COVID Vaccine 4

 

To

Shri Rajiv Gauba

Cabinet Secretary

Govt of India

Dear Shri Gauba,

The  Pricing and Accelerated National Covid-19 Vaccination Strategy 21-4-2021 (PANCVS) notified by the Union Health Ministry has given a free license to the vaccine manufacturers to set prices arbitrarily, ostensibly in a transparent manner, as indicated in Para 8(ii) below.

Manufacturers would in a transparent manner make an advance declaration of the price for 50% supply that would be available to State Govts. & in the other than Govt. of India channel, before 1st May 2021. Based on this price, States, private hospitals, industrial establishments through their hospitals may procure vaccine doses from the manufacturers. Private Hospitals would have to procure their supplies of Covid-19 vaccine exclusively from the 50% supply earmarked for other than Govt. of India channel. The price charged for vaccination by private hospitals would be monitored

I have tried to verify from the websites of the Serum Institute of India (SII) and Bharat Biotech to see whether they have disclosed any price at all under this category of supplies but, despite my best efforts, I have not been able to locate any such disclosure. On the other hand, several private hospitals, supplying SII’s Covishield and Bharat Biotech’s Covaxin, are levying prices as high as they wish. It is a free-for-all situation today, as far as vaccines are concerned. It is the low-income families who have been hit badly.

Though PANCVS requires the authorities to “monitor” the prices charged, neither the Central agencies nor the States seem to have cared to monitor the same.

At the present juncture, however much the Centre may deny it, there is an acute vaccine shortage across the country and those wishing to get vaccinated are literally scrambling for vaccination wherever available. Those seeking vaccination include all income groups, as it is a matter of life and death for them.

Especially those belonging to the low-income groups, who will lose their daily livelihoods if they fall ill, are anxious to get vaccinated immediately. On the other hand, the private hospitals are merrily making money on vaccines, irrespective of the income and the social status of the people. While the two indigenous vaccine producers do not seem to have disclosed their prices as required, the CoWin website itself indicates the prices charged by some private hospitals in Visakhapatnam as per the following extract from that website.

Vaccination centers for 18-44 age group:

  1. Apollo Hospitals Health City (Visakhapatnam(Urban)) – Pin: 530040

Vaccine: COVAXIN.

Cost: Rs.1250

Total 17 slots are available on Jun 04

DOSE 1 NOT AVAILABLE

(Dose1: 0, Dose2: 17)

 

  1. Apollo Hospitals Health City (Visakhapatnam(Urban)) – Pin: 530040

Vaccine: COVISHIELD.

Cost: Rs.850

Total 20 slots are available on Jun 04

DOSE 1 NOT AVAILABLE

(Dose1: 0, Dose2: 20)

CoWin: https://selfregistration.cowin.gov.in

What is the basis for the private hospitals charging such high prices? It is not clear, nor has the Union Health Ministry cared to verify whether the prices charged amount to earning excessive profits. There does not appear to be any element of public accountability in this.

It looks as though the position across the country is the same, as evident from the following two news reports.

https://www.thehindu.com/data/data-private-vaccination-centres-charge-two-to-three-times-the-base-price-of-covishield-vaccine/article34714939.ece

https://timesofindia.indiatimes.com/india/at-rs700-rs1500-price-of-covid-vaccine-in-indias-private-sector-among-costliest/articleshow/82509814.cms

I have also enclosed the soft copies of these reports for your ready reference.

From these reports, the following findings emerge.

