More people having stents implanted now they are cheaper

China's centralized procurement drive, which has slashed the price of heart stents by more than 90 percent, has also accelerated the adoption of state-of-the-art products and helped expand access to stent implantation surgeries, the National Healthcare Security Administration said this week.

Coronary stents, tiny tubes used to open blocked arteries in people suffering from heart disease or who have been hit by an acute heart attack, used to cost around 13,000 yuan ($1,800) each, with imported ones costing nearly 20,000 yuan. The high price — largely due to marketing and distribution expenses — strained the pockets of many patients, especially those who required two or more stents.

To address public concerns, the administration's first bulk buy program targeting high-value medical consumables focused on coronary stents. The program, launched in November 2020, aimed to squeeze out intermediate costs and entice manufacturers to cut prices to win bids for volume contracts.

It eventually led to an average price cut of 93 percent, with the price of each stent falling to 700 to 800 yuan.

But the dramatic price reduction has also triggered doubts over the quality of the more affordable products, their availability at hospitals and manufacturers' production capacity to meet bulk demand.

The administration said on Monday that from 2021 to last year, the number of coronary stents supplied through the bulk buy program that were used on patients grew by 17 percent a year. That matched the nationwide increase in coronary intervention surgeries.

"The majority of patients in need now opt for stents involved in the bulk buy program and over 95 percent of stents used across the nation are such products," it said. "In total, about 3.7 million patients used these stents from 2021 to 2023.

"Clinical experts also said that nearly all mainstream products in the market have been selected and there is barely any need for medical institutions to change the regular brands they use. There is also no change in these products' clinical efficacy."

The administration said the ratio of chromium alloy drug-eluting stents — a relatively advanced type compared to bare metal or stainless-steel stents — in use rose from 60 percent to 95 percent, signifying an upgrade in product usage by Chinese patients.

"Heart stents chosen during the program have proved of high clinical quality," the administration said, and they could reduce the occurrence of postoperative narrowing of arteries.

Nationwide, the number of medical institutions that carry out stent implantation surgeries grew from 2,400 in 2020 to 3,600 last year. Among them, the number of secondary hospitals — the middle level in a three-tier system — rose from 1,200 to 1,700.

In response to rumors that the price reduction had affected the incomes of physicians and made them reluctant to carry out surgeries, the administration said that doctors from a number of well-known hospitals said they earned more legitimate income nowadays.

"Some regions have raised the surgical service price, which used to be relatively low, so as to reward the value of professional skills of healthcare workers," the administration said.

"Local authorities also allow medical institutions to retain part of the healthcare funds saved thanks to the bulk buy program so that hospitals and medical staff can also reap benefits."

Another concern among the public is manufacturers' capacity to produce enough stents to supply the large volumes promised in contracts.

The administration said that from 2021 to 2023, the quantity supplied was 1.3 times the agreed amount. The number of participating manufacturers grew from eight to 10 during the period.

wangxiaoyu@chinadaily.com.cn