Bengaluru: Amid growing calls for transparency in healthcare costs, the Karnataka Food Safety and Drug Administration has ordered all hospitals, distributors and retailers in the state to display base price (actual procurement cost to hospitals / hospital pharmacies) and Maximum Retail Price (MRP) on all bills for medicines, medical devices and consumables.
The move follows mounting scrutiny over the significant difference in landing/base price and the MRP printed on medicines, medical devices and consumables. In several cases, patients are billed at or near MRP without any transparency about the actual acquisition cost, Karnataka FDA said in the circular dated October 1, 2026.
Under the new directive, hospitals must issue an itemised bill showing each medicine, device, implant and consumable separately starting November 1.
For every line item, the bill must state the product name, with generic and brand names where applicable, along with the batch number and the manufacturing and expiry dates.
Bills must also show the landing or base price, exclusive of taxes, the MRP as printed on the pack or notified by the National Pharmaceutical Pricing Authority (NPPA), the price charged to the patient, and any applicable taxes not already included in the MRP.
The price charged to the patient cannot exceed the MRP, the regulatory body noted.
The state FDA also directed hospitals to put up notices at billing counters, pharmacy counters and admission desks informing patients of their right to see the landing price and MRP on their bills, and publish this information on their websites where available.
It added that records of purchase invoices, landing prices and billing details must be maintained for at least three years for inspection and barred hospitals and institutions from charging above the MRP printed on the pack or above the ceiling price notified by the NPPA.
The order applies to all government, private and trust hospitals, nursing homes, clinics, day-care centres and diagnostic centres, covering both in-patient and out-patient services.
It also covers carrying and forwarding (C&F) agents, stockists, distributors, wholesalers and retailers licensed with the department.
Responding to the Karnataka FDA’s move, the Association of Indian Medical Device Industry (AiMeD) welcomed the initiative but pushed for the tracking of prices across the entire supply chain.
Mr. Rajiv Nath, Forum Coordinator, AiMeD, said: “We appreciate the Karnataka Government’s efforts to bring greater transparency to healthcare billing and trade margins. While disclosure of procurement cost and MRP at the hospital level is a useful first step, it captures only the margin at the final point of supply. For effective policy intervention and identification of where excessive mark-ups may arise, the entire value chain needs to be mapped transparently from 1st post of sale when GST is initially applied on import landed price or manufacturer’s selling price through entire supply chain to the patient. End-to-end visibility of ensuring MRP and transaction value captured at invoice at each stage of supply chain will help ensure that corrective measures are evidence-based, fair and focused on the actual source of price escalation.”
