PANAJI
In the absence of any price-regulation, hospitals in Goa appear to have been making big bucks off cardiac procedures involving the use of cardiac stents by hiking the price of the device by anything between 200 to 300 per cent.
To put this in perspective, while the cost at source of a Drug Eluting Stent (DES) is around Rs 23,000 to Rs 28,000, the cost of a bare metal stent varies between Rs 10,000 to Rs 14,000.
Yet, the patients, especially in private medical facilities, end up paying as much as Rs 1.2 lakh for a DES and Rs 20,000 for a bare metal stent. In other words, the cost of the stent accounts to a marginal chunk of the total cost of the procedure.
For instance, in a response to an RTI query, it was revealed that the cardiology unit of Goa Medical College and Hospitals, Bambolim has procured a total of 1,805 stents between mid-February 2014 and November 1, 2015 costing Rs 4.09 crore.
GMC, like many other hospitals, purchased the stents in a bulk amount through the process of tendering and as a result, the wholesale cost prices reflected in the RTI response are much lower than the retail price charged for the same device in private hospitals.
To make matters worse for many cardiac patients, depending upon the extent of the blockage, doctors may choose to use anything between one to three stents. Add the cost of drugs and other hospital charges to this and the cost of an agioplasty or a bypass is enough to push patients into debts.
Moreover, one can never be too sure if the stent inserted during a procedure is the one which has been billed to a patient.
Interestingly, prices of foreign-made stents are almost identical to the ones manufactured in India and import duty on cardiac stents is zero. This forces one to question the disparity between the MRP of imported and indigenous stents.
Stents have been notified as a ‘drug’ under the Drugs and Cosmetic Act, 1940. It would appear that one of the major reasons why it continues to remain out of the umbrella of price-regulation is because it has yet to be included under the Drug Price Control Order (DPCO).
President of Chemists’ and Druggists’ Association of Goa Prasad Tamba informed that the central government is in the process of including stents under DPCO through the Drug and Cosmetics (Amendment) Bill, 2015, a move that he feels will ensure direct control and help in fixing an offset price.
Speaking about the inclusion of stents under DPCO, President of Goa Medical Council, Dr Shekhar Salkar stated, “If the Central government passes this Bill, it will directly benefit the patients.” The beneficiaries, however, would also include various State government-run hospitals as the amendment intends to cap the cost of bare metal stents at Rs 20,000 and DES at Rs 28,000.
