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Author: Lokesh Sharma

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HIGHLIGHTS

  • The MRP of a total knee system varies between Rs 59,091 and Rs 4,13,059.
  • The distributor, who gets the product for Rs 1,67,162, earns a margin of Rs 2,45,297, or 147%, on the product.
  • Distributors and hospitals are earning hefty trade margins that can range from 67% to as high as 449%.

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NEW DELHI: In what could set the stage for capping prices of knee implants, an analysis by the National Pharmaceutical Pricing Authority (NPPA) shows that importers, distributors and hospitals are earning hefty trade margins that can range from 67% to as high as 449%.

After capping prices of cardiac stents, the NPPA report can see the government moving in a similar direction with regard to orthopedic knee implants, official sources said, underlining the Centre’s commitment to rationalize cost of medical care and make it more affordable and accessible.

The analysis shows that in case of an “insert” — used to replace a damaged bone or cartilage in knee replacement surgery — the average total trade margin is 449%, whereas that on the “total knee system” is 313%.

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In this scenario of rising and varying prices of medical supplies, it is imperative that the medical supply chain transforms and innovates to achieve transparency, efficiency and end- customer-focus. The online-n-offline medical industry integrators like nwow.in are bringing the end customer or multi-scale hospitals on the same platform as the manufacturers and large distributors leading to drastic cost saving as well as price transparency with ease of buying.

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Apart from substantial trade margins, the analysis shows a huge disparity in the landed price of imported knee implants and their MRPs. The prices of a range of products available in the market vary drastically. For instance, in case of Femoral — a device used in knee replacement surgery — the maximum landed price is Rs 29,470, whereas the MRP is Rs 1,69,123. The product is available to the distributor at Rs 83,000.

The MRP of the total “knee system” is Rs 4,13,059, whereas the landed price for the importer is Rs 65,781, the NPPA analysis shows. It reveals that the distributor, who gets the product for Rs 1,67,162, earns a margin of Rs 2,45,297, or 147%, on the product.

There is also a significant gap in the range of prices for any particular product. For instance, the MRP of a total knee system varies between Rs 59,091 and Rs 4,13,059

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The data shows distributors and hospitals earning the maximum margin — ranging from 120% to 163% — whereas importers also keep a significant share of the trade margin, ranging between 29% and 109%, depending on the product.

TOI had earlier reported that orthopedic implants are under the NPPA scanner and the government is expected to bring them under price regulation very soon. In May, the regulator placed the devices on the list of products to be monitored and asked companies to submit their price data by the end of the month.

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Initially, the regulator shortlisted 19 such commonly used medical devices, including catheters, heart valves, orthopedic implants and intraocular lenses, and asked companies to submit price and production data. It made recommendations to the health ministry to include more medical devices under the national list of essential medicines.

Though NPPA’s analysis of the price data for knee implants forms a strong basis for the government to bring them under price control, it is ultimately the health ministry which takes a call on placing the devices under NLEM. Thereafter, NPPA will be empowered to cap prices of knee implants.

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Source : timesofindia

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A CT Scanner refers to Computed Tomography. CT scan uses X-rays to make detailed pictures of parts of your body and the structures inside your body.

CT Scanner are categorized technically by the number of slices or scans or images it can take per rotation . The single slicer takes one image per rotation and is the bottom most in the ladder.

The hierarchy goes as : 1( single), 2 ( Dual) , 4 ( Quad) , 6, 8, 16, 32, 40, 64, 128, 256, and 512 scans/sec.

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What is it for?

 

CT scans are vital for detecting terminal diseases like brain tumors, cancer,neurological problems and other underlying abnormalities of the body, organs, bones, soft tissue and blood vessels typically provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels. CT scanning provides more detailed information on head injuries, stroke, brain tumors and other brain diseases than regular radiographs (x-rays).

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APPLICATION IN THE  MEDICAL WORLD

 

Quickly identify injuries to the lungs, heart and vessels, liver, spleen, kidneys, bowel or other internal organs in cases of trauma.

It successfully guides biopsies and other procedures such as abscess drainages and minimally invasive tumor treatments.

Plan for and assess the results of surgery, such as organ transplants or gastric bypass.

It helps in stage, plan and properly administer radiation treatments for tumors as well as monitor response to chemotherapy.

