With several states managing to bring down the cost of RT-PCR tests for Covid-19 to about half the Rs 4,500 ceiling fixed by the Indian Council for Medical Research (ICMR), the cries to revise the price have become louder.
The fact that some private labs are offering package deals of 50 or more tests, including the Covid-19 test, for just Rs 5,000 has also buttressed the argument that the ICMR cap may be too generous.
In many states, as the number of Covid-19 tests being done in private labs has gone up, governments have announced the reimbursement rate they pay private labs for samples sent to them. It ranges from as little as Rs 2,000 in Gujarat to Rs 3,500 in Haryana.
However, for those getting tested in hospitals and for those paying for the test themselves in a lab, the cost is Rs 4,500, the ceiling fixed by the ICMR. The Central Government Health Scheme (CGHS) and a similar scheme for the Delhi government employees also continue to observe the Rs 4,500 price ceiling.
Though the ICMR had appealed to private labs to test for free when announcing the price ceiling and giving approval to private labs to do Covid-19 tests, not surprisingly there haven’t been any takers for that appeal. Private labs argue that with salaries to pay and costs of kits and reagents to bear, they couldn’t possible do it for free.
A leading player in the diagnostics market, Thyrocare, has been advertising packages such as Safe Surgery Profile, Safe Pregnancy Profile, Safe IVF Profile and Safe Dialysis Profile, each of which claims to do between 50 and 53 tests, including the RT-PCR test for Covid-19, for just Rs 4,999. Interestingly, during the debate on pricing when labs were criticised for charging the full ceiling price, Thyrocare had put out detailed calculations in the public domain which showed that the actual cost of the RT-PCR test would be Rs 5,000. They claimed that even at Rs 4,500, they would not be covering the full cost of the doing the test.
“If what Thyrocare says is true, how do they manage to do 51 tests including RT-PCR Covid-test for Rs 4,999? Are they saying that the cost of 50 tests is just Rs 500?” asked Dr Rohit Jain of Pathologists Society.
“These 50 tests alone would cost Rs 1,500-2,000 according to several pre-surgery packages advertised by various labs. This is a clear indication that the RT-PCR test does not cost even Rs 4,500 as claimed by these labs. It probably costs around Rs 2,500 or less, which is the reimbursement rate fixed by some state governments and even at that rate labs make profits,” pointed out Dr Jain.
The fact that labs are willing to do the tests at the rates fixed by state governments, some as low as Rs 2,000, suggests his reasoning is sound.
“The reimbursement rates fixed by states demonstrate that the ICMR price cap is significantly inflated,” said Malini Aisola of All India Drug Action Network (AIDAN). AIDAN has repeatedly demanded that government ensure free testing for everyone by reimbursing private labs based on a rational assessment of costs.
“A majority of people require testing on the directions of government bodies, employers or as a prerequisite to accessing healthcare services. For many the cost would be prohibitive and it is the government’s duty to provide free testing as it is a critical tool for containing the outbreak. Free testing would also dampen incentives to profit by private labs and more appropriate use of test kits, which are in limited supply,” said Aisola.
What states are paying pvt labs
Gujarat — Rs 2,000
Karnataka — Rs 2,250
Tamil Nadu — Rs 2,500
Haryana — Rs 3,500
Mumbai (BMC) — Rs 3,500
Delhi — Rs 3,500 (if samples sent by govt, Rs 4,500 if lab collects sample)