Remdesivir rate volatility leads to many insurance claim rejections

Huge variations in the prices of Remdesivir, a very important drug in the treatment of severe cases of COVID-19, have resulted in a large increase in insurance claim rejections and also black-listing of hospitals by insurance companies.

With COVID-19infections hitting a new high every day, there is a shortage of the antiviral Remdesivir. This is leading to emergency purchases of higher priced drugs. As a result, insurers are now rejecting many claims for cashless treatment than they used to earlier.

General insurance companies like Star Health, Bajaj Allianz and Max Bupa say that the rejection rate of COVID-19 claims have gone up from 2-3% last year to as high as 9%. Insurers have called for price controls for commonly used pharmaceutical products like antivirals and antibiotics on a war footing.

Star Health and Allied Insurance is blacklisting a growing number of hospitals for price gouging. S. Prakash, MD of the company said, “The MRP of important COVID drugs like Remdesivir is quoted differently by different hospitals, resulting in retail prices that are five-six times higher.”

Prakash also added, “We know the true cost and the MRP of Remdesivir by the same company is fixed differently for different hospitals, although the cost price is the same. The hospital with higher infrastructure fixes a higher MRP on these drugs and could go as high as 5x-6x from its original retail price.”