Aids in Measuring bone mineral density for the detection of osteoporosis.

A C.T scan is the doctor’s guide to figure out what is going inside the patient’s body, depending upon the extent of the problem, different scan may be required.

There are various types of scans that are available depending upon the need of the patient such as

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What should an ideal CT scanner contain?

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The Application of CT Scanners depends on Scope and Size of Hospitals and Diagnostic Centres.  A effectiveness of CT Scanner depends on the number of Images / Scans it can take per second.

Smaller hospitals and nursing homes do not require a very high end CT as they do routine scanning more , and that  too 80-90% of cases are head cases .

  • It should be fast in processingC.T scanner contain
  • Have agood memory storage.
  • Starting up time should be low
  • Scan volume should be high
  • Irrespective of the type of CT scanner selected the most critical element in the entire process of selection and utilization of ascanner depends on the availability of service in the local region and the type of service contracts. One must watch out for situations in which a manufacturer may lower the cost of its scanner to compete with other manufacturers but indirectly make up for the loss of the scanner cost by levying higher rates for service contracts.

Therefore, examining the type of service available in the region

And the type of service agreement with a manufacturer is crucial at the time of selection.

As CT Scanner Manufacturing companies have stopped manufacturing the 1,2,4 slice CTs , and are usually starting from 16 slice onward.

For the High End CT Scanners above 16 slice onwards the initial cost and running cost is quite substantial and is not viable for smaller hospitals and diagnostic centres.

Hence the used/ refurbished Emotion is a good machine o buy, as it can make the project viable and can be value for money.

Medventura an Online Portal for Medical Equipment and Consumables takes special care for the needs of Healthcare Industry in India. The Siemens Emotion Single Slice CT Scanner, one of the best CT scanner available in India has been verified and checked by Medventura. Since Medical Advancements the advancements in diseases and diagnostic practices have also got a boost, the Siemens single slice scanner contains all the features required to conduct a good diagnose. Not only this, it is reliable, affordable and durable.

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Some of its technical specifications are

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Scanner : gantry

Generation: 3rd

Aperture (cm): 70

Maximum scan field of view (cm):  50 Couch

Length and width (cm):217.5 x 43

Horizontal movement range (cm): 153

Vertical movement range out of-gantry (cm):45 – 83

Maximum weight on couch (kg) 200

Tube and generator

Generator power rating (kW) 40

Anode heat capacity (MHU) 6.3 7.7 3

Maximum anode cooling rate (KHU/min):  635

Guaranteed tube life: 130,000 scan Seconds

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Image storage

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[Total hard disk storage capacity Supplied as standard (Bytes)-18 GB]Additional facilities Independent workstation: Standard

Contrast injector : Optional CT fluoroscopy software and Hard-copy imaging device

Bone mineral: Densitometry CT angiography Standard Dental

Radiotherapy CT: simulation soft

After taking into contrast all the features it has , we have come up with the conclusion that SIEMENS CT SCANNER is the best choice for your hospital, diagnostic centre.

Widen your clinical capabilities with SOMATOM® Emotion. It is famous for its great versatility and high performance from exam set-up to image acquisition and processing – and will give you high efficiency in delivering high quality clinical outcomes.

Innovative dose-saving features such as IRIS, CARE Dose4D and Dose MAP, combine the best possible image quality at the lowest possible dose.

These machines are installed in big numbers and the users face lots of problems with parts and service, but Medventura also provides service agencies who can take care of the machines in a good effective manner and also take up repairs and maintenance contracts for the same.

The combination of Siemens  best technology and medventura’s reliable pricing and support, widen your horizons and pick up the best option for yourself.

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Read more :  Trends in CT System Purchase in Emerging Markets

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Fully efficient and functional medical equipment is required for the flawless functioning of a medical laboratory. When purchasing medical equipment and consumables, online shopping is considered to be one of the several affordable choices. One major benefit of buying medical supplies online is that the internet remains the excellent junctions to find and purchase from a wide range of laboratory equipment including x – ray machines, CT Scanners, MRI Machines and Disposable Medical Consumables like Syringes, Gloves, Cotton Swabs, First Aid kits, etc just within few clicks at one place. Each of these products is used to perform specialized functions.

