Relief for critical heart patients

Heart patients in need of angioplasty and stents can have a sigh of relief as the government has moved to fix the uncontrolled prices of stents that had been worrying patients and their families for years.

Patients now do not know which stent costs how much in Bangladesh and many opt for going to India for their implant needs as it is a lot cheaper there.

Private hospitals are selling stents sometimes for double the actual price.

Once the MRP is fixed, prices of stents, a spring-like metal device used to prop open blocked arteries, would be the same in all hospitals, public and private.

Currently, patients have to pay between Tk 80,000 and Tk 1.5 lakh for a single drug-eluting stent at a public hospital though some private hospitals charge almost double, according to cardiologists. They blame unscrupulous middlemen and doctors getting commissions.

If the rate is fixed, they hoped the price would come down to Tk 60,000 to Tk 1.3 lakh. A bare-metal stent, which now costs Tk 40,000 to Tk 50,000 at National Institute of Cardiovascular Diseases, will come down to Tk 30,000 to Tk 40,000, they said.   

Directorate General of Drug Administration (DGDA) under the Ministry of Health & Family Welfare at a meeting with all stakeholders on Tuesday decided that the Maximum Retail Price (MRP) along with the date of expiry and registration number have to be mentioned in each pack of stents.

The MRP would be fixed by adding a certain amount with the import cost of each stent.

A total of 22 companies and 47 stents are registered with the DGDA, its Director General Maj Gen Mustafizur Rahman told The Daily Star, adding that as per the terms and condition of the registration, a label on the packs containing price, date of expiry and registration number was mandatory.

But hardly one or two follow the rules, he said.

The DGDA also decided that every hospital would have to hang a list of stent prices at a prominent place so that patients and their families could see and decide.

The DGDA would ask the ministry if the prices of stents could be controlled like it is done in India.

India in February slashed stent prices and fixed maximum Rs 30,000. As the stent price is less than half in India than in Bangladesh, many patients have been going there.

The Indian High Commission making visa procedures easy for medical tourists helped many Bangladeshi heart patients.

Experts fear that if the situation did not change, heart patients would continue to opt for India.

The DGDA director told The Daily Star, “We have decided that MRP will have to be mentioned on the stent packets with immediate effect.

“We will issue letters to hospitals asking them not to buy any unregistered products. If any unregistered product is found in any hospital, we will file law suit against that hospital.” 

He said it was the ministry which is to control the price of stents.

“Even though we can't control the price, we want to come to a common ground regarding the stent price considering the lower income and lower-middle income people,” he said.

Malpractices, like different hospitals charging different prices for stents and doctors taking commissions came up for discussion during Tuesday's meeting at the DGDA, the director said.

A national committee has been formed to find anomalies in this sector, he added.

Cardiologists hailed the move for fixing the prices of stents and said it would greatly help the poor patients. 

They said if the rates were fixed, prices would come down significantly as the patients would know the price of the stent and doctors and hospitals would not be able to charge extra.

Prof Afzalur Rahman, director of National Institute of Cardiovascular Diseases and president of Bangladesh Society of Cardiovascular Intervention, also said poor people would be greatly benefited.

“With this decision [labelling MRP] I think the price of a stent will become even lower than the price the NICVD is charging right now,” he told The Daily Star.     

President of Bangladesh Cardiac Society Prof AKM Mohibullah said there was no control over the pricing of the stents as a result patients had to suffer a lot.

Prof SM Mustafa Zaman of BSMMU Cardiology Department said, “With this decision, I hope people will prefer to implant stent in the country.”

Representatives from the ministry, Prime Minister's Office, administrators of public and private hospitals, top cardiologists, stent importers, and Anti Corruption Commission, among others, were present at the meeting held at the DGDA on Tuesday.