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Profits from medical devices used to bribe doctors?

Patients pay three times import price for stents

MUMBAI: Heart patients in the state, including in Mumbai, pay 700% more than the import cost for stents, revealed the first-ever cost survey by the Food and Drug Administration (FDA). The survey has also shown that the maximum retail price (MRP) itself is majorly exaggerated and depends on the whims and fancies of distributors or other middle agencies.The FDA, during a six-month-long survey, tracked a multi-national company that imports stents from the West and sells it to Indian distributors. The investigation exposed unregulated profit-mongering at each step of the supply chain. The report said that company importing the stents itself made a profit of 120% before selling it to the distributors.The department tracked six such distributors across Mumbai, Pune and Nashik and found that they, too, made average profits of 125% before selling them to hospitals. Hospitals across the three cities, in turn, also made average profits of 25% before selling the stents to heart patients who needed them for procedures such as angioplasty. The report stated that for one of the stents, which had a landing cost of Rs 25,000, the MRP was fixed at Rs 1.55 lakh.“Due to such exorbitant pricing, the importing company, distributors and hospitals are minting huge profits, while patients have to suffer. The profit percentages are clearly borne by the patient,” said FDA commissioner Dr Harshadeep Kamble. He added that as heart-related operations invariably come under emergency category, patients are often left with no option but to pay the price.Based on the findings of FDA’s vigilance department, Kamble has recommended to the Centre that cardiac stents be brought under the list of essential medicines under the Drugs Price Control Order as these are lifesaving drugs. “There has to be fixed profit margins for importing companies, distributors and hospitals. Patients cannot be left at the mercy of such pricing practice,” he said.An insider from one of the major importers said the profiteering happens more at the distributor and hospital level. Distributors that TOI spoke to, however, said they have to have a varied and large inventory of stents to cater to big hospitals. “Stents comes in 50 to 60 sizes and different material. So, we ought to charge some sum to maintain a large inventory,” said a Dadar-based distributor.Dr N O Bansal, head of cardiology at JJ Hospital, said the government has to begin a dialogue rather than clamping the industry. “Price regulation is necessary, but the government cannot fix profits. Rather we need to see that the domestic industry excels so that we do not have to import devices,” he said.