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Measures may have modest impact on dialysis costs

The special attention dialysis got in the Union Budget on Monday was not without reason, and while the measures announced, including a waiver of customs duty and excise on certain parts of dialysis equipment, were long-awaited they may not bring down costs significantly.

For starters, the government had only last year imposed a heavier levy on consumables used in dialysis, spiking the procedure rates by 17 to 20 per cent, and increased the equipment cost a couple of years ago: moves that had led to various associations of nephrologists seek a reversal.

The prices were increased despite a writ petition filed by a Delhi-based advocate in the Supreme Court in 2013 that raised the issue of making the cost-intensive procedure more accessible. It had pointed out that of the nearly 7.85 million Indians suffering from chronic kidney disease, only 22.5 per cent could access and afford dialysis treatment. The Centre was yet to respond to the notice the apex court had served on the measures it planned to take to bring down the costs.

But the tax exemption announced on Monday applies only to dialysis equipment and not consumables.

“After the tax on consumables was increased, a PIL was also filed in the Madras High Court. We had discussed the issue with the Maharashtra Health Minister too during the conference of the Indian Society of Hemo Dialysis. He had said he would look into the tax burden on patients,” said Alan Almeida, consultant nephrologist with Hinduja Hospital, also secretary of the Mumbai Nephrology Group.

He pointed out that consumables were part and parcel of dialysis and the Budget announcement did not hold the promise of a total reversal of the additional taxes levied.

The machine’s cost too had gone up two years ago from Rs 5.5 lakh earlier, to up to Rs 6.5 lakh. “The cost of the dialyser, which is used each time a person undergoes a dialysis, also went up from Rs 500 to Rs 550,” said Manish Doshi, coordinator with Jivan Jyot Drug Bank, an NGO that supplies the equipment to various hospitals for needy patients. He added, however, that the Maharashtra government had reduced VAT on the machine on January 1, this year.

The modest impact on the overall procedure cost is, nevertheless, welcome, said doctors. What received a more positive response was the proposal to start a ‘National Dialysis Services Programme’, as part of which dialysis services will come up in all district hospitals.

“There are many dialysis centres in Mumbai. There will be two at every station, but there is still a need for more,” said Haresh Dodeja, nephrologist and kidney transplant surgeon with Fortis Hospital, Mulund.

He said end-stage kidney disease was rare because there was a solution available. “The drop in cost will make it accessible to more patients,” he said. Explaining the need for more centres, Dr Dodeja said the dialysis facility in Fortis Mulund got patients from areas such as Ulhasnagar, Panvel and Dombivli.

Word of caution

Besides, most centres in Mumbai were running full and there was also a need to take the facility to the State’s interiors, said Dr Almeida. He, however, cautioned that it should be ensured that the staff members running these units were skilled.


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Printable version | Jul 25, 2021 6:38:25 AM | https://www.thehindu.com/news/cities/mumbai/news/measures-may-have-modest-impact-on-dialysis-costs/article8297667.ece

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