Prices of stents are expected to fall further since the Drug Regulatory Authority of Pakistan (Drap) issued import licences to 128 companies for stents and medical devices after the intervention of the Supreme Court.

This is also the first time a QR Code has been issued for the licences, which will allow patients to track the devices and confirm that they are genuine and were bought at the normal prices.

Stents are small expandable tubes used to treat narrowed arteries. They can open narrowed arteries, reduce symptoms such as chest pain and help prevent cardiac arrest in people with coronary heart disease caused by a build-up of plaque.

The discovery of Rs250 million worth of unregistered cardiac stents from the Mayo Hospital in Lahore last January revealed cases in which patients were told they had received stents even though the devices were not placed in their arteries.

This is also the first time a QR Code has been issued for the licences, which will allow patients to track the devices and confirm that they are genuine and were bought at the normal prices.

This led to suo motu notice by the SC, which has since pushed Drap and other stakeholders to ensure quality stents are available at affordable prices.

It was also revealed that there was no mechanism for the sale of stents, because of which companies’ representatives instead of selling the product through medical stores were present in hospitals’ cardiac centres and sold stents to patients without giving them authentic receipts, which kept patients from being able to find out what kind of and what quality stent had been placed in their arteries.

The Federal Investigation Agency (FIA) has also carried out an inquiry in this matter.

The head of the Rawalpindi Institute of Cardiology (RIC) retired Maj Gen Dr Azhar Mehmood Kayani told Dawn that it had become impossible to sell stents at high prices in public sector healthcare facilities in Punjab after the SC’s intervention.

“We are providing stents, wires, balloons and other devices for Rs90,000. Because of the devaluation of the rupee, after getting approval from the SC, they are now being provided for Rs100,000, apart from hospital charges,” he said.

He said this was the first time medicated stents manufactured in the United States were being sold for Rs60,000.

Across the world, stents manufactured by Abbott are considered the best and even those are being sold for Rs67,000.

Non-medicated stents were being sold for Rs22,000, and after the deviation of the rupee they are now being sold for Rs22,500,” Dr Kayani said.

He said he was sure stent prices could be reduced, but not increased.

When asked about complaints that patients had received substandard stents, and sometimes received stents when they did not require them, he said the National Intervention Cardiology Board (NICB) has been established to keep stents from being placed without its permission in the future.

“The NICB would also analyse if doctors are capable of placing stents in the body. Moreover, it has been decided that as many as three CDs should be made of every procedure – one would be kept in the lab, the second would be given to the NICB and the third would be handed over to the patient.

“In case of any complaint, the patient would be able to lodge a complaint with the NICB so that it would be checked if a stent was required or not,” he said.

Patients at public sector hospitals have benefited from the decrease in stent prices, said a Pakistan Institute of Medical Sciences doctor who asked not to be named.

But, he claimed, he had observed that private hospitals that had cut the costs of stents by Rs50,000 had increased other charges by the same amount.

“The authorities should look into it,” he said.

He said the FIA had carried out an inquiry into the prices of stents that revealed that companies that were importing stents were declaring Rs2,500 to Rs3,000 in their customs documents.

“I believe that the prices of medicated stents can be decreased to Rs10,000, and all the concerned authorities should look into it to ensure that prices would be decreased and patients get the facility at cheaper rates,” he added.

Drap media coordinator Akhtar Abbas told Dawn the authority has taken a number of steps to ensure the prices of stents drop.

“We have issued licences to 128 companies, due to which competition will increase and prices will decrease automatically,” he said.

In response to a question, he added that the introduction of QR codes would end the sale of smuggled stents.

He said competent individuals had been deputed in the NICB, due to which things would improve across the country.

Published in Dawn, August 12th, 2018