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Should the Exorbitant Amounts Charged for RT-PCR Tests be Refunded?

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Introduction

A plea has been filed in the Honourable Supreme Court of India seeking a refund of exorbitant amounts charged by private hospitals and labs for RT-PCR Tests.    

RT-PCR Test

The RT-PCR test is a real-time Reverse transcription-polymerase chain reaction (RT-PCR) test used to detect nucleic acid from SARS-CoV-2. Meaning thereby, RT-PCR tests are used to find the presence of Coronavirus in the body of an individual.

Odisha Brings Down the Price of RT-PCR Test

Recently, a plea has been filed in the honourable Supreme Court of India which sought to fix the price rate of the RT-PCR test at Rs.400, wherein the Apex Court asked the Government of India to file its response on the same. The Court on November 26, issued notice to the centre, states, and Union Territories seeking its response about a reduction in the price of RT-PCR Tests. Due to this, the government of Odisha, after analyzing the actual cost of test equipment, reduced the cost of the RT-PCR test to Rs.400. This makes Odisha the lowest among all states in the country.

Uniform Price Rate

The Indian Council of Medical Research (ICMR) has left the states to decide the price of COVID-19 tests. In most government facilities, coronavirus testing is free of cost. On March 31, a petition was filed in the Honourable Supreme Court of India seeking direction to the centre and authorities concerned to provide free testing facilities to all citizens in the country. Wherein, the apex Court suggested the centre should create a mechanism wherein private hospitals and laboratories did not charge exorbitant amounts from COVID-19 tests from the public. And the Court also directed the government to reimburse the fees charged by labs.

Even though the price of RT-PCR kits falls sharply across India, the prices charged by private hospitals and laboratories remain the same. Even though the prices are not the same across India, they vary accordingly such as in Assam it is Rs. 2200, in Meghalaya, it is Rs. 3000. So, by considering this, a Delhi based Advocate Ajay Agarwal filed a petition in the Honourable Supreme Court of India, who sought a direction to the central government to fix the uniform RT-PCR test price across India at Rs. 400. A test kit for COVID-19 RT-PCR costs Rs. 199 but in India, it costs more than 250% for a test. He pointed out that the machines used to detect COVID- 19 is not a new one; it is the same machine used by laboratories that detect HIV, malaria, etc.

He submitted a report, where he pointed out that, a Nagpur based COVID-19 RT-PCR test kit manufacturer Orange City Glasco Pvt Ltd sells a test Kit for Rs. 199. They even provide a 25 Rupees discount for each product when the order crosses 1 lakh. So, by comparing the actual price and the prices charged by private hospitals and laboratories, it is very clear that exorbitant amounts are being charged.  

Testing More is Cheaper

Experts have pointed out that while conducting a large number of sample tests, the expense of a single test becomes more economical.  It is said that when a total of 10,000 tests are conducted at one go, the price for a particular sample can drop at Rs. 500. In addition to these RT-PCR tests, some researchers are using CRISPR, a gene-editing tool to identify coronavirus, which is quicker when compared to RT-PCR tests and is accurate too, and costs around Rs. 450. But the problem with this test is, it is largely experimental and off from commercial viability. 

IIT Kharagpur’s COVIRAP Method

Recently, researchers at IIT-Kharagpur developed a diagnostic method, using a low-cost portable to detect coronavirus in samples. As per reports, this method produces a result more like results produced from RT-PCR. But it is said that the accuracy level in the said method is slightly lower than the gold standard RT-PCR method. Unlike the RT-PCR machine which costs up to 25 lakhs and requires molecular biologists to operate, the method developed in IIT costs only Rs. 5000 and can even be manufactured at lower costs.

So, this method is very suitable for all and is affordable for all. But yet, this method of testing did not hit the production unit. But, when it does, the burden on the poor and indigent poor will vanish.   

Refund of the Exorbitant Amount

Private hospitals find the amounts prescribed by the Court, and the government is deficient and untenable. Patient groups say that private hospitals are still flouting the new regulated prices. The private hospitals are unhappy with these directions and have also approached high Courts opposing any government regulation of COVID-19 treatment prices. The Breach Candy Hospital in Mumbai has stated that it would have to shut down the hospital if they follow the government’s order, which is reserving 80% beds for COVID-19 patients at capped prices.

On December 5, 2020, a petition was moved by Advocate Ajay Agarwal in the Honourable Supreme Court of India, where he sought a refund of unreasonable amounts charged by private hospitals and labs for RT-PCR Tests across the country. The petitioner asked the Court to fix a uniform price rate (Rs.400) for RT-PCR Tests across the country.

The petition pointed out that laboratories are looting crores and crores of money from poor and indigent people. He added that private hospitals and laboratories are using the pandemic as a tool to loot exorbitant money from people. It sought direction from the centre to ensure a refund of exorbitant amounts as it was not only unrealistic and unreasonable but also shocking.

In a country like India, people below the poverty line are in crore, and due to pandemic effects, many have pushed to indigence state. So, collecting unreasonable money by using this pandemic situation is mere extortion. The responsible persons should be punished, and the excess amount is refunded at the earliest, said the plea.

Even though every government hospital provides free or low-cost treatment for COVID-19, many are choosing private hospitals over government hospitals. Only those who can’t afford to pay the amount charged by private hospitals are opting for government care. This situation must be changed. This is because of the lack of proper health care facilities and the unhygienic situation at government hospitals. In a report, the Indian government spends only 3.6% of total GDP on health care, way lower than other countries. Lack of finance makes the government hospitals to run in this situation. And lack of government policies and lack of proper healthcare facility legislature shares an equal contribution to this situation.

In states such as Tamil Nadu, Kerala, Karnataka, and Andhra Pradesh, the state government has established a committee to study and finalize the capped prices. This committee consists of many experts and some including representatives from the private healthcare sector. 

Conclusion

Advocate Ajay Agarwal has filed a petition in the honourable Supreme Court seeking a refund of the exorbitant amount charged for RT-PCR tests. He asked the Court to fix the price rate at Rs.400 across the country. The bench led by Chief Justice SA Bobde and Justice AS Bopanna and V Ramasubramanian had issued notice to the Union government regarding the same.


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