Even as stent prices have been capped, the cost of the three main consumables used in angioplasty have, in many cases, become even more expensive than stents as hospitals try to make up for the huge margins they lost on stents.

The modus operandi is same as in the case of stents before the price cap. Though the consumables are bought at a third or less of the maximum retail price (P) printed on them, hospitals charge patients the P.

The total procurement cost of these three consumables — guiding catheters, balloon catheters and guiding wires — is roughly Rs 10,000-12,000. However, many hospitals are charging anything between Rs 32,000-42,000 and some even more, well above the cost of a stent, which has been capped at Rs 30,000.

In many hospitals, these consumables are also being sterilised and reused, but patients are being charged for a new one or slightly less than the P helping hospitals make even more profit.

Last year, authorities in Mumbai and Jaipur had exposed how many hospitals including top corporate and chain hospitals were re-using singleuse devices like guiding catheters and balloon catheters on multiple patients.

It is so rampant across the country that the health ministry had issued a memorandum warning against re-use of disposables in CGHS patients. Yet the practice continues unabated.

"We purchase our balloon catheters for Rs 12,000 and bill the patient Rs 14,000. The P is Rs 24,000. It is sheer greed that makes these corporate hospitals charge patients double the price at which they are procuring," said a senior interventional cardiologist working in a mid-sized standalone hospital.

Many other hospitals follow similar practices. "We never charge the P on consumables. But paying in advance, buying in bulk and maintaining credibility help us get hugely discounted prices. A balloon cathether that another hospital would get at Rs 11,000, we get at Rs 8,000 and would bill patients at Rs 11,000. Patients find it affordable and higher volumes of patients helps us keep the prices lower through economies of scale. And despite not charging at P, we do make profit," said the CEO of a group of hospitals in Mumbai.

Catheters have been categorised as drugs just like stents. However, the government is yet to take steps to cap the price of these consumables or procedure charges. – TOI 

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