Heart patients suffer as importers halt stent supply after price cuts

A recent Directorate General of Drug Administration (DGDA) decision slashing coronary stent prices by up to 40% has triggered a supply chain disruption as European stent importers, dissatisfied with the reduced margins, have halted sales in protest, leaving hospitals scrambling for alternatives and placing an enormous burden on vulnerable patients.

On December 12, the DGDA announced the price cuts and said the new rates will take effect on 16 December. But European stent importers wrote to hospitals not to use their stents until a revision of the prices.

As a result, since Saturday hospitals have been using only the stents of the American importers, whose prices are relatively high.

There have also been cases of patients sent home from hospitals without undergoing stent placement due to unavailability of the correct size from American importers.

The DGDA has fixed the maximum retail price of stents for 27 importing companies in the country. Among them, three are American and the rest are importers from European and some other countries.

European stent importers claim that the DGDA has followed the 2017 mark-up formula only for the three American companies in determining the prices. Consequently, the remaining 24 importing companies have halted the supply and sale of stents until the prices are revised.

Patients suffer

A cardiologist from the National Institute of Cardiovascular Diseases, who prefers not to be named, told The Business Standard, "An angiogram was performed on a patient who came from Sirajganj with heart issues.

As a blocked heart artery was found, the patient was taken to the operation theatre for surgery. However, as the required stent size for the patient's heart was not available from the three American suppliers, the patient was sent back from the operation theatre."

The patient has been instructed to contact the hospital after a few days, he said.

"If 40 heart stents are needed per day, at least 25 of them are supplied by European importers. Due to the cessation of stent sales by European importers, it becomes challenging for patients.

"In many cases, patients who would have used a Tk66,000 European stent, may now cost Tk1,40,000 due to the complexity of sizes."

That is taking a toll on the patients' expenses, the cardiologist said.

A European stent importer, on condition of anonymity, said, "Our products are given to the cath labs of hospitals, and we are paid after they are placed on a patient's body. We have written to hospitals not to use our stents except in dire circumstances. Because the price of the stent has been reduced by discriminating against us. We have written to DGDA yesterday to revise the price. If this demand is not accepted, we will go to the Supreme Court."

Scope for negotiation remains, says DGDA

Nurul Alam, spokesperson and deputy director of the DGDA, claimed that the allegation of the European stent importers that the price decision was taken without discussion is not true.

"We have been trying to reduce the price of heart stents for the past few years. Last August, the prices of three brands of rings were reduced after holding meetings with the importers. Later, we had two or three meetings with all the importers. The importers were initially against the price reduction citing the dollar crisis. But they agreed to the prices set in accordance with the advice of a 13-member expert committee," Nurul Alam told The Business Standard.

"We have informed the importers before finalising the stent price reductions. Holding patients' lives hostage by refusing to sell products at these prices is unacceptable," he said.

If any patient suffers harm due to this disruption, the responsibility will lie squarely with the importers, he warned.

"Instead of blaming patients, let them bring up the issues, and we can find solutions through discussion," he stated.