Times of India (TOI) deserves to be complimented for the spirited campaign against hospitals and doctors making unconscionable mark up in the prices of stents. TOI reported how a stent can cost the patient over ten times by the time it moves from the manufacturer to the patient: the paper pointed to the increased price of Rs 40,000 to Rs 2 lakh at the patient’s end. The sustained reporting helped the government fix the price for certain categories of stents at much lower prices.
Such practices are rampant for a wide range of medical devices like hearing aids, valves, knee replacement parts and implants. These sophisticated parts are produced by a handful number of large multinationals which, often, cartelise. In the Indian system other pernicious practices creep in, like monopoly distribution agencies which again, in turn, form cartels. Down the line, there is the collusion amongst the local dealers, hospitals and doctors. TOI has pointed to the liberal mark-up made in the price of stents taking care to benefit the entire chain.
Look at the escalation in costs in taking an x-ray. Some three decades ago Hindustan Photo Films was the principal supplier of x-ray films. Thanks to the lead provided by management expert M K Raju, the facilities at HPF were upgraded. DuPont extended technical assistance to HPF. The film supplied was modestly priced and one could take an x-ray at less than Rs 50.
Volumes have expanded manifold since. If one expected the benefit of such volumes one is disappointed. Multi-specialty hospitals which take such x-rays in hundreds every day, charge a whopping Rs 500 plus per x-ray. It is again common practice on the part of these hospitals to insist on taking such x-rays afresh even if they were taken by another multi-specialty hospital. The patient under the knife of the hospital surgeon, can’t think much about the basic cost or its escalation at different stages. Do you hear of value engineering or cost break-up in regard to any of the product or services provided by such hospitals? Remember, you are at the knife-point too numbed to raise any such concerns.
Sadly, there is no independent regulatory authority on such usurious practices. Charan Singh as Prime Minister chided Apollo Dr Pratap Reddy’s proposal for setting up a corporate hospital: “how can you make money out of a patient’s misery,” he asked and reportedly threw the proposal to the waste paper basket. It is true corporate hospitals and other secondary and primary care medical institutions have revolutionised healthcare. Sadly, in this process the concern for costs seems to have gone for a toss.
IE is glad to note the price of cardiac stents being reduced by 85 per cent and are made available in the range of Rs 7260 to Rs 29,600 with effect from 14 February. This will help in savings of up to Rs 1 lakh per patient to millions of heart patients across the country.