By AHMAD KASHMIRI
A drastic reduction in the prices for cardiac stents recently made headlines that now onwards manufacturers of this life saving product will not only sell the product at 85 percent less but also they will have to print its detailed information on the label. This development emerged when an Indian court gave a direction to this effect to the government.
“The National Pharmaceutical Pricing Authority on Monday fixed the ceiling price of drug eluting stents (DES) and bioresorbable stents at Rs 30,000 and that of bare metal stents at Rs 7,500. The prices will be effective from notification on February 14.” (Times of India, Feb 14, 2017).
The news reports further reveal that according to data submitted by stent companies to the NPPA, the average manufacturing cost of a DES for a domestic company is about Rs 8,000 and prices of imported DES start at about Rs 5,000. The NPPA also revealed that a stent could cost the patient over ten times by the time it moved from the manufacturer to the patient.
The data showed that hospitals made the maximum profit on stents, marking up prices by as much as 650% in some cases. Many hospitals saw stents as a big part of their revenue stream and made huge profits from them. Hospital groups had strongly opposed attempts at price control on stents.
With the new notification, hospitals will have to bill stents separately. All hospitals will also have to follow Para 24 (4) of the Drug Price Control Order (DPCO) 2013 which states: Every retailer and dealer shall display the price list and the supplementary price list, if any, as furnished by the manufacturer, on a conspicuous part of the premises where he carries on business in a manner so as to be easily accessible to any person wishing to consult the same.”
The health ministry notified the inclusion of stents in the National List of Essential Medicines (NLEM) on July 19 last year, after the Delhi High Court sought action on a public interest petition seeking price control on stents.
However, this did not happen out of nothing and effortlessly, instead the credit goes to a lawyer Birender Sangwan who in 2014 visited his friend’s brother at a hospital who had undergone a heart surgery, he inspected the box of coronary stent, a tube placed in the artery.
“It kind of hit me…there was no bill and I couldn’t find any details of price. My friend’s brother had paid Rs 1,26,000 for the coronary stent. I felt the price was exorbitant,” 37-year-old Sangwan tells ScoopWhoop News while sitting in his chamber at Rohini District Court.
After doing some preliminary research, Sangwan shot a letter to Union Health Ministry complaining about overpricing of coronary stents installed in patients. He also filed an RTI application to ascertain under which category stents are classified in health sector – drugs or metals.
He says that RTI reply bewildered him when he came to know that cardiac stents were exempted from customs duty. Secondly, stents are notified as drugs but not covered under any price control mechanism in India because they were not included in the National List of Essential Medicines (NLEM). “I had to get it to that list,” says Sangwan, who filed a petition in Delhi High Court in 2014 asking regulation on prices of stents.
Sangwan’s initial success came in July 2016 when the government included coronary stents in the NLEM list 2015. But the pricing regulation came six months later when coronary stents became part of the first Schedule of the Drug Prices Control Order (DPCO), 2013.
The final success of Sangwan’s more than two-year-long battle came on February 14 when the government decided to cut prices of life-saving coronary stents by up to 85 percent.
Back home, where a Drug Policy is awaiting implemention for several years now, we have thousands of tales with regard to dissatisfaction and loopholes of the healthcare and drug delivery system. Every hospital visitor has a separate tale of misfortune to narrate with regard to treatment, diagnosis, patient care, surgeries et al. The irony is that even educated people are ignorant of the rights of patients and their families. Every time the issues, concerns and the crisis are managed by saying that it is too technical a field to understand and by raise finger to anybody! The offences and crimes are buried in the name of fate of the patients or victims.
It is a lesson for us that if a lone Sangwan can bring about a revolutionary relief by his efforts why can’t our organizations, associations and groups meant for such causes do similar exercises collectively to help our people by addressing the concerns which we face here in Kashmir hospitals.
I don’t mean that everything is bad, there is much good and applaudable in the field of healthcare in the hospitals here, but bad practices and ignorance of patients and caretakers overshadow the good.
– The writer can be reached at: firstname.lastname@example.org