Adopted in developing countries; proven technology yet to get recognition in West

A treatment protocol that drastically reduces the cost of kidney transplants, developed by a Hyderabad-based nephrologist, has been adopted successfully in several developing countries.

The Philippines, Cuba, Guatemala and the Dominican Republic have already implemented Dr. K.S. Nayak’s treatment approach, while several other Latin American countries are in talks with him to firm up the modalities to incorporate it in their surgery protocols. The protocol, Dr. Nayak said, would bring down the cost of therapy for those undergoing transplants. “The one-time cost of the equine-based drug is Rs. 35,000. The rabbit-derived drugs meant for the same purpose cost more than Rs. 1 lakh. Moreover, the rabbit-based antibodies have to be administered multiple times, escalating the cost for the patient. Our management protocol involves administering low doses of equine-based drug and managing the patient carefully,” Dr. Nayak told The Hindu. The drastic reduction of the cost of therapy was acknowledged in an article published in the latest issue of ‘Harvard Business Review’, he said.

Expensive

According to him, drugs account for the high cost of kidney transplants. To ensure that the body accepts a foreign organ and to avoid rejection, patients are given antibodies that suppress immunity. Right now, these antibodies are usually derived from horses and rabbits. “The rabbit-origin drugs are expensive and multiple doses are usually given. If the same antibodies derived from horses are given, the cost would come down drastically and a single dose would be sufficient,” he says. “This is a proven technology but the procedure is not getting due recognition in western countries now. Even in India, there are only four or five centres that employ this method.”

Dr. Nayak, Director of Renal Services at Lazarus Hospital, laments that pharma firms shy away from producing equine-based drugs despite their success. “Only one Indian company, Bharat Serums and Vaccines, manufactures this drug.”

So far, close to 75 patients in Hyderabad, 120 in the country and 400 patients worldwide have successfully received transplants using Dr. Nayak’s approach. “Worldwide, the acceptable rejection ratio for kidney transplants is 20 per cent. Evidence shows that our technique has a rejection rate of [only] seven per cent. Even among the seven per cent, there is 90 per cent chance of reversal of rejection,” says the senior nephrologist.

Dr. Nayak’s evidence-based studies were published in the 2007 issue of the prestigious medical journal, Transplantation Proceedings.