Stents are used to open up blocked arteries. Government has now put a price cap on the stents and experts totally disapprove of it, as they believe that this will block innovation and put patients in jeopardy.
The National Pharmaceutical Pricing Authority (NPPA) recently put a ceiling price to make stents affordable but experts say this may not have the desired impact on patients' well-being unless steps are undertaken to ensure patient access to innovative technology.
Following the NPPA's notification, several companies sought permission to withdraw their stents from market. The experts said it was a justified outcome of the government's short-sighted and unilateral approach to treat all stents as equal.
By not considering the need to categorize stents, based on their technological differences and benefits, the government is not only limiting choice but also jeopardizing the physician's ability to provide the best healthcare outcome, they said.
While 50-70 percent of patients would do well with a standard, older-generation drug eluting stent, a significant percentage of cases demand specific advancements, such as sleeker stents, or more trackable stents, or stents with higher burst pressure, or those that can cross through a calcified lesion, they added.
"I believe that considering affordability is important but not at the cost of putting brakes on the evolving technology that is so essential to ensure patients' well-being. It is true that the edge seems to have disappeared from the angioplasty scene with disappearance of the latest stents," said Shirish Hiremath, President of the Cardiologist Society of India.
"While the price capping benefits the larger community, it poses challenges for the more complicated and difficult patient conditions for whom the primary stents do not work. It also takes away the choice from the patient and the opportunity to have a meaningful dialogue with their providers to decide what is best for them and what they are ready to pay for," said D.S. Ratna Devi, CEO, Dakshayani and Amaravati Health & Education and Founder Indian Alliance of Patient Groups.
"The non-availability of latest metallic drug eluting stents is going to affect both cardiologists and patients. These new generation stents are of better quality and are easier to insert in difficult patient lesions, especially in cases where there are calcifications and curves in the coronary blood vessels.
"While the percentage of difficult lesions is increasing every day, the withdrawal of technically superior stents is going to cost lives. Exactly how many lives will be lost, only time will tell," said Mukharjee Madivada, Consultant Interventional Cardiologist, Maxcure Hospital, Hyderabad.