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But before purchasing medical equipment, it is always recommended you have sufficient information regarding the item’s uses, features, specifications and description. Additionally, buyers need to conduct a search on the internet to confirm the easy availability of reagents, controls, spare parts and consumables among others. They should also confirm if there is any warranty and after-sales service both for new and refurbished products. Furthermore, buying medical equipment and consumables online is very reasonable and affordable compared to local stores. This is because online stores offer large discounts on assorted equipment and consumables according to individual’s budget. Of a truth, online shopping offers the value for the money invested in medical equipment and consumables.

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There are online stores that provide and sell medical equipment from top manufacturers in the medical industry and can assure product guarantee and consumer satisfaction. However, it is recommended to always choose one vendor for all your medical equipment and consumables as it will be very easy to buy the best product at negotiable price instead of contacting different sellers. Not only is buying medical equipment and consumables in India beneficial, but also the best way of shopping that is comfortable convenient and that saves lots of effort and precious time.

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For more details on buying or selling in the healthcare industry in India, please visit

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Medical equipment costs are growing leaps and bounds.  Diagnostic centers, clinics and hospitals are looking at more pocket friendly approaches in order make it less burdening for them.  The cost of an MRI machine is $150000 – $300000.  The above cost does not include transport charges and installation & maintenance charges.  Refurbished medical equipment market has been a great boon for users that make the equipment purchase less burdening.  Refurbished medical equipment is a highly grown market with an estimate to reach 11.91 billion USD by 2021.

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Products that fall under the category of ‘refurbished’ may include those that were used in field tests, demonstrations and sales display.  Those products that were returned for reasons other than defect and were tested by manufacturer.  Those products that were returned by customer due to a damage caused to the package or item during shipping.  Products that were leftover and sold to refurbisher by a downsized company.  Since all the products will be tested by the manufacturer before selling, refurbished products can be safely purchased by buyers without any hesitation on the product quality of functioning.

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Some of the major factors that are influencing the increased sale traffic of refurbished medical equipment are increased privatization in the healthcare sector, poor government reimbursement for subsidies for various medical treatments, increased patient population base etc.  The huge opportunities for growth and revenue has attracted large number of multinational medical equipment manufacturing companies to play an active role in this segment of the market. Leading players such as Philips Healthcare, GE Healthcare and Siemens Healthineers have established refurbishment facilities in both mature and emerging markets that are further adding to the growth prospects of these markets.  However, few drawbacks in this market are stringent regulatory environment in countries such as China, Kuwait and lack of standardization of policies related to sale and use of refurbished medical devices

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Analysis of refurbished medical equipment market indicate that equipment associated with radiation oncology systems, biotechnology instruments, minimally invasive devices and diagnostic imaging equipment have huge demand in the market.  The diagnostic imaging equipment such as X-rays, mammography MRIs and CT systems have accounted for 75% of the total market share.  Refurbished medical equipment can be highly reliable and can offer significant savings to the medical facility.

Even though there are multiple benefits associated with the usage of refurbished medical products, cost savings, quality products, customer service and reliability can be seen as the main benefits associated with the usage of refurbished medical products.  When a product with the label ‘refurbished’ is bought from a reputed medical equipment company, users can be rest assured that the product has been thoroughly tested and is made safe and reliable for usage.

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There are umpteen number of portals online for buying and selling refurbished medical equipment.  However, a very handful of them run with interests of consumers taking into consideration.  Major players such as Stryker India have their own dedicated online portals such as usedstryker.com to handle refurbished medical equipment.  Other players include Medicomart and Mediamart.  Medventura, a unique online platform created by highly trained and dedicated professionals is truly innovative in every aspect of it.  Being run with best interests of consumers, the platform has category wise listing of products grouped into equipment and consumables.

The platform facilitates business to business and business to consumer sales.  Its wide reach of target audience is an added advantage.  The option for manufacturers to advertise the products

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With the advances in science and technology, medical field has seen significant growth.  Precision and accuracy are the latest buzz words in medical field.  Gone are the days where doctors have to either rely on information from patient or by their physical examination while diagnosing a disease.  In this new age, doctors heavily rely on medical equipment which provide precise and accurate information about the disease or the medical condition of a patient.  Advances in science made it possible to increase the efficiency of medical equipment.  These changes in the efficiency are clearly noticeable from as small a device as stethoscope to as big a machine as CT scan.

