Revision as of 13:03, 23 February 2015

Hearts, Indian

‘Indian hearts age faster, prone to early disorders’

Times of India

Chennai: In India, the figurative term ‘young at heart’ could be just that — figurative. An Indian’s heart ages much faster than a Westerner’s, a study by Apollo Hospitals has found.

The results — compiled from cases the hospital group has been treating across the country — would be used as the baseline for a larger study the group is planning to undertake in association with the Indian Council of Medical Research (ICMR), group chairman Dr Prathap C Reddy said.

‘‘We have found that some heart disorders including blood vessel blocks found in a 35-year-old Indian are similar to those found in an average 60-year-old in the US. Indians are not only predisposed to heart diseases, but the progression of the disease is also faster in Indians. Considering that the incidence of heart disease in Indians is itself four times more than their Caucasian counterparts, this is disturbing,’’ Dr Reddy said.

Moreover, diagnosis of heart diseases happens late in India. Analysing data from more than 10,000 people who underwent CT scans at the group’s hospitals across the country, he said that many Indians in the age group of 35-60 years, who assume themselves to be healthy, may have cardiac problems. ‘‘Today, we know that nearly 10% of Indians develop heart diseases without having any risk factors like high blood pressure or diabetes. Scans have revealed a heart disease acting as precursor to diabetes and hypertension in these people. Since most heart diseases show no symptoms, young patients come to us only after the damage is done,’’ he said.

Senior cardiologists say the incidence of heart diseases is not confined to cities. ‘‘We are increasingly seeing rural people with heart diseases because their diabetes remains undiagnosed for a long time,’’ says Dr S Thanikachalam, head of cardiology, Sri Ramachandra University.

Cardiac disease: India

Cardiac stents: 2008-13

The Times of India Feb 16 2015

2008-13: number of cardiac stents implanted in India

Rema Nagarajan

Patients spend Rs 2,500cr on stents every year in India

Rs 1,500cr could be saved if govt pricing norms were followed

Patients spend about Rs 2,500 crore on cardiac stents alone every year in India even by conservative estimates, the bulk of it being paid from their own pockets. This does not include the cost of blood tests, angiography, procedures, charges for hospital stay, doctor's charges and so on. An estimated four lakh stents were implanted in India in 2014. Of this, over 85% were drug eluting stents (DES), for which most patients pay anything between Rs 55,000 and Rs 80,000. Annually, the stent market is estimated to grow by about 15%, with the growing incidence of cardiovascular diseases. Hence, the market is expected to grow steadily .

Industry sources estimated that though the share of DES was around 78% in 2013, it would have gone up to over 85% in 2014. In that case, the total number of DES sold in 2014 would be about 3.5 lakh.If the average price being paid by patients for a DES is taken at about Rs 65,000, the total expense on DES alone would have been approximately Rs 2,275 crore.

The Union health ministry had fixed Rs 23,625 as the price of a DES under various government schemes. If DES was available to everybody at this price, that would cost just Rs 827 crore, a saving of almost Rs 1,450 crore each year.Even if they were all priced at the imported price of about Rs 40,000, the total expense would be just Rs 1,400 crore, a saving of over Rs 800 crore.

Stent manufacturing companies pointed out that what patients pay is based on what hospitals are charging and that it is not the amount the companies are making, which they say is much lower.While Prime Minister Modi talks of `Make in India', when it comes to stents, more than 60% of the market is with just three US-based multinational firms -Abbot, Medtronics and Boston Scientific, which import the stents.

The rest of the market is divided between various Indian device companies like Vascular Concepts, Shahajanand, Meril Life Sciences, Translumina and others who charge Rs 12,000-30,000 for a DES.Their share of the market remains low despite these firms selling their stents in many European and South East Asian countries. Dealers for several multinational companies are known to offer hefty amounts as incentives to doctors and hospitals for every stent used to retain their market share. The margin between the import price and the final price paid by patients is huge enough to accommodate the cost of these large `incentives'.

Approximately , 40,000 bare metal stents (10% of the stent market) were sold at an average cost of Rs 6,000-10,000, which works out to a market of about Rs 32 crore. The Cardiological Society of India's National Interventional Council registry says 8,500 bio-absorbable stents were implanted in 2013. Industry sources claim that this segment of the market has shrunk a bit. Even assuming just 8,000 bio-absorbable stents -the most expensive variety with prices ranging from Rs 1.75 lakh to Rs 2 lakh plus -are sold in India, at an average price of Rs 1.75 lakh, the spending on such stents would amount to about Rs 140 crore. Add the numbers up and the total spending on stents of all kinds would be at least Rs 2,500 crore.

If we were to add the costs associated with hospitalization, sundry tests and so on for each angioplasty , the total amount being spent on angioplasties would be at least twice as much, if not more.