Mumbai: The cost of angioplasty procedures has declined by 8-18% following the government’s decision to slash prices of coronary stents by up to 80% in February last year, a study conducted by IQVIA, formerly QuintilesIMS, on behalf of Advanced Medical Technology Association (AdvaMed), showed.

The 8-18% reduction in overall angioplasty procedure cost is for patients undergoing single vessel procedure, which forms around 70% of the total number of patients undergoing angioplasty.

An angioplasty surgery is performed in cardiac patients to open blocked arteries. A stent, a tiny tube-shaped device, is placed in the patient’s narrowed or blocked coronary artery to maintain normal blood supply.

The National Pharmaceutical Pricing Authority (NPPA) had cut prices of coronary stents sharply last year in a bid to make angioplasty affordable and improve access. Price of widely used drug-eluting stents, which used to be earlier priced as high as Rs200,000 was brought down to Rs30,000 by the regulator.

AdvaMed, a lobby group representing international medical device companies, along with IQVIA, conducted the study to understand the impact of stent price control on the overall angioplasty procedure cost and the total number of angioplasties performed across hospital segments.

The growth in number of angioplasty procedures conducted has been in the range of 2-7%, the study showed.

“The initial findings from the study indicate that benefits to patients and growth in procedure volumes have not indicated significant change in the short term, while the long-term impact remains to be seen," AdvaMed said.

The findings are based on a survey of and feedback from 276 stakeholders, which include interventional cardiologists, hospital administrators and angioplasty patients across hospital segments (corporate chains, large private hospitals, mid-sized private hospitals and government hospitals) in metro and tier-1 towns.

“Procedures such as angioplasties come as packages and a lot needs to happen before a patient gets to a place where she/he has to decide on the procedure. Most people try and manage with medicines until it becomes an emergency, so looking for an impact (of stent price cut) this early is difficult," Dr Ratna Devi, chief executive officer, DakshamAHealth, and founding member, Indian Alliance of Patient Groups, said.

In corporate hospital chains, there has been a 8-12% reduction in angioplasty procedure cost, to Rs205,000-Rs220,000, while in large private hospitals the cost is down 14-18% to Rs160,000-Rs180,000. In medium-sized hospitals, the cost has reduced by 8-12% to Rs115,000-Rs125,000, as per the study.

The study showed that patients at government-funded hospitals have not benefited significantly from stent price control as stents were available at less than Rs30,000 even before price capping at a majority of these hospitals.

“The singular focus on controlling prices of devices without attempting to address the large picture will not improve patient access. An enhanced access to quality care requires a holistic approach encompassing cost optimization at various levels in healthcare delivery and investments to strengthen healthcare infrastructure," AdvaMed said.

“It is important that policy decisions are made with due consultation and engagement with the medical community to ensure that patients are truly benefited. Without 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," Dr Shirish Hiremath, president of Cardiological Society of India, said.

Mint reported on Wednesday that NPPA chairman Bhupendra Singh has, in a letter dated 9 January, asked Union health secretary Preeti Sudan to call an urgent meeting of the cardiac stents core committee of the National List of Essential Medicines (NLEM) to “re-consider" the issue and review if all drug-eluting stents are equal, or if a new category is required.

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