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Internal infection because of various medical conditions or anatomical damages to human body were difficult to identify and pinpoint until a few decades back.  But thanks to the CT scanners, the job of doctors has been made much easier.  A CAT scan or CT scan produces cross-sectional images of a specific area with computer-processed combinations of multiple X-ray images taken from different angles as source.  These images provide the ability to see the inside of an object or body part without the need to cut the body part or object

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The precise, accurate and clear information a CT scanner provides made its usage significantly increase over the last two decades in many countries across the world.  In the year 2007, in US alone, a staggering number of 72 million scans were performed with the help of CT scanner.  The use of CT scan is not limited or restricted to any part of the body.

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It can used to diagnose various diseases that fall under cardiology or neurology or pulmonology.  There are multiple benefits associated with CT scan.  CT scan provides the ability to capture only the area of interest as part of the image by eliminating the superimposition of images of structures that are not part of area of interest.  A CT scan images are of high-contrast resolution which translates into the ability to differentiate between tissues with a difference in physical density by less than 1%.  Multiplanar reconstruction is the most important benefit wherein a volume of image is built by stacking the axial slices.  Multiple other 3D rendering techniques such as surface rendering, volume rendering and Image segmentation increase the image quality.

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The increasing growth of CT scan market has having the reverse effect on the X-ray market which is getting phased out gradually.  This trend of increased growth of CT scan market having a diminishing effect on X-ray is more evident in developed markets such as US and Western Europe.  In emerging markets such as India, Russia and Israel etc., the growth potential for CT scan market is very high.  This is due to the fact that X-ray machines are still extensively used among the emerging markets.  Governments across the emerging markets have realized the importance of a nation with healthy population.  This has led to increased budgetary spending in healthcare industry in the emerging countries.

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CT scanners are extensively used in imaging centers, hospitals and clinics.  Currently, 16 and 64 slice scanners enjoy great deal of popularity among the service providers.  However, 320 scanner systems are also available.  Some of the dominant players in the CT scan market include Toshiba Medical Systems, Siemens, Trivitron Technologies, Philips Healthcare and GE Healthcare.  These major players in their economic interest to grab the market are also investing heavily in their R&D in order to bring more and more enhanced features with their products.  As we advance in science and technology field, we can be assured that CT scanners will come with innovative, safe and enhanced features that make the job of diagnosing a disease by doctor a cake walk.

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read more article : Emerging trends impacting Global MRI Systems

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A metabolic disease in which there are high blood sugar levels during a prolonged period of time is diabetes.  Most commonly, Diabetes is of two types which is Type 1 Diabetes and Type 2 Diabetes.  When pancreas fails to produce enough insulin, it may result in Type 1 diabetes.  Type 2 diabetes starts with insulin resistance.  This could be a result of excessive body weight and lack of exercise.  Some of the chronic diseases such as Diabetes result in other body organ complications such as cardiovascular diseases.  About half of the patients with Type 2 diabetes may die of cardiovascular disease.

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ECG or Electrocardiography is the process of recording electrical activity of heart over a period of time through the electrodes placed on the skin.  Hospitals and diagnostic centers use ECG to assess patient’s heart rhythm, diagnose poor blood flow to the heart muscle or the condition which is called Ischemia.  It can also be used to diagnose abnormalities of heart including heart chamber enlargement and abnormal electrical conduction.

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The six channel ECG machine is an automatic ECG measurement system with complete digital design, digital filtering and auto gain.  There has been a significant development in new medications in the past year 2016.  Two medications require a special mention here as they began to reduce the mortality rates considerably.  Empagliflozin works with the kidney and modifies the progression of heart disease.  Liraglutide has a comprehensive effect on many organs.  Thus these diabetic drugs seem to reduce the cardiovascular disease and death because of the disease.

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Above is just one example of latest trends in medical technologies.  Science and technology is still evolving and growing leaps and bounds.  Technology solutions belonging to other industries seem to greatly influence the healthcare industry.  The wearable industry is one such industry which has greatly integrated with healthcare.  Various states of human body is being tracked and monitored with the help of wearables.  Some of them include the heartbeat, pulse rate etc.  Present days smart watches also have the ability to track the activity the individual has undergone over a period of time and also provide the number of calories an individual has exhausted as part of the activity.  Some of the companies have made a tie up with medical specialists where the individual’s health and activity is regularly monitored with the help of smart watches the individual is wearing.