  1. The CoWIN website shows that the bulk of private-sector vaccination right now is by four big corporate hospital groups — Apollo, Max, Fortis and Manipal
  2. Though not explicitly disclosed, the manufacturers’ prices for Covishield and Covaxin seem to be Rs 600 and Rs 1200 per dose. As in the case of many other commodities, no Maximum Retail Price (MRP) is prescribed either by SII or Bharat Biotech. There seems to be no assessment made by the Union Health Ministry of the extent of profits earned by the manufacturers.
  3. The minimum price charged for either vaccine varies widely across the States and there seems to be no valid justification for such a wide variation.
  4. From Rs 250, the cost of vaccines in the private sector has shot up by up to six times. It now ranges from Rs 700-900 for Covishield manufactured by the Serum Institute of India (SII) and Rs 1,250-1,500 for Covaxin manufactured by Bharat Biotech (BB).  Some private centres are charging Rs 1800 for Covishield and Rs 1500 for Covaxin.
  5. Out of the 325 private hospitals surveyed in one study, 273 hospitals are charging Rs 800-1000 per dose of Covishield, 20 hospitals charging Rs 1000-1200 and 3 hospitals charging Rs 1200-1400..
  6. An overwhelming majority of countries are not making people pay from their own pocket for Covid vaccination. India is not only one of the few exceptions, the cost of vaccines in the private market in India is among the highest — almost $12 for getting a shot of Covishield and $17 for Covaxin.
  7. Covishield’s median price at the private hospitals sampled was 75% of the average monthly expenditure of the poorest urban households. In the case of Covaxin, the dent on the income of an urban poor family would be worse.

These are startling findings, indicating how, at a time when the Centre’s vaccine strategy (if one can call it a strategy at all!) has converted a buyer’s market to a sellers’ market, by creating a serious vaccine shortage in the country, PANCVS has unleashed serious imbalances in the way vaccine doses are priced by the private agencies, how it has led to profiteering by both the vaccine manufacturers and the private hos[pitals and how it has placed an unduly heavy cost burden on the low-income groups in the country.

There cannot be anything more regressive than this at a time like this, when millions of the workers in the unorganised sector find themselves deprived of their livelihoods for no fault of theirs and when they are left with no alternative other than rushing to any vaccination centre they could reach and get vaccinated. No doubt, the State-run vaccination centres are providing vaccines free of cost but PANCVS has restricted the window available to them to procure vaccines, as the Centre is starving them of vaccine allotments. The States therefore feel helpless in dealing with the vulnerable sections of the population in their respective areas. PANVACs has also introduced inequities in the availability of vaccines not only across the States but also across the different income groups.

With inadequate hospital infrastructure available in the public sector, many low-income families are forced these days to seek medical treatment for Covid in private hospitals which in turn are collecting from them unreasonably high charges, often, under the table, without issuing receipts. The Centre and the States are, either deliberately or otherwise, have chosen to be mute spectators to this. As a result, the financial position of many low-income families in the country, already crippled due to the Covid-related lockdowns, has further worsened during the last few months. Expensive vaccination has compounded this situation further.

To get vaccinated and insulate oneself against the deadly Covid virus is a fundamental right under Article 21 of the Constitution and the most vulnerable sections of the population are being denied that right.

A quick assessment would show that the ongoing Covid crisis, triggered by PANCVS, has crippled the finances of the vulnerable sections of the population in India, whereas it is the vaccine manufacturers and the corporate hospitals who seem to have taken advantage of the shortages and profiteered at the cost of the poor.

PANCVS has broken down the enormous leverage that India would have commanded in the vaccine market by virtue of its huge population of 1.3 billion and literally placed the country, especially the States, at the mercy of both the domestic manufacturers and the overseas ones. No wonder that many overseas manufacturers are dictating terms to the country today. This in itself will further escalate the vaccine prices in India as the suppliers will quote the prices in dollars. The upward hike in the vaccine prices as a result of the entry of the foreign suppliers, especially in a non-competitive market, will further accentuate the inequalities and hit the poor most.

PANCVS, in my view, calls for an immediate review, especially keeping in view the concerns already expressed by several State Chief Ministers.

Separately, an independent judicial enquiry should be commissioned to assess the undue profits earned by the vaccine suppliers and the private hospitals at the cost of the poor in India.

Regards,

E A S Sarma

Former Secretary to Govt of india

Visakhapatnam


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