Capped Prices of Coronary Stent - Pros and Cons
In February National Pharmaceutical Pricing Authority (NPPA) had capped the prices of specialized cardiac stents between and placed them in two categories priced between Rs 7260 to Rs 29,600. This is 85 per cent less than the original price of this device. While patients applauded the move, there have been various downsides to it too and that has got the experts thinking.
Stents are tiny metal tubes coated in medication and is inserted into clogged arteries to keep the blood flowing well. It was earlier unaffordable but the move has ensured that lot of people are now able to afford the device which is inserted in the process of emergency angioplasty in which the clog is crushed with a balloon and the device inserted.Pros1. Saving lives
It has been known that stents save thousands of life every year globally. It is a medical boon that should be made readily available to people so that they have a chance at surviving cardiac arrests with the least amount of expense. In India, where majority of the population is below poverty line, this is a positive step in the right direction.2. Better chances
Chances of survival are at least 30 percent higher in the usage of stent as compared to other methods like dissolving of clot with the help of the very expensive medicine, thrombolysis. With far higher chances of survival, stent is a crucial option for patients and capped prices have helped patients afford it without burning a bigger hole in their pockets.Cons1. Unnecessary usage
The comparatively lower price of stent after the price drop has made it an unnecessary choice of patients and hospitals in cases where it is not required and where the clot could be cleared with medication. They are supposed to be used in emergency angioplasty instead of making it the go to option. This would be harmful for patients at large.2. Multi-vessel angioplasty
Stent should be used for crushing clogs in single vessel and in cases of multiple vessel blockages, an open heart surgery should be the ideal option. However, with lower prices of stent patients now prefer to go for multi-vessel angioplasty with three stents inserted in the three vessels since it is still cheaper than open heart surgery. It is a medical fact that even the latest drug-eluting stent get clogged in about 5 per cent of cases. Stent blocking in all three vessels will lead to lesser chances of survival.3. Unavailability of latest stents
Soon after prices of stent was capped by NPPA, most of the major stent manufacturing companies either filed or withdrew their latest products from the Indian market. If this continues to happen, latest and more medically advanced stents will never be introduced in India with manufacturers fearing loss due of capped prices in the market. The government has been talking to these manufacturers to make available stent that were present in the market prior to the price capping.4. Research suffers
Stent manufacturers have to pitch in a great part of the profit into research for more medically advanced stent and hence price capping has influenced their targets to a great extent leading to withdrawal. The research, testing and controlled testing of new stents take both time and money. The price cap will influence the research on stent to a great extent which is not good for medical science.5. Imported stent
Now that the prices of indigenously manufactured and imported stent are the same, doctors as well as patients prefer to use the imported ones which will affect the Indian manufacturers and researchers.
The big price drop seems to be having more downsides to it rather than advantages. The government and NPPA has to come to a solution before Indian research and manufacturers of stent suffer and become dependent on foreign companies who might simply chose not to release their latest products in India.