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Medical industry is taking leverage of IT to provide new and innovative solutions that were unimaginable of a few decades back.  EHR or Electronic Health Records is the process of maintaining patient’s full medical and treatment history so that it is accessible by doctors or patient wherever they have access to internet.  This is still in its nascent stage but its practice is gaining momentum rapidly.  Medical industry especially the organ transplant field seems to be greatly getting benefited from the 3D printing technology.  Organ transplant operations are expected to become more scalable with the help of 3D printing technology.

Telemedicine is another new field of medical science that is rapidly picking up the pace.  It is not always possible for a patient to be physically available in front of the doctor for diagnosis.  Factors such as his medical condition, personal commitments, professional commitments and distance can be a major hurdle in paying a visit to doctor. Telemedicine is a great boon that facilitates the diagnosis of patient’s condition without the need for the patient to be physically present in front of the doctor.  This technology has a great potential as it can reduce the distance between doctor and patient and provide world class health care in remote areas.

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read more article : What is the medical equipment and Types of medical equipment ?

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Gone are the days when surgeons had to cut open human body to understand the anatomy and physiological processes of human body in both health and disease.  The latest in science and technology has made it a reality to examine the physiological processes and anatomy of human body without a single cut.  MRI or Magnetic resonance imaging is an imaging technique that falls under radiology with the help of which pictures of anatomy or physiological processes can be formed.  Radio waves, strong magnetic fields and field ingredients may be used to generate these images.

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MRI scanners are considered superior to X-rays and CT scanners.  Some of the risks that come associated with the use of MRI scanners is people need to go into a tube kind of structure apart from bearing the louder sounds.  This can be quite a discomfort for people who are claustrophobic.  Also, MRI scanners may take more time when compared to CT scanners to generate the image.  Further, people with medical implants and other metal implants may not be able to undergo MRI scan safely.

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MRI falls under the science of nuclear magnetic resonance.  Some atomic nuclei have the ability to absorb and emit radio frequency energy when placed in an external magnetic field.  When it comes to clinical and research MRI, hydrogen atoms are the most commonly used in order to generate a radio-frequency signal that is detectable and which can be received antennas that are placed in close proximity that is put under examination.

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The advantage of using hydrogen atoms here is that they are abundantly present naturally in humans.  Water and fat present in humans have increased concentration of hydrogen atoms.  Radio wave pulses excite the energy transition nuclear spin with magnetic field gradients localizing the signal in space.  The parameters of pulse sequence can be altered thus generating different contrasts between tissues which are dependent on the relaxation properties of hydrogen atoms.  Widely used in clinics and hospitals, this equipment is critical in medical diagnosis, disease staging and follow-up.

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Various specialty departments of medicine such as neuroimaging, cardiology and gastroenterology use MRI.  MRI is the choice of tool in order to perform investigation for neurological cancers.  Higher resolution and better visualization technique make it the most preferred tool.  MRI scans provide high contrast resolution images of grey and white matter and hence it stands out to be the obvious choice for many disease conditions such as dementia, epilepsy and other infectious diseases.  In cardiology, cardiac MRI is widely used as a complementary to other imaging techniques.  It is extremely helpful in the assessment of serious heart ailments such as congenital heart disease and cardiomyopathies etc.

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By 2021, the MRI market is expected to reach USD 7 billion by 2021.  Top MRI manufacturers include, GE, Philips, Hitachi and Siemens.  The MRI market has become extremely competitive with vendors adopting various strategic initiatives both on the business end as well as on the research side.  On the business front, companies adopting merging and acquisition strategies in order to make their presence across the globe and also to make entry in new markets.  On the research front, manufacturers such as Philips have launched MRI/PET imaging systems into the market.  These systems without ionizing radiation combine functional imaging data and anatomical imaging to deliver high quality soft tissue characterization.  Besides the above listed factors, some of the MRI System Market Drivers are emergence of hybrid imaging technologies, advent of MRI-compatible pacemakers and development of superconducting magnets.  With so many advantages, the MRI scan definitely takes a more preferential tool position among the medical community for disease diagnosis and health assessment.

