Medical audits will check stent prices, say activists

NPPA data suggests that the price of a stent increases nearly 2000% by the time a patient gets the implant

Demanding that the government introduce medical audits, where doctors will have to account for drugs and devices used, health activists on Monday said they were ‘alarmed’ that doctors and hospitals were taking ‘cuts’ for recommending use of coronary stents, which may not be necessary, in heart patients.

After seeing that massive margins charged at each step in the distribution and supply of stents, activists have demanded that the government develop standard treatment guidelines for cardiovascular interventions with the help of expert doctors, free from conflict of interest, and implement medical audits of procedures.

Pushing people into debt

“We have consistently highlighted the unconscionable prices that patients across the country are paying for stents that are pushing patients and their families into increasing indebtedness or leaving them without life-saving treatment,” said Dr. Mira Shiva of the All India Drug Action Network (AIDAN). “The pricing data which was submitted by the industry to the NPPA has made it clear beyond doubt,” she said.

The recommendations come after data published by the National Pharmaceutical Pricing Authority (NPPA) showed that the price of a stent increases nearly 2000% by the time the patient gets the implant.

The NPPA data also shows that the largest cut goes to the hospitals, which can be as high as 650% more than the price at which the hospital purchases the stents from the distributor.

Coronary stents were included in the National List of Essential Medicines (NLEM) after a petition was filed before the Delhi High Court by advocate Birender Sangwan.

In a second petition, also filed by Mr. Sangwan, which is pending before the same court, the Government has been directed to report to the Court after the ceiling prices have been notified. Even as the NPPA is examining different formulas to fix an affordable price for stents, industry lobbying to thwart these efforts appears to have increased in recent weeks.

‘Govt. must act now’

“With the evidence of over-pricing now crystal clear, the government must act immediately to control the prices of these life saving devices” said Mr. Sangwan. “There is a clear obligation under the Constitution for the government to fulfil the fundamental right to health and ensure the affordability of devices such as stents.”

“Reports indicate that companies and industry associations are lobbying intensely for a ceiling price based on a simple average of hospital prices which will ensure that the profiteering continues and hospitals can take huge cuts on the stents. There is an urgent need to fix the price at an affordable price that does not expose people to exploitation,” said Malini Aisola of AIDAN.