Heart comes for free but transplant cost hits patients

A heart transplant is surgery to remove a person’s diseased heart and replace it with a healthy heart from a deceased donor. Most heart transplants are done on patients who have end-stage heart failure.

Heart transplants are done as a life-saving measure for end-stage heart failure. Because donor hearts are in short supply, patients who need heart transplants go through a careful selection process. They must be sick enough to need a new heart, yet healthy enough to receive it.

The cost of Heart Transplant in India is around Rs 20 to 25 lakh from each surgery, but it is difficult for common man to afford the high transplant cost.

Last year, a private hospital in the city did its first heart transplant. The lucky recipient was Kolkata-based Vika (name changed). The 28-year old, who comes from an economically weak background, was billed Rs 7 lakh for the procedure. However, another recipient got a new organ in the same hospital for Rs 20 lakh. Today, the hospital charges Rs 20 to 25 lakh from each heart recipient, making it difficult for patients from humble backgrounds. This, despite the organ coming for free.

Recently, another patient in his early 20s passed away, unable as he was to get a new heart. Not that he didn’t find a matching donor. He was unable to afford the high transplant cost. With no government hospital in Karnataka conducting heart transplants, his family tried to get help from the government and some trusts but in vain.

“Cost of organ transplant varies from one hospital to an other, although the organ is obtained for free. The cost depends on the type of organ and the status of the hospital. But why should a recipient, for whom the new organ is the only hope to live, face such high-margin cost differentiation (ranging from Rs 5 lakh to 25 lakh)? If one hospital can conduct a transplant for Rs 7 lakh, why not the others,” asked Reena Raju. The first woman from Karnataka to get a new heart, Reena is the founder of Light a Life Foundation that supports patients with end-stage organ failure.

A 45-year-old corporate was asked to pay Rs 25 lakh for a heart transplant by a reputed private hospital in the city.Though financially well off, the corporator had other responsibilities restricting him from shelling out the whopping amount. Referred to another hospital by an NGO, he finally got a transplant done for Rs 15 lakh.

Not just about the procedure “The government should realize that the cost involved in an organ transplant isn’t just about the procedure. A heart recipient has to spend Rs 30,000 to 50,000 on post-operative care for six months; life-long medication costs Rs 10,000 to 15,000 every month. If no immediate action is taken at the government level, getting a new organ will become a far-fetched dream for the poor,” she added.

Said Dr Bagirath Raghuraman, senior consultant cardiologist, heart failure clinic, Narayana Health City: “Cost of procedures in different hospitals depends on the category of the ward (general, semi-private, private, deluxe), patient’s health (the more a person is, the longer will be the hospital stay), comorbidities that a patient has, like diabetes mellitus, need for dialysis, intensive care, ventilator support and medications.”

The way out

Doctors say private hospitals can work out a single-category ward admission for all patients for a particular procedure, capping costs of individual variables.”Negotiating with insurance companies for a comprehensive package at a fixed premium can also help recipients,” said Dr Raghuraman.Dr H Sudarshan Ballal, nephrologist and chairman, Manipal Hospitals, emphasized the need to set up an universal insurance scheme for all recipients under public-private partnership to reduce cost.”A rate for each type of organ transplant can only be fixed if the government and private hospitals form a steering committee, come up with regulatory indicators and then fix a recipient-friendly rate.

This should also cater to the high cost that hospitals have to incur to make provisions for transplants. For this, hospitals need government subsidies and contributions from NGOs,” he said.