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Read more article :  An MRI Scanner buying guide

 

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[et_pb_section admin_label=”section” transparent_background=”off” allow_player_pause=”off” inner_shadow=”off” parallax=”off” parallax_method=”off” custom_padding=”||0px|” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off”][et_pb_row admin_label=”row”][et_pb_column type=”4_4″][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”] Humans are pushing the threshold of medicine in their quest to live a disease free and healthy life.  The research in the medical field has led to invention of various tools or medical equipment to aid diagnosis and to treat medical conditions.  Stethoscope is a best example to this.  What started as a small invention consisting of a monaural wooden tube has evolved greatly over the period of time. Some of the present day stethoscopes are electronic stethoscopes that can overcome the low sound levels of body by electronically amplifying the sounds. [/et_pb_text][/et_pb_column][/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]

Today, the medical industry is highly evolved and it has different departments under its umbrella.  The life support equipment that includes incubators, anesthetic machines, ECMO and ICU Ventilator etc. are used to maintain a patient’s bodily function.

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The treatment equipment may include LASIK surgical machines, medical lasers and infusion pumps etc. Diagnostic equipment includes medical imaging machines such as MRI machines, ultrasound machines and X-Ray machines etc.  These kind of medical equipment are used in clinics, hospitals and diagnostic laboratories.  Diagnostic Medical Equipment such as equipment for the control of diabetes may be used in home.

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The industry of medical consumables in India is having a steady growth.  Valued at USD 3.5 billion in 2015, it may expand to USD 4.8 billion by 2019.  The growth numbers undoubtedly attract foreign manufacturers who are actively being part of the Indian medical equipment market.  India has skilled man power in the medical industry and hence it has become a preferred medical tourism destination with people from foreign continents visiting India to address their health needs.  The medical tourism industry is projected to grow $7-8 billion by the year 2020.

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Medical tourism industry in India has witnessed large number of people from US and UK.  People from neighbouring countries such as Bangladesh and Afghanistan are not left far behind.  People from CIS countries, Russia and the African continent also accounted for a large portion of numbers.  There is a great deal of demand for cancer diagnostics, orthopaedic and prosthetic equipment and electromagnetic equipment.  Some of the factors that are playing a key role in attracting good number of medical tourists to the country include cost, ease of travel, quality of care and language.

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Treatment costs in India start at one tenth of the price at which people are treated in US or the UK.  Specialties related to eye, heart and hips have been the major medical departments that witnessed significant number of foreign patients.  Indian has 28 JCI or Joint Commission International accredited hospitals.  JCI accreditation is a significant milestone for a hospital.  In US, majority of the states recognize JC accreditation as a condition of licensure.  The government of India has removed various restrictions on visa by implementing measures such as visa on arrival thus playing its role in increasing the number of visitors from various foreign countries

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Corporate companies and startup companies are cashing the opportunity of demand that the increased medical equipment supply has created.   Companies are finding various avenues to fill the demand and supply gap.  Recent startups such as Medventura have created an online platform wherein buyers and sellers can interact with each other & find best hospital medical supplies.  The manufacturers/sellers can market their products by listing them on the site.  Interested parties can create an account, login into the site, review the description of the equipment and indicate their interest in purchase to the buyer.  The site provides a unique platform that benefits all the players.  Platforms such as these are gaining momentum as they provide a seamless experience for both buyers and sellers wherein buying and selling are no more a tedious job.

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Read  more article :  Refurbished Medical Equipment

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No action will be taken against hospitals under the scanner for overcharging on stents if they refund the money to patients before receiving a demand notice, drug price regulator NPPA said. The country’s drug pricing regulator has said.

 

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The National Pharmaceutical Pricing Authority (NPPA) said the matter would end there for such hospitals if there were no further complaints.

“If the hospitals under the scanner refund money to patients before NPPA issues ‘demand notice’, matter ends till there is no new complaint,” the regulator tweeted.

Explaining that a ‘show cause notice’ (SCN) is issued for seeking the explanation of the hospital/company, it added that a ‘Demand Notice’ (DN) is issued when a violation is proved.

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The regulator also said “it would ensure complete audit of their angioplasty bills in the near future” but did not share details citing “request of patients who have got refunds and their concerns of follow up need in the same hospitals“.

The NPPA had said yesterday its helpline has received complaints against Oxygen Hospital in Rohtak, Haryana and Bharat Heart Institute, Dehradun, Uttarakhand for overcharging on stents.

