In 2015, Vivek Sharma walked into Max Super Speciality Hospital in Gurugram and launched a trade war.

Three years later, the social worker’s actions have resulted in a wide-ranging inquiry into sales practices at super-specialty hospitals in New Delhi, particularly as they relate to medical devices.

Sharma, whom The Ken could not reach, bought a 10-mL disposable syringe made by the American manufacturer Becton Dickinson and Company (BD) from the hospital pharmacy at the maximum retail price (MRP) of Rs 19.50 ($0.27). The syringe had a green stopper and the brand name “Emerald”. Then, Sharma went to a medical shop outside the hospital and asked for a BD Emerald syringe, 10-mL. The MRP was Rs 11.50 ($0.16); Sharma got a discount and paid Rs 10 ($0.14).

Sharma’s next stop was the Competition Commission of India (CCI), the competition regulator, where he lodged a complaint against the hospital and the syringe-maker. The two were colluding to fleece customers by setting a higher MRP for a product that is available more cheaply in the open market, he alleged. CCI referred the case to the Director General (DG), and on 31 August, the DG ruled there was no specific collusion between BD and the hospital. Further, the DG ruled the syringe Sharma had bought at the hospital was different than the one he had bought at the medical shop.

What gives? Isn’t a 10-mL syringe of a company, bought from any shop, still a 10-mL syringe of the same company? And how does a hospital get off charging Rs 19.50 on a syringe that costs much less elsewhere?

If you’re an average Indian, chances are you get three needle pricks every year. In 2012, some 3 billion injections were administered nationwide, according to the World Health Organisation. At an average MRP of Rs 6 ($0.08) a syringe, that conservatively makes a Rs 1,800 crore ($245 million) market. So it’s unsurprising that what began as a crusade by a social worker for consumer rights has morphed into a fierce fight between manufacturers to protect and increase their business. On one side are predominantly Indian companies, and on the other are foreign companies.

They are ostensibly fighting over how much medical consumables—the syringe, in specific—cost to you, the consumer. But in reality, this is about market share, profit margins and bottom lines.

The Indian government is deciding whether it should play referee. If it does, its regulations could determine which heart implant, syringe, and other such devices a patient receives in a hospital. This, in turn, would shape the Indian medical device sector, which is expected to reach Rs 60,200 crore ($8 billion) by 2020.

“The problem is not only in syringes, the problem is universal in all medical disposables, consumables and implants,” said Rajiv Nath, joint managing director of Hindustan Syringe & Medical Devices Ltd (HMD), one of India’s oldest syringe companies.


Gayathri Vaidyanathan

Gayathri writes on health, environment and science. She has reported and produced stories for the Washington Post, Discover, Nature, and the New York Times, amongst other publications. In her last assignment, she was the lead science writer for E&E News in Washington, D.C. E&E News is a news organisation focused on energy and the environment. Over the past decade, Gayathri has travelled across North America, Africa and Asia on long-form reporting projects. She has a master’s in journalism from Columbia University and a bachelor's in biochemistry from McMaster University in Ontario. At The Ken, Gayathri will write on healthcare, the pharmaceutical business and the environment. Based in Bengaluru, you can reach her at gayathri at the rate

View Full Profile

Available exclusively to subscribers of The Ken India

This story is a part of The Ken India edition. Subscribe. Questions?


Annual Subscription

12-month access to 200+ stories, archive of 800+ stories from our India edition. Plus our premium newsletters, Beyond The First Order and The Nutgraf worth Rs. 99/month or $2/month each for free.

Rs. 2,750


Quarterly Subscription

3-month access to 60+ new stories with 3-months worth of archives from our India edition. Plus our premium newsletters, Beyond The First Order and The Nutgraf worth Rs. 99/month or $2/month each for free.

Rs. 1,750


Single Story

Instant access to this story for a year along with comment privileges.

Rs. 500


Annual Subscription

12-month access to 150+ stories from Southeast Asia.

$ 120


Quarterly Subscription

3-month access to 35+ stories from Southeast Asia.

$ 50


Single Story

Instant access to this story for a year along with comment privileges.

$ 20



What is The Ken?

The Ken is a subscription-only business journalism website and app that provides coverage across two editions - India and Southeast Asia.

What kind of stories do you write?

We publish sharp, original and reported stories on technology, business and healthcare. Our stories are forward-looking, analytical and directional — supported by data, visualisations and infographics.

We use language and narrative that is accessible to even lay readers. And we optimise for quality over quantity, every single time.

What do I get if I subscribe?

For subscribers of the India edition, we publish a new story every weekday, a premium daily newsletter, Beyond The First Order and a weekly newsletter - The Nutgraf.

For subscribers of the Southeast Asia edition, we publish a new story three days a week and a weekly newsletter, Strait Up.

The annual subscription will get you complete, exclusive access to our archive of previously published stories for your edition, along with access to our subscriber-only mobile apps, our premium comment sections, our newsletter archives and several other gifts and benefits.

Do I need to pay separately for your premium newsletters?

Nope. Paid, premium subscribers of The Ken get our newsletters delivered for free.

Does a subscription to the India edition grant me access to Southeast Asia stories? Or vice-versa?

Afraid not. Each edition is separate with its own subscription plan. The India edition publishes stories focused on India. The Southeast Asia edition is focused on Southeast Asia. We may occasionally cross-publish stories from one edition to the other.

Do you offer an all-access joint subscription for both editions?

Not yet. If you’d like to access both editions, you’ll have to purchase two subscriptions separately - one for India and the other for Southeast Asia.

Do you offer any discounts?

No. We have a zero discounts policy.

Is there a free trial I can opt for?

We don’t offer any trials, but you can sign up for a free account which will give you access to the weekly free story, our archive of free stories and summaries of the paid stories. You can stay on the free account as long as you’d like.

Do you offer refunds?

We allow you to sample our journalism for free before signing up, and after you do, we stand by its quality. But we do not offer refunds.

I am facing some trouble purchasing a subscription. What can I do?

Please write to us at [email protected] detailing the error or queries.