Thapathali-based Paropakar Maternity and Women’s Hospital has been running a fair-price pharmacy for years, through which the hospital administration has been selling medicines at discounted prices. Patients seeking treatment at the hospital, as well as others buying medicine from its pharmacy, receive an average discount of around 40 percent.

Like Thapathali Hospital, many state-run hospitals, including Bir Hospital, National Trauma Centre, Kanti Children’s Hospital, Manmohan Cardiothoracic Vascular and Transplant Center, Shahid Gangalal National Heart Centre, have long operated their own pharmacies where medicines are sold at discounted prices under policies introduced by successive governments.

Now, as Minister for Health and Food Safety Neesha Mehta has showcased the achievements of her first 100 days in office, many state-run hospitals have erected new signboards reading ‘affordable pharmacy’.

“Neither have new medicines been purchased recently, nor have the prices of any medicines been reduced,” said a pharmacist serving at the National Trauma Centre, who requested not to be quoted in the news, as he fears retribution. “We have been selling medicines at the same prices as we did a year ago. The ‘affordable pharmacy’ signboard was installed just a day earlier.”

Pharmacists, as well as health officials at Bir Hospital and the Thapathali hospital said they have been warned against speaking to the media and told they could face consequences if anything is published, as they would have to answer to ministry officials and officials of the minister’s secretariat.

Officials say that medicine prices are determined by procurement costs. Suppliers, manufacturers and stockists compete in tenders by offering prices below the maximum retail price printed on medicines, hoping to secure large-volume sales. Hospital pharmacies require huge quantities of medicines, as thousands of patients from across the country seek treatment at those hospitals every day.

“Hospitals invite quotations for the next fiscal year’s requirements, and suppliers compete to win the tender,” said an official at Bir Hospital. “The medicines currently being sold were purchased at the start of this fiscal year. Prices in the next fiscal year could remain the same, decrease or increase, depending on the new tender.”

Former health officials say there is much more the health minister could do to improve public health and urge her to seek suggestions from experts instead of claiming credit for initiatives introduced by previous governments.

Dr Jageshwar Gautam, former director of Thapathali Hospital, said the hospital had started a fair-price pharmacy in 2018 following a government directive.

Pharmacists at Thapathali Hospital pharmacy informed that a 1-gram injection of paracetamol, with a maximum retail price (MRP) of Rs 713, is sold at Rs394. A Ceftriaxone 500 mg injection, whose MRP is Rs 90, is available for Rs39, Calcium Carbonate and Vitamin D3 Tab strip, whose MRP is 90 is available at Rs 24, Sinus nasal drop, whose MRP is Rs 75 is available at Rs 30, iron calcium strip, whose MRP is 140 is available at Rs 33, Calcium Carbonate and Vitamin D3 Tab strip of Indian company, whose MRP is indian rupee 94.50 is available at Rs 97, the MRP of Tranexamic acid used to control bleeding is Rs110 but is available at Rs 40 in the hospital pharmacy. Meropenem injection, with an MRP of Rs 550, is available at Rs 316.

“We don’t know why the authority placed another new signboard, but the medicines available at our pharmacy have long been sold below the MRP," an official at the hospital said.

Most state-run hospitals opened their own pharmacies following the Supreme Court order in 2015 which directed the government to set up subsidised pharmacies at every public hospital and prohibit private pharmacies from operating on hospital premises.

The Health Ministry officials say the “affordable pharmacy” signboards were installed to inform patients that medicines are sold below the MRP at hospital pharmacies.

“Many patients do not realise that hospital pharmacies sell medicines at discountd prices,” said Dr Samir Kumar Adhikari, joint spokesperson at the ministry. “The signboards are meant to let patients know they can buy medicines for less than MRP.”

When asked about why the minister included the move as her 100 days achievements, Adhikari refused to comment.