Price Capping of Stents

National Pharmaceutical Pricing Authority (NPPA) has capped the ceiling prices of drug eluting stents (DES) and bio-reabsorb able  vascular scaffolds (BVS) at Rs 29,600 and bare metal stents (BMS) at Rs 29,600 and bare metal stents (BMS) at Rs 7,260. Including VAT, these stents are expected to cost Rs 31,080 and Rs 7,623, respectively. 

The government has made it clear that companies, distributors and hospitals have no choice but to comply with its order slashing prices of cardiac stents by over 75%.

Companies, distributors and hospitals found violating NPPA’s order by overcharging patients for the devices would be penalized.

What is a Stent?

A coronary stent is a wire mesh tube used to clear blockages in coronary arteries and prevent heart attacks. It is inserted into clogged arteries to keep the blood flowing well. The clog is crushed with a balloon and the device inserted.

Pros

  1. Saving lives: Stents save thousands of life every year globally. It is a medical boon that should be made readily available to people so that they have a chance at surviving cardiac arrests with the least amount of expense. In India, where majority of the population is below poverty line, this is a positive step in the right direction.
  2. The decision, expected to make the life-saving devices more affordable, also signals a shift in the way stent suppliers will operate in the country.
  3. With far higher chances of survival, stent is a crucial option for patients and capped prices have helped patients afford it without burning a bigger hole in their pockets.
  4. While some companies said they are still figuring out how they may adapt to the decision, others are already considering cost-cutting options like discarding the middlemen who supplied their products to hospitals.
  5. According to Indian stent company Sahajanand Medical Technologies, one of the biggest cost in this business is the cost associated with the supply chain and most of the margins made by stent makers goes into paying the distributor. The Stent manufactures can get a drug distribution license to save on the working capital cost.
  6. Stents in any case are supposed to be used in emergency angioplasty instead of making it the only option.  Capping of prices will curb unnecessary use of stents

 

Cons

  1. The government should facilitate innovation in medical technology, not regulate it.
  2. There’s enough and more to be done in designing devices which will help doctors in diagnosis and treatment.
  3. Companies are ready to pump in millions of dollars for research & development, so it’s only natural they’ll price their products with an eye on offsetting their expenditure and ploughing back profit for more research.
  4. It’s up to the government to step in with subsidies and take the burden of patients. The rising cost of healthcare is a huge concern but innovation shouldn’t be put on the back burner because of it.
  5. Expansion of price controls on medical devices will not resolve the country’s long-term health challenges and can lead to shortages, delays in the introduction of new devices, and quality concerns for price-controlled devices.
  6. Capping prices would do more harm than good for achieving the goals of the government, patients and the industry.
  7. Coronary stents have halved the number of patients dying from heart attacks and implantable cardiac defibrillators have raised the chances of surviving a sudden cardiac arrest from 5% to 98%.
  8. Arbitrary price restriction will discourage innovators and manufacturersfrom coming up with newer generations of stents, thus limiting the choice of doctors and patients alike.
  9. Patients do not need access to any stent, but access to the best quality stent.
  10. Patient choice and clinical outcomes will be negatively
  11. Price capping will increase the entry of inferior quality, outdated products in the market, resulting in substandard care to patients.
  12. Policy decisions should be driven by patients’ need for quality and safety. Affordability at the cost of patient access to quality is not desirable in the long-term interest of the patient.
  13. The journey of the Indian medical fraternity towards global recognition might slow down.

The government should aim at improving access with a focus on quality and efficacy of medical devices. While making such policy decisions, the government should adopt a consultative approach and involve all the stakeholders — Indian researchers, clinicians, local and global device manufacturers — to ensure best results and a progressive way !!!

 

A Murderous Game: Blue Whale

Blue Whale is a murderous online social media game which entices young people to take on challenges instructed by an online administrator called the “Master” over a 50-day period.

It is a murderous game and needs to be banned by the government. But where is the responsibility of PARENTS, SOCIETY and the MEDIA???

Parents

1. Emotional support

Children need emotional support to be empowered enough to reject games such as Blue Whale. Common signs friends and family need to look out for include being withdrawn from social gatherings, persistent depression and unhappiness, crying and irritability, worries that stop them from carrying out daily tasks. Angry outbursts, problems in eating or sleeping and lack of interest in activities enjoyed previously are also warning signs.

