ISLAMABAD: The Supreme Court on Thursday constituted a special committee under cardiologist Dr Azhar Kiani to consider a set of proposals aimed at ensuring the availability of good quality, affordable stents at public and private healthcare facilities in the country.

A three judge SC bench headed by Chief Justice Mian Saqib Nisar also summoned a report justifying the utilisation of funds granted to scientist Dr Samar Mubarakmand for various projects, including the Thar Coal Power Project, which he had promised to accomplish.

The directions to submit an explanation within 15 days came when Dr Mubarakmand furnished a report detailing how Rs37 million granted to the scientist for the production of locally manufactured stents were spent.

On a suo motu, the SC has taken up a case based on reports that a few public health institutions, such as the cardiac ward of the Mayo Hospital in Lahore and other government hospitals in Punjab, were placing stents in cardiac patients even when the intrusive procedure was not required, and if the procedure was needed, charged patients up to Rs180,000 for each stent.

Report summoned justifying utilisation of funds granted to scientist for various projects

On Feb 6, the court had ordered a financial audit of the Rs37m granted to Dr Mubarakmand in 2004 for the local production of cardiac stents.

The SC had also ordered Additional Attorney General Mohammad Waqar Rana to furnish a similar report by contacting the departments for which the funds were released.

On Thursday, the chief justice observed that after stents, the next matter that will come to the court’s attention will be procedures related to kidney diseases and hepatitis-C, treatment for which is very expensive.

Our endeavour would be to curtail the cost of these expensive treatments to a reasonable level, the chief justice observed, adding that the profession of medicine should not be like other businesses with disproportionate profit margins.

The chief justice also resolved to bring prices of stents down to a reasonable level in two months in such a way that stents of a uniform generation and quality are available at all public and private hospitals.

The committee constituted by the SC was asked earlier to consider proposals recommended by Dr Kiani of the Rawalpindi Institute of Cardiology for the availability of good quality, cheap stents in the country.

After the proposals are agreed upon, the court will order the government to implement them.

Proposals include establishing a national interventional cardiology board that would set the standards and guidelines for the accreditation and operation of public and private cath labs, set the qualification standards for interventional cardiologists to operate cath labs, recommend medical devices of acceptable quality for use by cath labs – including negative lists of devices, and disclose and recommend the best price available of medical devices to assist in procurement by all cath labs.

The Drug Regulatory Authority of Pakistan (Drap) would register medical devices as per the approved list issued by the board in the shortest possible time, and ensure that all medical devices are supplied directly to cath labs with no intermediaries.

Drap would also set up and operate and national device registry for all lifesaving medical devices imported into Pakistan, and the device registry would track each device from the point of import, transfer to distributor storage, delivery to the cath lab and utilisation during a procedures.

Published in Dawn, February 9th, 2018

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