Hospitals to bloat bills to cover stent cap loss

Hyderabad: Days after National Pharmaceutical Pricing Authority (NPPA) capped stents at just Rs 30,000 per unit, city’s cardiac centres are scrambling for cover.

With the decision likely to dent profit margins, cardiac players are now planning to compensate losses by raising cost of angioplasty procedure as maintenance of a lone Rs 5-crore worth cathlab machine runs into Rs 25 lakh per annum, excluding salaries, sources said.

Now, your hospital bill is likely to have extra heads like junior technical charges, junior cardiology charges, senior cardiology charges, cathlab stay charges, surgeons’ standby charges and over-hospitalisation.

“Stent business is the revenue generator for most hospitals as it leaves big profit margins, but after the NPPA order, they will have to remodel their business. One way to do this is to raise overall cost procedure,” said a city doctor, on condition of anonymity.

In fact, TOI learnt several key players, including cardiologists went into a huddle and held a session two days ago to discuss a way out.

With an estimated 6,000 monthly stents, including 1,000 under the state-funded Aarogyasri scheme used on patients across 145 cathlab centres in Telangana, the NPPA cap is seen as a huge blow to hospitals, said industry observers.

And here’s the worst-kept secret. The

stent

business is so profitable that it leaves over 800% margin for hospitals on some brands marketed by US-based device makers. On the flip side, patients too may be affected in the long-run.

“Expensive ones with a price tag above 1 lakh have been withdrawn after the NPPA order. But cheaper ones worth Rs 40,000 are still available. Now, there are no bio-resorbable stents in the market as multinational device makers are finding the Indian market unviable due to steep price cut,” said Dr Anil Krishna, consultant, interventional cardiologist. MD MaxCure Group of hospitals.

Though he acknowledged black sheep bringing disrepute to the profession while dealing with stent business, he disagreed with NPPA’s attempt at painting the entire cardiac fraternity with the same brush.

In the long term, the stent capping decision is also likely to hit poor cardiac patients using Aarogyasri scheme as they may remain deprived of latest technology-based products, said Dr T Narsinga Reddy, chairman of Aarogyasri Private Network Hospitals, Telangana, and president of the state chapter of Indian Medical Association (IMA).

“Bare metal stent per unit under Aarogyasri costs Rs 9,000 per unit, while drug eluting stent per unit package comes for Rs 24,000, but with the NPPA order, we are sure device makers won’t release new generation stents now,” he said.