Avg stent costs little over Rs 16,000 on import
Angioplasties Resume With Old Models
Manufacturers and distributors have withdrawn the latest generation of cardiac stents from most city hospitals in the name of re-labelling, forcing patients to settle for dated versions. In centres where the stents have not been physically removed, there are verbal orders not to offer the “highend“ varieties to patients.
This is despite the National Pharmaceutical Pricing Authority (NPPA) issuing clear orders that manufacturers, importers and retailers are required to implement the price cap without trying to create any artificial shortage. NPPA had capp ed prices of bare metal stents at Rs 7,260 and that of drug-eluting and bioresorbable stents at Rs 29,600 on Monday . Ithas now written to all chief secretaries to ensure compliance. Cardiologists told TOI on Thursday that the bioresorbable vascular scaffold (BVS)--the most recent version that dissolves into the body after healing the diseased artery--is now practically unavailable after prices were capped. “The companies have taken it away for pasting new rates, our fear is they will not return any time soon,“ said a senior cardiologist from Bombay Hospital, Marine Lines. The latest version of the drug eluting stents (DES) has also been whisked away from centres. Both categories of stents used to be sold for more than Rs 1.5 lakh to Rs 2 lakh before their price was fixed at Rs 29,600.
The National Pharmaceutical Pricing Authority said it is “puzzling“ that none of the 52 imported brands of DES are superior to each other, as per global clinical norms, to justify their wide price variation. It added that the average landed cost of a DES imported by nine companies was only Rs 16,918.
Cardiac surgeon Dr Pavan Kumar said many centres had to postpone angioplasties on Wednesday due to confusion at the stentmakers' and suppliers' end. On average, over 12,000 angioplasties are carried out in Mumbai Metropolitan Region every year.
On Thursday , heart procedures resumed in most hospitals albeit with the older version of stents that had disappeared from catheterisation labs for a while now. “The technology available to patients now is the first and second generation of DES that arrived more than two years ago. It is not that they are ineffective but the newer generation offered certain ease in placing them,“ said interventional cardiologist Dr Dev Pahlanji, who consults at Breach Candy Hospital.
Pahlanji explained the first generation DES were polymerbased, which were found to be slightly toxic. The next generation took care of toxicity repla cing polymer with cobalt and chromium as well as altering the type of catheter required to deliver the device in the artery.“But it can be determined only over time if the treatment outcomes will differ,“ he said. Cardiologist Dr Anand Rao said newer generations have some technical superiority in terms of deployment, make and compatibility with body tissues.“But there is no solid data to compare outcomes between different generations,“ he said.
A spokesperson from Medtronic, a leading stent player said, “We have not taken any decision on withdrawal of any product. As per the requirement, we have initiated relabeling of all products.“
If the stents do not come back to the hospitals in time after the so-called relabelling, the health ministry must step in and ensure that any attempt to create an artificial shortage of these medical devices is thwarted. Any shortage will negatively affect healthcare and make patients suffer for no fault of theirs
Angioplasties Resume With Old Models
Manufacturers and distributors have withdrawn the latest generation of cardiac stents from most city hospitals in the name of re-labelling, forcing patients to settle for dated versions. In centres where the stents have not been physically removed, there are verbal orders not to offer the “highend“ varieties to patients.
This is despite the National Pharmaceutical Pricing Authority (NPPA) issuing clear orders that manufacturers, importers and retailers are required to implement the price cap without trying to create any artificial shortage. NPPA had capp ed prices of bare metal stents at Rs 7,260 and that of drug-eluting and bioresorbable stents at Rs 29,600 on Monday . Ithas now written to all chief secretaries to ensure compliance. Cardiologists told TOI on Thursday that the bioresorbable vascular scaffold (BVS)--the most recent version that dissolves into the body after healing the diseased artery--is now practically unavailable after prices were capped. “The companies have taken it away for pasting new rates, our fear is they will not return any time soon,“ said a senior cardiologist from Bombay Hospital, Marine Lines. The latest version of the drug eluting stents (DES) has also been whisked away from centres. Both categories of stents used to be sold for more than Rs 1.5 lakh to Rs 2 lakh before their price was fixed at Rs 29,600.
The National Pharmaceutical Pricing Authority said it is “puzzling“ that none of the 52 imported brands of DES are superior to each other, as per global clinical norms, to justify their wide price variation. It added that the average landed cost of a DES imported by nine companies was only Rs 16,918.
Cardiac surgeon Dr Pavan Kumar said many centres had to postpone angioplasties on Wednesday due to confusion at the stentmakers' and suppliers' end. On average, over 12,000 angioplasties are carried out in Mumbai Metropolitan Region every year.
On Thursday , heart procedures resumed in most hospitals albeit with the older version of stents that had disappeared from catheterisation labs for a while now. “The technology available to patients now is the first and second generation of DES that arrived more than two years ago. It is not that they are ineffective but the newer generation offered certain ease in placing them,“ said interventional cardiologist Dr Dev Pahlanji, who consults at Breach Candy Hospital.
Pahlanji explained the first generation DES were polymerbased, which were found to be slightly toxic. The next generation took care of toxicity repla cing polymer with cobalt and chromium as well as altering the type of catheter required to deliver the device in the artery.“But it can be determined only over time if the treatment outcomes will differ,“ he said. Cardiologist Dr Anand Rao said newer generations have some technical superiority in terms of deployment, make and compatibility with body tissues.“But there is no solid data to compare outcomes between different generations,“ he said.
A spokesperson from Medtronic, a leading stent player said, “We have not taken any decision on withdrawal of any product. As per the requirement, we have initiated relabeling of all products.“
If the stents do not come back to the hospitals in time after the so-called relabelling, the health ministry must step in and ensure that any attempt to create an artificial shortage of these medical devices is thwarted. Any shortage will negatively affect healthcare and make patients suffer for no fault of theirs
No comments:
Post a Comment