Stents cost nearly twice the price in developed countries

Need to undergo an angioplasty? Chances are, you will pay double of what’s charged for stents in developed countries.
The table alongside tells the tale succinctly.

The drug eluting stent is the most common heart stent used in over 95% of the cases for reopening blocked arteries. Abroad, stents cost half of prices in India, and patients enjoy insurance benefits as well, thus further lowering their out-of-pocket expenses.

“In Germany, the upper limit for stents is €350 which is much less than the price level in India. The average across Europe is €600-700,” said a medical device expert.

In contrast, private hospitals in India charge upwards of `1-1.2 lakh for a stent even though only 65-70% of the total population is covered by either private or government insurance, according to industry estimates.

The British Heart Journal reports that healthcare experts in India think heart diseases are likely to impact 65 million people by 2015. They attribute the spooky situation to two key factors:
One, there is no price control mechanism for medical devices, including stents. Two, health insurance, in this context, has a very limited role.

According to CM Gulhati, editor of the Monthly Index for Medical Specialities, both stent manufacturers and hospitals are exploiting these twin factors to pocket huge margins.

“A hospital charges patients Rs1.2 lakh for a stent it has purchased for only `65,000. Usually, hospitals buy the device at nearly half the amount they ultimately charge patients,” said Gulhati.

There is no transparency when it comes to the MRP (maximum retail price), say experts. The patient simply does not get to see the MRP on stents. “Prices are negotiated by hospitals directly with the manufacturers. While manufacturers charge hospitals a high amount under the garb of the stent being imported, hospitals in turn impose any random amount on patients,” said the medical devices expert, requesting anonymity.

In developed countries, governments and private insurance firms agree on guidelines about the maximum amount they will pay hospitals. Hence, prices there are reasonable. “With health insurance being a fragment in India, there is no pressure whatsoever on hospitals to charge within any a fixed range,” said expert.

Gurmit Singh Chugh, MD of medical devices firm Translumina Therapeutics, said that it is important for the industry, hospitals and the government to come together to formulate a fair pricing policy for stents. “It is also time to decrease our dependence on the MNCs by manufacturing our own high-quality stents with extensive research and data.”