Why should stenting for cardiac patients be so costly in Bangladesh?
The first line of live-saving treatment for a heart patient with severe heart blockages is stenting, a less invasive procedure than the bypass surgery. Patients quickly recover after this procedure. These are the main reasons why angioplasty – stenting – has become very popular with both patients as well as physicians all over the world. In Bangladesh, about 45,000 stents are placed in the hearts of around 25,000 patients annually.
Worryingly, this cardiac stent implantation surgery has also not been spared from the impact of the recent trend of steep depreciation of taka against the dollar. A stent had always been costly in Bangladesh compared to the countries in the South Asian region so much so that the government had to fix the prices of different categories of stents. Even after that, the price of a stent was high.
The price has been further enhanced by 20-35 per cent from February by the government. For many middle class families managing nutritious foods everyday has gone beyond their buying capacity. And with food, the cost of health service and treatment has also greatly risen, but when the price hike affects the life-saving treatment such as stenting, people are left with little hope about life.
Reportedly, the price of a Xience Xpedition stent made by an American medical devices manufacturer called Abbott is Tk 47,000 in India and Tk 70,000 in Nepal. But with the recent price hike by the Directorate General of Drug Administration, the maximum retail price of it has reached Tk 125,500 from the previous Tk 108,628.
For ensuring transparency in the stent supply chain, it is now necessary to revisit the markup formula through which the DGDA fixes the stent price, says a health expert. It has been reported that the ‘commission’ paid by the stent suppliers to cardiologists also plays a role in the present high price of the product in Bangladesh. This ‘commission’ could be 20-50 per cent of a stent price.
If the stent price is not reduced it will not only be difficult for patients to avail the treatment, this situation will also force patients to go to India for receiving the treatment at a lower cost.
For a long time, people have been demanding an increase in the health budget of the country so that patients can get better heath service from the country’s public health delivery system. Not only is the government not paying heed to this, it is also failing to bring transparency to the cost of treatment in Bangladesh as a whole.
