October 20, 2011

Hospitals ‘mint' money on heart stents

Company-cardiologist nexus leaves patients high and dry The stents, meant to unclog arteries of the heart, have become a major source to make a fast buck for many hospitals in the capital. With no mechanism to regulate the sale or use of stents, hospitals have developed a profit generating commission system at the cost of patients, with the tacit approval of cardiologists and stent manufacturing companies. There is no strong regulatory body such as the US Food and Drug Administration (USFDA) to monitor and regulate stents industry in India. As a result, Indian stents, according to experts familiar with the industry, although good in quality, are seldom prescribed and used on patients. Only imported stents are used and this opens up opportunities for the hospital management to charge exorbitantly. The government does not have a ‘pricing' control system of stents; as a result, patients are forced to pay hefty amounts. The commission system of stents works in an intricate way. “Suppose, there are four imported stent companies vying for a ‘contract' with a hospital. The company that supplies an imported stent at a very low price than the others is recommended by the cardiologist and chosen by the hospital. Only that stent will be used for a fixed period of time on all the patients by the hospital. Thanks to no regulatory body in India, these companies compromise on quality because they can't maintain quality standards at such cheap prices,” reveals a doctor close to the system. The stent manufacturing company first ‘ropes in' the cardiologist by coming into an agreement over the commission. After that, the company takes the cardiologist-approved stent to the hospital management for approval and eventually fixes commission to the hospital. “Unfortunately, the hospital and the doctors act like middlemen in a vegetable market who make money at the cost of patients. The Maximum Retail Price (MRP) of the stents will be hefty but the actual rate at which the hospitals purchase the stents will be very low. On some category of stents, hospitals make 100 per cent profit,” doctors concede. As a result of these commission schemes, the hapless patient ends up paying hefty amounts. “It all boils down to ethics. Nobody can question the surgeon on what kind of stent they are using on the operation table,” senior doctors say. In addition to charging the stents at MRP, corporate hospitals have introduced a system of imposing ‘handling charges' in the final medical bill. “In addition to the MRP, on an average, hospitals charge an extra 15 to 20 per cent on each stent towards handling charges. The government has literally turned a blind eye towards this malpractice,” officials close to the system said. Link: Original Article

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