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After stents, government to track drug and device prices

After a price cap on stents, the National Pharmaceutical Pricing Authority (NPPA) under the Ministry of Chemicals and Fertilisers is under the process of preparing a database for monitoring the prices of several drugs and medical devices including heart valves.

After stents, government to track drug and device prices
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City doctors welcome the move saying that now that there are trans catheter valve replacement procedures that are effective for aged patients who cannot undergo surgery, there is an urgent need for a price cap as many cannot afford the treatment due to high costs. 

Almost 10 years ago, valve replacement surgeries could be broadly seen in two categories, mechanical valves made of metals and bio prosthetic valves for aortic and mitral valve replacement. However, today with the entry of the percutaneous trans catheter valve replacement, there is another option, especially for the aged who cannot undergo surgery due to high risks involved. Dr Rajaram Anantharaman, senior consultant, interventional cardiologist says that a price cap on the latest procedure would benefit many patients in the older age group. “Now, trans catheter valve costs anywhere between Rs 12.5 lakh and Rs 20 lakh. With people living longer, we have a large group that could benefit from this procedure, but the high costs keep it out of reach for many,” he says. 

A mechanical valve made of metal and bio prosthesis or tissue valves are are both priced between Rs 1.5 lakh and Rs 3 lakh depending on whether they are sourced from abroad or made in India. Several factors are considered for deciding on the options, including the person’s age and gender. Mechanical valves last longer, but the person must be on anticoagulants that increase the risk of bleeding and need regular monitoring. While on the other hand, bio prosthesis does not need anticoagulants beyond three months, but they wear out within 10 years. 

Dr K Dhamodaran, cardio thoracic surgeon, Stanley Medical College Hospital, says, “A price cap would definitely help patients who seek treatment under the comprehensive insurance scheme. While some bio prosthesis manufacturers claim that they last for about 10 to 15 years, their actual durability is even less than 10 years. The cost becomes a burden, when they have to undergo the procedure again for a replacement.” 

Dr Anantharaman adds that with many patients having rheumatic heart disease, the procedures are performed for those even at the age of 20, for example. “The question is how many times will they be able to undergo the surgery,” he says.

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