Cardiologists fume over differential stent pricing
Differential pricing is being demanded by cardiologists and the Medical Technology Association of India so that high-end stents can be provided to patients who can afford them. In February 2017, a price cap was imposed on stents, which narrowed down the types of stents available.
The difference in price is about 15 to 20 per cent only. There are two categories of stents — bare metal, and drug eluting stents. There are different variations and grades in the drug eluting stents, but due to the price cap, only a few variants are available. There is a move to allow for all types to be made available so that patients can pay for what they can afford.
Dr Amaresh Rao, additional professor and unit head of the department of cardio thoracic surgery at Nizam’s Institute of Medical Sciences, explained, “The standard pricing of the stent and now the differential pricing being asked for is not going to help patients in any way. The patient has not seen a major benefit, as the cost of the procedure continues to be the same.”
He says there must be “a heart team in all major hospitals to decide whether it is medical management, stenting, or open heart surgery that must be done. This is becoming essential as a combined opinion will give the right option to the patient rather than just having four or five blocks managed with stents.”
While the price cap was introduced to stop patients being charged exorbitant prices for stents, hospitals and doctors say they are not happy with the stents now available. “We are seeing too many sub-standard materials from Indian and Chinese manufacturers flooding the market. This is being exploited in the name of cheap prices and often patients who come in under government insurance schemes are not aware of the quality that is being given to them. There is a strong case for suggesting that too much of unnecessary and unwanted stenting is done,” said a senior cardiologist on condition of anonymity.
As Dr Amaresh Rao suggests, what is needed is a better informed and rational policy when it comes to heart treatment. Checking that lower priced stents are of reasonably good quality, and rationalising prices at the upper end, is probably the way forward.