Mumbai: While the Central government continues to receive plaudits for capping the prices of stents used in cardiac surgery, health activists are asking if profit-driven medical institutions will actually pass on the benefit to patients, or find ways to recover the considerable cost difference from them.
On Tuesday, the National Pharmaceuticals Pricing Authority (NPPA) capped prices of stents according to quality: bare metal stents now won’t cost more than ₹7,260, while drug eluting stents and biodegradable stents will be capped at ₹29,600. The government has also stipulated that a manufacturer intending to stop production will have to inform the NPPA at least six months in advance.
A senior city-based doctor said the move is good, but needed more thought. “The United States is the biggest market for stents while India accounts for merely 5-10%. Instead of this ceiling, the government should have capped profits made by hospitals and distributors,” he said. Till now, maximum retail prices of cardiac stents were increased by 300% to 700% and the profits were shared by hospitals and distributors. Despite the NPPA order, activists say benefits being successfully passed on to patients depends on awareness.
Angioplasties may rise
Unnecessary angioplasties have been common but may increase due to the price control, say activists. “As per a rough estimate, about 15% of the patients a cardiologists sees in his OPD would need an angioplasty, but in most corporatised hospitals, doctors are actually given targets of 40% for conversion,” activist Dr. Arun Gadre, who is member, Alliance of Doctors for Ethical Healthcare and author of Dissenting Diagnosis , said.
“The medical field is highly commercialised and they have a way out for everything. For example, if there is a price control on 500mg of paracetamol, they will come up with a 450mg variation. That’s how smart they are,” he adds. Dr. Gadre says it won’t be surprising if hospitals hike costs of other disposables required in angioplasties like the balloon, wire, connectors and special syringes, and increase hospital stay cost. There is also a fear that more stents would be used on a patient.
Bypass surgeries too
According to Dr. Abhijit More, co-convenor, Jan Swasthya Abhiyan, the lack of standard treatment protocols means there is always a risk of un-indicative procedures being performed. “Such malpractices are already there due to commercialisation of the medical field. The NPPA order is laudable, but when the government regularises one thing, the industry discovers another way of making profits.” He adds that with regulation of stent prices, there could be more push towards bypass surgeries. “We have been trying our best to push for the Clinical Establishment Act that will bring in these changes.”
Awareness needed
“If something has been brought under price control, it does not mean it will be of bad quality. Consumers need to understand this and question each and every part,” Dr. Gadre said, adding since people fear for their life, they get carried away by what the doctor says. “Doctors, on the other hand, have been playing around with this fear that patients harbour.”