The regulator had earlier issued show cause notices to Max Hospital, Saket, New Delhi and Nidaan Multispeciality Hospital, Sonepat, Haryana.

It had also said it was investigating overpricing complaints against hospitals such as Lilavati Hospital (Mumbai), Max Saket (New Delhi), Metro Hospital (Faridabad), PGI Chandigarh, Ram Murti Hospital (Bareilly), and has alerted the concerned State Drug Controllers.

However, Max Healthcare and Lilavati Hospital have said they are in compliance with NPPA guidelines and have not overcharged patients for stents.

In a major relief to patients, the NPPA last week slashed prices of coronary stents by up to 85 per cent, capping them at Rs 7,260 for bare metal ones and Rs 29,600 for the drug eluting variety.

Source : Moneycontrol

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Disposables like catheters, guide wires and balloons used in every angioplasty are reused and billed repeatedly in many private hospitals.

Adding to the risk of infection, you could be paying for something that has already been paid for. And the hospital may be making a profit of Rs 20,000 to Rs 30,000 on every procedure with simple reuse and rebilling, say industry sources.

The practice is so rampant that the health ministry has issued an office memorandum warning against reuse of disposable surgical items, particularly in cardiology, when they are meant for one-time use.

Medical Equipment HIGHLIGHTS

  •  Private hospitals may make a profit of Rs 20,000 to Rs 30,000 by reusing disposables
  •  Risk remains higher as these things can not be  resterilised properly, say doctors
  •  Government hospitals do not indulge such  practices as there is no pressure to make profit

“The items after one procedure are sterilised and reused and (patients) are charged full amount of these items,” stated the memo dated December 21, 2016. The matter had been “viewed by this ministry seriously”, it said, and clarified that “reuse of disposable items, particularly in cardiology and other specialties, is not permitted in healthcare organisations empanelled under CGHS (Central Government Health Scheme)”.

It goes on to warn of “suitable action including withdrawal of CGHS empanelment” against defaulters. It is silent on action against big corporate hospitals that are not empanelled under CGHS.

“Most private hospitals, especially hospitals chains, insist that cardiologists reuse these items. While reusing these items a couple of times might be justified in some cases where you want to help bring down costs for a patient, in most of these hospitals, not only do they reuse four or five times, patients are also billed afresh for each of these items, helping the hospitals make a profit of Rs 20,000 to Rs 30,000 on each procedure or patient,” explained a cardiologist who has worked in several leading private hospitals.

All disposable items have clear instructions on the packaging saying they should be used only once and cannot be resterilised. Some cardiologists in private hospitals admitted that reuse was common but said it was not a problem if the items were properly resterilised. Companies, they said, insisted on single use to sell more of their products.

hospitals reuse disposables
Image Source : timesofindia.indiatimes.com

Cath lab technicians and dealers who sell disposables and stents to hospitals also confirmed that such reuse was common. Hospitals like AIIMS and PGI hardly ever reuse these items as there is no pressure to cut corners to make profit.

“In the US, solid catheters or catheters without holes can be resterilised and reused but only once or twice. But reuse of catheter with holes like a guide catheter used in angioplasty is not allowed as it is difficult to clean the insides where blood residue might remain. This is to prevent any chance of HIV and Hepatitis B infection. Also, resterilising affects the quality of the item as it hardens the plastic, making it less flexible,” explained a senior AIIMS cardiologist.

Chain hospitals are the worst offenders, according to a cardiologist who has worked in one such institution. “If doctors in one hospital in the chain reuse an item five or six times, that is lauded as a great example of cost saving. It is pushed as standard operating procedure across the entire chain, putting enormous pressure on doctors who try to resist such unethical overuse of a disposable item,” explained the cardiologist.

“Reuse is bad and doing so without the patient’s consent is criminal,” said another cardiologist. “And charging for resued items is fraud of the highest order being done in most elite hospitals to push up profits. It is easy to investigate and expose this. The government can get the number of angioplasties done in a hospital and ask for proof of purchase of the disposables for the last two years. There is a formula for how many disposables are needed for each angioplasty. They will find that far fewer disposables have been purchased than the required number, which will show clear reuse. Such hospitals should be prosecuted,” he said.

However, reusing of items with patients‘ consent to reduce costs for the poor should not be treated as criminal acts, he added.

Source : Timesofindia
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