After slashing the cost of bare metal and drug eluting stents by 40-60% in late 2011, the Director General of Health Services (DGHS) has proposed a further 40% reduction in the prices of stents. Stents are used to prop up clogged blood vessels on heart patients.
In a note sent by DGHS Dr Jagdish Prasad to health minister Ghulam Nabi Azad for approval earlier this week, he has proposed new rates for heart and vascular stents for reimbursement to Central Government Health Scheme (CGHS) beneficiaries.
"This move is for CGHS beneficiaries, as the government is still paying a much higher amount. But this will reduce the burden for the common man too, as private companies will be forced to cut down prices too. It will save the state exchequer several crores," Prasad said.
HT stories on September 22 and 23, 2011 — 'CGHS pays double for medical device costing Rs 45,000' and 'CGHS pays double price for bare metal stents' — had highlighted the loss to the state exchequer. Prices have been almost halved since then.
Records from the Escorts Heart Institute, the largest centre for stenting in India, show that 30% of total stents last year, which was about 5,500 approximately, were used for government scheme beneficiaries. The stent industry estimates show that India consumes two lakh stents annually, of which 1,50,000 are drug eluting stents.
By a crude calculation, one can estimate that if 30% of 1,50,000 stents are consumed by government health scheme beneficiaries, which is about 45,000 stents annually, the state stands to lose Rs 45 crore (Rs 10,000 per stent) to private hospitals, where new generation USFDA stents are used. This difference will grow if stents of other categories are used.
"The current prices of stents are still too high and statistics show that cardiac diseases are on the rise and people are dying for want of affordable treatment," Prasad said.
The DGHS has suggested bringing down the prices of the Indian-manufactured stents without FDA (USA) or CE (Europe) approval from the current Rs 40,000 to Rs 25,000 (see box). Prices of all CE (Europe) approved drug eluting stents are set to decrease from Rs 50,000 to Rs 35,000. This time the DGHS has proposed a new category of USFDA approved "new generation" stents for Rs 60,000.
For angioplasty, where doctors open up the clogged arteries by putting a fine mesh tube called stent, the CGHS reimburses the hospitals the cost of the procedure (Rs 90,000) plus the cost of the stent. This price revision in stents by over 40% will have a huge impact.