Supply price surge: Govt contemplates revision of surgical procedure rates

PESHAWAR: The government is deliberating a potential revision of rates for various surgical procedures, particularly cardiac surgeries, as the existing rates under the Sehat Card Plus scheme have become impractical for both public and private hospitals in Khyber Pakhtunkhwa due to an unprecedented surge in the prices of medical supplies.

The Pakistan Tehreek-e-Insaf (PTI) government has recently restored the Sehat Card Plus programme in Khyber Pakhtunkhwa, with an aim to facilitate thousands of patients awaiting essential surgeries.

However, even during the operational period of the Sehat Card Plus programme previously, a majority of hospitals hesitated to perform cardiac surgeries under the scheme, citing the inconvenience caused by the increased prices of medicines essential for such procedures.

Some cardiac surgeries require additional funds, which the majority of patients are unable to afford.There exists a significant disparity between the current market rates for cardiac operations and the rates fixed by the government.

Speaking to The News, Chief Executive of the Sehat Card Plus programme Dr Riaz Tanoli acknowledged the issue and stated that the government was contemplating revising the rates for several surgical procedures, including cardiac surgeries.

He said that they urged hospitals on their panel to continue providing services at the previous rates during Ramazan, as Chief Minister Ali Amin Gandapur has ordered the formation of a committee to review the rates.

The first Policy Board meeting is scheduled for this month, where it is anticipated that rates will be increased by 20-25 percent.In Peshawar, cardiac surgeries are conducted at a few hospitals, which are struggling to manage the growing number of patients requiring such procedures. PIC is a big set up with huge staff and resources.

Among the public sector hospitals, Peshawar Institute of Cardiology (PIC), Hayatabad Medical Complex (HMC), and Lady Reading Hospital (LRH) offer cardiac surgery services.

The majority of patients opt for the cardiac centre at HMC, where a small team of two or three surgeons, led by Dr Mohammad Aasim, conducts surgeries. However, the waiting list for patients under the Sehat Card scheme extends until June 2026.

Despite these efforts, the current rates may still result in significant financial burdens for patients requiring cardiac surgery, with costs exceeding Rs400,000 for certain procedures.Cardiac surgeons have expressed concerns that the existing Sehat Card rate may cover only basic procedures with minimal profit margins, leaving more complex surgeries financially inaccessible to patients.

The current rate does not cover valve replacement procedures, such as single valve, double valve, or multiple valves, nor does it suffice for Aortic Root Replacement, which requires prosthetic materials. Even for CABG+IABP, the allocated amount will not cover the disposables used in the operation theaters. It’s imperative that the packages be updated to reflect current rates before implementing a comprehensive policy. Otherwise, the already compromised financial situation of government hospitals, with billions in pending bills from suppliers, will worsen,” a prominent cardiac surgeon told The News in Peshawar.

Two years ago, a private hospital was removed from the panel list for refusing to accept a patient for cardiac surgery under the Sehat Card scheme, ostensibly due to increased medical supply prices.

Before the launch of Sehat Card, the government provided angiography and angioplasty services at LRH and HMC at nominal rates, supported by Zakat and Baitul-Mal.Even during the suspension of Sehat Card by the outgoing caretaker government, cardiac surgeons at HMC continued their practice, and operated on deserving patients from their own resources and contributions.

The Sehat Card proved beneficial to patients, as Baitul-Mal and the Zakat system did not support open heart surgery.Cardiac surgeons at HMC used to solicit donations from friends and colleagues to fund certain deserving patients for DVR+Tricuspid Repair, a costly and high-risk procedure.

It has been over a year since the provincial government has failed to make payments to suppliers, despite utilising items against cash deposited in hospital accounts or under the Sehat Card status.

Due to the lack of medical supplies in hospitals, the cost of angiography at LRH under the Sehat Card is higher than in small private hospitals. Patients are required to procure medicines worth Rs8000 to Rs10,000 on their own, even if they undergo angiography under the Sehat Card at LRH.

Cardiac surgeons stress the need for the government to ensure that patients receive quality treatment under the Sehat Card, particularly for surgical procedures.

According to their estimates, various procedures, including CABG, ASD, and LA Myxoma, cost between Rs5,50,000 to Rs600,000 each. CABG+IABP is priced at around Rs9,50,000, while VSD & total correction for ToF is approximately Rs600,000.

Mechanical Valve procedures like AVR and MVR require around Rs8,50,000, whereas Tissue Valve AVR and MVR cost around Rs12,50,000. Aortic Root Replacement is estimated at Rs13,00,000, while double Mechanical valves DVR range from Rs11,00,000 to Rs12,000,000.­