2. Consult a Specialist

Seek out a medical expert to speak to your child and treat injuries that may result from teens self harming themselves. Specialists such as counsellors and therapists could also be helpful.

3.Talk To the Teachers

Teachers are increasingly aware of self harm and mental illness faced by the child. The school should be able to provide a detailed understanding of how the child is coping and name members of the staff who may be able to help. This could also include the school      nurse, counsellor or class teacher.

4. Clear communication matters

Clearly communicating with your child and letting him/her know that you care for their wellbeing is important. Take out the time to not just talk, but actively listen to your child as well. Young internet users with depression and thoughts of self harm may use the internet’s seamless communication to perpetuate suicidal behaviour. Communicating well and clearly can make a difference to the life and well being of the child.

5. Increase Web Safety

Parents and educators can also help youth surf the web safely and prevent them from engaging in online abuse through web safeguards. Monitor the sites your child visits by searching the web history. Keep tabs on your child’s surfing habits and encourage young people to openly talk about things that concern them, online or otherwise.

6. Strengthening the teen-parent bond

You need to be there as a parent for your child. Check for withdrawal from social activities or early warning signs that abuse could be experienced. Signs of self harm can be linked to the challenges of the Blue Whale Game. Most children who take part in this game may send out a cry for help before harming themselves. You need to step in and safeguard your child through timely interventions and continuous interaction that allows them to express their feelings, thoughts and concerns.

AS SOCIETY

1. Counselling and social support

Those in need of help need you to be open minded and understanding. Society needs to reduce the stigma towards teen mental health issues and help those who are suffering. Depression has social stigma attached to it, leaving the child affected feeling scared of rejection or judgmental attitudes from others. Mental health issues can affect anyone from any age or background. One of the most common signs of this disorder is feeling trapped into making wrong choices and taking part in the Blue Whale game could be one of this.

2. Laws in place to protect teens

By proliferating social media groups with vulnerable youth, the game entices youth to complete 50 self harming tasks and challenge their limits. Teens across US, India, Brazil, and other nations have faced the ultimate consequences of this game. This game was started in Russia where it has already claimed the lives of many youngsters. Cases of suicide have been reported in Argentina and Britain too. Governments and society need to have laws and sanctions in place to block such deadly games.

3. Breaking through the supportive mask

Bad academic performance or being treated badly by peers can make children vulnerable and these games, with their supposedly supportive administrators talk juveniles to mutilating themselves or ending their lives. Society needs to change the perception that these games are for a positive purpose. The aim should be to denigrate these killer games and condemn them across the community.

III. Media Responsibility

1. Coverage of sensitive topics in responsible way

The media often sensationalises cases and glorifies violence. There needs to be a change in the way online manipulation is depicted in movies, games and other mass media. Topics that are sensitive such as poor exam performance, peer pressure and bullying need to be covered in a way that is sensitive and understands the world of the teen rather than subjecting them to further stigma.

2. Positive role models for children

Philipp Budeikin, a former psychology student who was expelled from his university and imprisoned for three years, perpetuated this deadly game. The Russian youth were the first to be targeted by Budeikin and his team and this twisted game perpetuated a very wrong role model for the children to follow in the form of the murderous administrators of the game. Media needs to portray positive role models who stand up to pressures and work their way through life’s issues with equanimity and confidence. Giving youngsters a positive role model they can look up to can serve as a powerful countercurrent to lethal games like Blue Whale.

3. Socially responsible depiction of such games

Social media sites need to have stricter laws in place to ensure socially responsible depiction of such lethal games. The Blue Whale game deserves to be exposed and unmasked for what it is – a murderous attack on young teens using mind manipulation. The media has an important role to play in depicting such games in stark and real light, so youngsters don’t glorify people like Budeikin and take their own lives.

Close to 310 deaths have been linked to this deadly game. With the advent of social media and online streaming, the internet has become a source of escape for youngsters. But unfortunately, they are likely to be targets of online manipulation with lethal consequences such as Blue Whale. Curated to seek out teens who want to be accepted and liked, this game offers rewards for successful challenges completed. Society, parents and the media need to join hands to safeguard the youth against such deadly games.