The cost of importing stents is estimated between Rs 10,000- 15,000 per stent. The importer then sells it to the distributor at a profit of 100-120%.
The distributor is responsible for providing stents to hospitals. These stents are sold at a further profit of about 120%.
Hospitals buy each stent at anywhere between Rs 20,000- 25,000. Distributors approach docs and hospitals on behalf of companies and importers. Doctors who prescribe angioplasties to patients in general earn a cut for every stent deployed. Bribes, too, come into play—both material and monetary.
Patients are supplied these stents at prices ranging from Rs 50,000 to Rs 2 Lakh, with a mark-up of 300-700%
Needless angioplasties on patients give doctors higher cuts. Some hospitals force doctors to meet monthly quotas of angioplasty
Number of angioplasties done in 2015-16 were 4,20,000 (according to the Cardiologists society of India) Estimates say four-fifth of these have been performed in private hospitals.
The Bigger Issue
- No statutory mechanism for manufacture and sale of stents.
- No body for approval for quality of stents distributed in India enabling market to be completely governed by foreign companies.
- 80% of Indian stent market controlled by foreign players.
- Medical devices worth Rs 21,000 crores imported in 2014 and the market is growing at 10% a year.
- Since no statutory control, suspect devices used on patients.
What Is Being Done
- The pharma dept passed a June order to include cardiac stents in the National List of Essential Medicines but no action has been taken yet.
- A petition filed in the Delhi HC has asked for fixing of MRP on stents. The pharma dept given time till December 22 to respond.
A Splint That Opens The Passageway
What is an angioplasty?
A coronary angioplasty is a process used to widen narrow or blocked cardiac arteries. This is done when an artery collapses leading to the reduction in the amount of blood being pumped by the heart to the rest of your body. The procedure is done through a catheter inserted in the artery through which a stent is placed to balloon the collapsed artery.
What is a stent
These are narrow mesh like tubes made of metal or fibre which are inserted into arteries to revive blood flow to and from the heart.
Types of stents
- Bare metal stents: These are made of stainless steel and have no special coating. The main purpose of such stents is to avoid artery collapsing but only modestly reduce risk of re-narrowing.
- Drug Eluting Stent: These are coated with medication that is released (eluted) to help prevent the growth of scar tissue in the artery lining. They are the most commonly used stents in India.
- Bio-engineered stents: Also known as anti-body coated stents, they don’t contain polymer nor do they use any drugs. The antibody on the stent’s surface attracts Endothelial Progenitor Cells which come from human bone marrow and help speed up the formation of healthy endothelium.
