Economic Survey 2018 hints at price regulation for diagnostic tests

Survey indicates the move after government puts price cap on devices

The Economic Survey 2017-18 has called for an urgent standardisation of rates of diagnostic tests, pointing to the delay in the implementation of Clinical Establishments Act in the country. 

“An analysis of prices of diagnostic tests across various cities in India reveals that there are not only wide differences in average prices of diagnostic tests but the range in prices is also substantial. The data on quality and accreditation of diagnostic establishments in the country is scanty. There is a need to prioritise standardisation of rates by devising appropriate quality assurance framework and regulatory mechanism,” the survey has said.

The Survey found while tests like lipid profile are available for as less as Rs 90 in some cities, in others it can cost as high as Rs 7,110. Additionally, while the average maximum rate for tests like lipid profile was 3.5 times the minimum rate, in case of absolute neutrophil count test, the rate variance was six times across cities.  

Yet regulatory action for standardisation and quality assurance is still mostly on paper in most parts of the country. The Clinical Establishment Act allows the government to fix rates for procedures and services, and also requires hospitals and clinics to display the rates. 

The National Council for Clinical Establishments has approved a standard list of medical procedures and a standard template for the cost of medical procedures. But the Act is currently applicable only in ten states and needs to be implemented and enforced by other states too, the survey said.

Last month union health minister J P Nadda had also directed all chief ministers to adopt and implement the act to curb malpractices in private hospitals. Around 10 per cent of all out of pocket expenditure on health in India is spent on diagnostics (including medicines and tests as a part of package, it said. " In developing country like India incurring higher levels of out of pocket expenditure adversely impacts the poorer sections and widens inequalities. Although out of pocket expenditure has declined 7 percentage points during 2004-05 to 2014-15, its share is still at 62 per cent high according to the national health accounts 2013-15," the Survey said.