixed under insurance scheme. However, in the lack of any monitoring, how much would this order get implemented, we will have to see,” says Chhaya Pachauli, director at Prayas and member Jan Swasthya Abhiyan. 

Rama Venugopal executive director, Value Added Corporate Services, who has experience in industry’s regulatory requirements said that the market is rampant with fraudulent and sub-standard products, with huge markups and price fluctuations, hence government inspectors should monitor and visit these units. Dr Sameer Agarwal , president of Practicing Pathologists Society, Rajasthan said that there is a huge mark-up in prices of N95 masks, which are now being sold around Rs 250-300 a piece, with GST being charged anywhere between 5%-18%. 

The Supreme Court recently asked the Centre to provide PPE kits to health workers working in ‘non-Covid treatment areas’ too. 

Source:- timesofindia.indiatimes.com

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