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The differences between foreign and Indian stents are narrowing: Dr Sachin N Patil

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The differences between foreign and Indian stents are narrowing: Dr Sachin N Patil Shahid Akhter, editor, ETHealthworld spoke to Dr Sachin N Patil, Consultant Interventional Cardiologist, Aster Aadhar Hospital, Kolhapur, to understand the impact and outcome of price capping on stents. Edited excerpts:

How is cardiac care spread out in Tier 2 and 3 cities?
In Tier 2 and 3 cities there are a lot of changing trends in cardiology in the sense, now the prior trend was that people used to go to bigger cities for any operation or heart attack etc, but now they are very much willing to get it operated at their own place. The medical facilities or the rapid expansion now is in Tier 2 and Tier 3 cities mainly. 70 percent of the growth is in tier 2 and tier 3 cities and 70 percent of the population stays there. Now everything is available locally, fortunately good policies of the Indian government have made it possible.

What is the impact of price cap on stents in these places?
Stent capping has brought a very good impact on the industry. It is a very good move and a very good initiative from the government because now the stents have become affordable and the needy patients can really undergo the procedure at a minimal cost in tier 2 or tier 3 cities. The doctor and the hospital charges are similar but the stent prices have come down by 80 percent so the direct benefit has been passed on to the patients. The affordability has come down and more patients are willing to get operated. They are getting treated in a very proper fashion. So that is a welcome change that the government has done.

Has this translated into higher (patient) volumes and affordability?
It has definitely brought a change in volume because the affordability or the price has come down. Definitely more patients are now willing to get operated and volumes have now increased tremendously.

Atleast in tier 2 and tier 3 cities the stent capping has benefited the patients. Patient benefit and affordability both the things have been covered here. The cardiologist and hospital charges are as prior but the stents have come down by 85 percent so the patients are getting benefitted.

With varying costs and choices, how do you decide a particular stent?
We go by the patient subset, it is a very tricky situation and a very complex angioplasty, we select the stents accordingly. Also, there is confusion which people carry for Indian stents versus foreign stents but that is getting narrowed down very fast. The Indian stents are also as good as the western stents. We are not seeing much difference in the real world practice and their results are equally good as others. Now due to the capping of margin most companies are supplying us directly.

What are the challenges that still confronting the Tier 2 and 3 cities?
There are challenges still. One issue has been sorted out by the government which is about stents but the price of other materials like the balloons, wires the catheters still they are slightly on the higher side which can come down so sometimes we have to reuse the material to keep the cost down. In Europe or America they use the a la carte system, whatever is used is built and everything is new because the costs are less. So similar kinds of trends if comes to India I am sure it will transform into better results, better outcomes and eventually healthcare. So I am sure these welcome steps government will take in due course of time.



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