Number of cath-labs in country up 100% in 5 years

Coronary Interventions Rise By 51% In Just One Year: Study

Cath-labs and coronary interventions in India are increasing exponentially, adding

substantially to healthcare expenses. While cath-labs have more than doubled in the 

last five years, from 251 in 2010 to 630 in 2015, coronary interventions rose 51% 

within a year, between 2014 and 2015, a new study by a think tank shows.

Increased interventions have resulted in a higher number of stents being used in 

procedures.The data shows 4,75,000 stents were used in 2015 for 3,75,000 coronary 

interventions. The figures stand out as just 1,46,719 stents were used in 1,17,420 

cardiac interventions in 2010. A paper published by Observer Research Foundation 

(ORF), based on analysis of data from different sources, highlights the potential role of 

price control in keeping health care costs in check. Acknowledging stent price capping is 

a significant step by the government, it suggests India needs greater transparency in 

costing systems, out come based measurements and evidence-based policy-making.

Authored by Ramesh Bhat, former professor at IIM Ahmedabad and president of the Indian

Health Economics and Policy Association, and Denny John, Evidence Synthesis Specialist at

Campbell Collaboration, the study says any analysis of the implications of economic

regulations, including price controls, will need a detailed appreciation of market forces.

Cardiovascular diseases are now the leading cause of mortality in India, with a quarter of all

deaths in 2015 attributed to the disease. According to the Global Burden of Disease (GBD)

2015 study , death rate due to heart diseases in the country stood at 272 per 100,000

population. Even with such figures, the paper suggests, cardiovascular diseases in India

remain highly under-diagnosed though the number of coronary interventions like angioplasty

are growing every year.

Moreover, the findings show, the use of expensive high-end drug eluting stents (DES) has

also gone up contributing to the increasing healthcare costs. According to the paper, the share

of DES in the total use of stents has reported a compounded annual growth rate (CAGR) of

53.52% between 2002 to 2015, whereas total stent usage has grown by 22.86% in the same

period.

It also highlighted the sources of financing of coronary procedures in India, which has a great

deal of impact on household expenditures as majority of it is still borne out-of-pocket. The

findings show over 43.9% of the financing of the coronary procedures in 2014 were

conducted through out-ofpocket expenditure. Analysis of the NSSO 71st round done in the

paper also show that one-fifth of hospitalisations due to CVD were paid for by borrowings or

sale of personal assets. The same survey found that 53% of the population suffered from

`catastrophic' health expenditures.

The study says severity of penalty is essential to price control and in determining compliance.

Besides, the government or the regulator will also need to create an ecosystem to ensure

effectiveness of such regulation.

Advocating for more effective monitoring of quality of medical products, the paper says,

“Given the fact that currently the market for medical devices is poorly regulated, and there is

no formal system to monitor quality of care, price control could have a negative impact in

terms of entry of inferior quality and outdated products in market“.

The paper recommends setting up of a Medical Technology Assessment Board (MTAB) to

initiate evidence based health policy process.

Source: The Times of India