The National Pharmaceutical Pricing Authority (NPPA), which regulates drug prices in the country, has capped the prices of medical oxygen and oxygen cylinders over complaints of black marketing and hoarding, in view of the increased demand for treating coronavirus disease (Covid-19) patients.
The price, at present, has been capped for a period of six months. Officials familiar with the matter said that the move was aimed at ensuring the availability of medical oxygen at reasonable prices, as many states are dependent on medical oxygen supply from other states.
“As of now, there is no supply shortage. However, since major oxygen manufactures in the country are not equitably distributed, it is pertinent to take proactive measures to ensure there is no shortage in future also, considering the demand is increasing because of Covid-19,” a senior government official familiar with the issue said, requesting anonymity.
Delhi, for instance, does not have an oxygen manufacturing unit, and gets its supply from Haryana, Rajasthan and Uttarakhand. Punjab gets its supply from Haryana; Madhya Pradesh from Rajasthan, Gujarat from Maharashtra; while Andhra Pradesh and Telangana get most of their supplies from Karnataka.
The demand for medical oxygen has gone up almost four times, from 750 metric tonnes per day to 2,800 metric tonnes daily, causing a strain across the production and supply chain. “During COVID, the supply of medical oxygen through cylinders has increased from 10% to around 50% of total consumption. Price regulation at this end is imperative for the continued availability of medical oxygen across the country,” the ministry of chemicals and fertilisers said in an official statement.
Adequate and uninterrupted supply of medical oxygen is an important pre-requisite for managing moderate and severe cases of Covid-19, with about 6% of the Covid-19 patients, including those in intensive care units (ICUs) and on mechanical ventilators, requiring oxygen therapy at any given time.
An empowered group at the Centre responsible for looking into this issue had recommended that the NPPA consider capping the ex-factory prices. Officials cited above said the Union health ministry gave a free hand to NPPA to take necessary steps to immediately regulate the availability and pricing.
A statement by the ministry of chemicals and fertilizers said, “The Authority deliberated upon the matter in its extra ordinary meeting held on 25.09.2020. It has been decided to invoke extra-ordinary powers in public interest, under Para 19 of DPCO, 13 and under Section 10(20) (l) of Disaster Management Act, 2005 to deal with the emergent situation arising due to the pandemic.”
As a result, the ex-factory price of liquid medical oxygen at the manufacturers’ end has been capped at Rs15.22 per cubic metre, exclusive of GST; and the ex-factory cost of medical oxygen cylinder at the filler end has been capped at Rs25.71 per cubic metre, exclusive of GST.
The Centre has also constituted an inter-ministerial empowered committee to take measures, including setting up a control room to monitor supply and demand of oxygen on a real-time basis, to ensure availability. The committee comprises members from the Union health ministry, department for promotion of industry and internal trade, department of pharmaceuticals and ministry of textiles, among others.
The measures taken by the committee include the provision for a 24×7 green corridor for movement of liquid medical oxygen tankers between states, so that there is an “unrestricted and unhindered” movement of tankers. The entry of heavy vehicles ferrying the tankers into the city limits during the day has also been permitted, to cut down on turnaround time.
States have also been advised to ensure facility-wise or hospital-wise oxygen inventory management and advance planning, for timely replenishment so that there is continuous availability. Also, micro-level planning is to be done to maintain oxygen pipelines and oxygen manufacturing units, so that there is no leakage of oxygen.
Critical care specialists say it is important to ensure a seamless supply of oxygen during the current pandemic.
“Unhindered oxygen supply is critical in saving the lives of Covid-19 patients. In moderate to severe Covid-19 cases, the lung cells don’t participate in normal functioning that results in lungs failing to take up oxygen from the blood and also not being able to remove carbon dioxide from the blood. It leads to oxygen levels dropping in the blood, for which oxygen support is given externally to compensate for the impaired lung function,” said Dr Yatin Mehta, chairman, critical care department, Medanta Hospital.