The seeds of the storm that has rattled the healthcare industry in India were sown in 2014 at the Metro Hospital in Faridabad.
It started with one man and his personal experience with the system. Birender Sangwan went to the hospital to visit his friend’s brother who was undergoing a heart surgery and needed a coronary stent – a tube-shaped device placed in the artery to open up blood flow.
“My friend paid Rs 1,26,000 for the stent and I found the price exorbitantly high. The hospital didn’t provide a bill for it and I couldn’t get the price details anywhere,” says Sangwan.
Sangwan, who’s a lawyer by profession, told The Quint that under Central Government Health Scheme (CGHS), the same stent was for Rs 23,000 and this enormous gap in price is what prompted him to file a public interest litigation (PIL) in 2015.
This petition led the government to rein in the blatant profiteering rampant in the industry. The National Pharmaceutical Pricing Authority (NPPA) – the government agency that fixes drug prices – ordered prices of bare metal stents to be capped at Rs 7,260 and drug eluting stents at Rs 29,600.
Health activists see this as a positive move and say this will address the lack of ethical standards by hospitals and doctors who have been prescribing stents indiscriminately with little or no evidence of efficacy.
Heart problems are extremely common in India and more than 5 lakh stents are used in the country annually. These slashed prices have paved the way for millions to have access to affordable medical devices.
The overpricing doesn’t stop at just stents and goes on to affect many devices, however big or small.
About 14-15 devices have huge unethical markups and we’re working towards a price cap for them as well. There is a lot of corruption in this industry and it has to be eradicated step by step.Sangwan
The 37-year-old lawyer adds that it’s the hospitals who are making the most profits here.
‘Price Cap Too Restrictive; May Lose Out on Better Products’
As there are two sides to how any move is perceived, many from the industry aren’t happy with how it has been implemented and are calling the price cap restrictive.
While some say it will cut into manufacturers’ funds for research and development, others say it may lead to the Indian market losing out on newer, better quality products whose prices are beyond the cap.
The NPPA has responded to the first argument saying that the decision was made after taking into consideration all the technicalities.
We did an elaborate study before cracking the whip on stents. When an original manufacturer sells a product, the cost of innovation, packaging and everything else is built into it. Beyond that, the profit margins of importers and hospital are only distorting the system.Bhupendra Singh, Chairman, NPPA
Sangwan’s Will to Work for Social Causes
Sangwan, however, feels that this corruption can only end with doctors taking upon themselves to work ethically and fulfill their moral responsibility towards the patients.
He says he’s been inclined towards working for social causes since his early days in law. A married man with kids, Sangwan “wants to do good for others and set an example for his children to follow.”
Armed with PILs, writ petitions and RTIs, Sangwan has filed a number of petitions in various courts regarding different issues in the country.
Last year, he petitioned on behalf of MCD workers in Delhi, when they went on strike, to ensure they get their salaries. After demonetisation, he filed a PIL to ask for all ATMs to be fully functional and also asked for relaxation of guidelines for those who had weddings coming up.
While his PIL against overpriced stents led to a government order putting a cap on their cost, it’s to be seen whether or not it makes a dent in the hospitals’ unbridled profiteering.
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