Nearly two months after it has set an upper limit of ₹4,500 per Covid19 test for private labs, Indian Council of Medical Research (ICMR) has written to States, now asking them to negotiate lower prices with labs.

On May 25, ICMR director general Balram Bhargava in a letter to all States and Union Territories wrote, “Earlier suggested upper ceiling of ₹4,500 may not be applicable now, therefore all State governments and Union Territories are advised to negotiate with private labs and fix up mutually agreeable prices for samples being sent by the government and also for private individuals desirous of testing by these labs.”

Currently there are 428 government labs and 182 private labs for Covid19 testing which include big chains like Thyrocare, Lal Pathlabs, Metropolis to name a few. Major private hospitals too have in-house testing facilities. The test in question is Reverse Transcription Polymerase Chain Reaction (RT-PCR) test which is considered gold-standard for Covid19 testing.

While the ICMR advisory on renegotiating testing rates has come a little too late, in Mumbai, Municipal Corporation of Greater Mumbai has already capped testing prices at between ₹2,500 and ₹3,500, said a spokesperson from a leading private lab. In Karnataka, such capping exists at ₹2,250 per test, while in Delhi such capping exists slab-wise and stands between ₹2,200 and ₹4,500.

Lack of transparency with regards to ICMR’s procurement prices of RT-PCR testing kits is glaring.

“ICMR had previously shared that it is procuring RT-PCR test kits at prices ranging from ₹740 to ₹1,150 but no details were made available. The Government should make public the prices, quantities and specifications for all Covid test kits procured. Test kit manufacturers may also be asked to submit data of prices at which they are selling kits,” said Malini Aisola, co-convenor of All India Drug Action Network.

For two months, experts say private hospitals were able to flout the price cap by imposing arbitrary charges and bill patients in excess of even ₹6,000, for testing by adding doctors’ consultation fees to capped prices of tests. “They have forced repeated and unnecessary testing of many vulnerable patients who has no option but to comply as they needed to access critical treatment,” Aisola further added.

S Srinivasan, founder of Vadodara-based Low Cost Standard Therapeutics said that schemes like Central Government Health Scheme (CGHS) and Delhi Government Employees Health Scheme adopted the allegedly inflated rate of ₹4,500, citing the ICMR benchmark price.

ICMR has claimed the scale up of testing in India to be a success and to have facilitated companies through handholding, but hurdles are far from resolved. “In reality there have been several hurdles such as lack of access to positive controls, lack of transparency of validation protocols, delays in validation and inability of ICMR to meet States' requirements for test kits and testing materials. Many of these challenges still persist, although validation sites have certainly grown in number,” said Srinivasan.