At the scientific session of the American Heart Association held in Chicago, cardiologists from Germany presented the results of an extended follow up of 2,603 patients who were randomised to treatment with two new generation stents — everolimus eluting Xience and sirolimus eluting Yukon Choice — and a first generation sirolimus eluting Cypher stent. Cypher is not in the market any more. The study published in the journal of the AHA showed there was no difference in outcomes between the two new generation stents.
In February 2017, the government had capped the price of stents + leading to a three-fourths reduction in the prices for drug eluting stents. Several multinational stent companies had threatened to withdraw their stents from India claiming that they were superior to Indian ones and hence deserved a higher price. Several cardiologists too had questioned the quality of Indian stents. However, with studies showing that Indian stents are as good as foreign ones, cardiologists appear to have changed tack.
“These are the kind of studies we need — large, randomised, long-term studies. More Indian companies should do such studies to establish their credibility internationally. Every stent needs to be proven,” said Dr Ashok Seth, head of cardiology for the Fortis Group of hospitals. He added that the study also showed there was no difference between stents with biodegradable polymer coating and permanent polymer coating putting paid to the argument that biodegradable polymer coated stents should get a higher price.
Stents cheaper, but not all get benefit
Before price cap, the cost was prohibitive for more than two stents, and so people often opted for open heart as it worked out to be cheaper than angioplasty. But now, multi-stenting is affordable and many patients who would have been forced to go in for an open heart surgery, now opt for stenting.
Dr Upendra Kaul, chairman of Batra Heart Centre, who initiated the earlier one-year study comparing Supra Flex to Xience along with Prof Patrick Serruys from the Netherlands, pointed out that even with good newer generation stents, 3% of patients still had heart attacks and needed restenosis each year. “Further research is being done to bring down this 3%,” said Dr Kaul.
Yukon stents are made in India from German technology, while Supra Flex is a fully indigenous stent, pointed out Dr Kaul. In an editorial in the journal Euro Intervention last year, Dr Kaul had written: “There is a perception in the minds of cardiologists, which gets passed on to the patients, that imported stents are superior.” He had added that it was time for Indian companies to prove to cardiologists and patients that their products were as safe and effective as those of multinational companies.
So far, no brand of drug eluting stents anywhere in the world has been shown to be superior to other brands in the market, both Dr Kaul and Dr Seth pointed out.
from Times of India https://ift.tt/2zRFOZb
