Split knee implant bills for clarity

Officials say segregating components will eliminate irregularities

Cement used for knee implants has to be priced separately and not made a part of the inclusive billing, stated drug controller as the Central government insists on clarity in medical bills.

A senior drug control officer, on condition of anonymity, explained, “Hospitals have been asked to bill each product separately and categorisation in the bill is important. The bill must have a separate and clear cost for knee implant price, trader margin, dealer margin and also the essential additional devices used for fixing the implant. The hospital bills are being checked for this purpose.”

National Pharmaceutical Pricing Authority has asked all drug controllers to ensure that the billing pattern for knee implants is standardised and those who do not adhere to it, action must be taken against them.

A senior orthopaedic surgeon explained, “The knee implant is not only one medical device. It comes with different additions to help fix the implant properly for the patient. After the knee implant prices were slashed only a standard set of devices are being used.”

While putting the implant, the cap needs to be fitted with cement and that filling often requires only one cement segment. But in certain hospital bills, two cement segments have been used, raising queries from the department. A senior drug controller explained, “Procedures require only one cement fitting but in certain cases two of them are used. This means that the patient has to pay additional `4,000 to `8,000. These are now being further checked.”

The two cement segments are used when the first one is not found to be enough. Like in case of obese or diabetic patients there is a need to fix two segments. But drug control officers state that there is an increase in the number of cement segments used and that is the reason for them to scrutinise the bills.

Dr Ramana Reddy, senior orthopaedic surgeon, explained, “For 80 per cent of the population standardised implants are used. But 20 per cent patient who wants better quality of implants or latest implants is being denied opportunity because of these curbs. They are now looking into the smaller parts which are required to fix the implant. In doing so, the quality is compromised in patient care. Many patients opt for implants which will last them more than 10 years and these are of higher grade and higher price. Denying the opportunity to best health care will not work in the benefit of patient in the long run.”

KNEE IMPLANT procedures require only one cement fitting but in certain cases two of them are used.

DRUG CONTROL officers state that there is an increase in the number of cement segments used which is the reason to scrutinise the bills.