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Saturday, November 5, 2011

Pune Hospitals, doctors upset over new CGHS norms

                 Hospitals and cardiac surgeons in the city are upset over new norms issued under the Central Government Health Scheme (CGHS) by the Union ministry of health and family welfare, slashing the rates for stents required in cardiac surgery.
As per the government resolution issued on October 31, the maximum ceiling for purchasing drug-eluting stents under the CGHS is now Rs65,000, as compared to Rs1 lakh being offered since 2007.
Drug-eluting stents are used in angioplasty to open blocked arteries. According to hospitals, reducing the ceiling means compromising on quality of stents used in surgeries and offering “second class” treatment to cardiac patients under the CGHS.
On an average, more than 800 patients undergo angioplasty annually under CGHS scheme in Pune. The CGHS is a health benefit scheme for central government employees who can avail of free surgery, consultation and diagnostics, according to rates approved and at designated hospitals under the CGHS.
“We are upset because, according to new ceiling rate, stents of international standards cannot be purchased. FDA-approved stents cost a minimum of Rs1 lakh, while stents available for Rs65,000 or less are offered by certain Indian companies which are not approved. This means only inferior stents can be offered to patients under the CGHS scheme,’’ said Dr Parvez Grant, cardiologist and chief executive officer of Ruby Hall Clinic.
According to Grant, cheaper stents are of poor quality and chances of re-blockage of arteries is high, which means patients would have to come back to hospitals with the same problem after a few years if inferior stents are used.
Cardiologist and medical director of NM Wadia Institute of Cardiology, Dr Anil Katdare, the second authorised centre to perform cardiac surgery under CGHS scheme, had similar views about the revised rates for cardiac stents.
“The decision of CGHS authorities to reduce the price of drug-eluting stents by Rs35,000 is surprising. This step will have two effects: it will either lead to use of stents with questionable quality in case of non-affording patients, or it may increase out-of-pocket expenses for the patients who want the best and can afford it,’’ said Katdare.
Both institutes insisted that the government should rethink its decision in view of compromising quality.
Madhavrao Bamne, president of the Pune unit of the All-India Central Government Pensioners Association, said it was the prerogative of CGHS authorities to approve cheapest possible rates. “If doctors really are concerned about the quality, they should take this matter up with CGHS authorities and prove it scientifically. They would be doing a good service then,’’ Bamne said.
Additional director of CGHS, Dr Eknath Kanade, said the new revision of rates had surprised him as well. “No discussions took place with local officials and we did not have any idea about this. If hospitals are upset, we can tell them to approach CGHS officials,’’ he said.

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