Sub: Exemption of import duties on critical medical equipment
As we are aware, private healthcare providers are responsible for delivering
nearly 80% of the secondary and tertiary healthcare. We are also conscious
that more than 75% of healthcare expenditure is born out of pocket. Common
man at times get left out to avail healthcare services related to major illnesses
like Cancer, Kidney, Brain and Heart surgeries, simply due to the cost
associated. There is urgent need to look at various options to bring down the
cost of healthcare services.
We would like to bring to your kind notice the problems faced by the
healthcare providers in delivering the affordable healthcare to the common
man suffering from major illness.
Cost of these healthcare interventions in case of major illnessesishigh because
of lack of manufacturing facility of medical equipment and implants. Majority
of these products are produced in western countries and all the hospitals in
India have to import these expensive equipment. With the foreign currency
becoming volatile and expensive, the price of these equipment has gone up
significantly.
It is relevant to mention that under the category of life saving implants, only
limited equipment are presently exempted from import duties. We need to
realize that all equipment used in healthcare in general and MRI, CT scan,
CathLab, Linear Accelerator in particular are life-saving equipment. To
illustrate, let us look at application of MRI in trauma cases:
“India has the highest rate of road accidents with an Indian dying every 5
minutes on our roads. For every death we have 10 young people who have
severely injured limbs which frequently have loss of blood supply. Here
identifying the cause and site of vascular obstruction on an emergent basis is
critical. Use of contrast based CT angiograms has the risk of renal failure as
many patients are in shock and with poor urine output. Modern MRI machines
offer a safe and rapid method of performing angiograms without the use of
contrast which help to save limbs. Moreover, rapid sequences in 3T MRI allow
the identification of intra-cranial injuries, solid organ injuries and Intra-
abdominal and thoracic injuries which when diagnosed and rectified early can
be life-saving.”
As such, we request you to kindly exempt healthcare equipment i.e. MRI, CT
scan, Cath Lab and Linear Accelerator from import duty. This will help making
Indian hospitals very competitive and enable the healthcare industry to reduce
the price. Today with high import duties it is impossible for any hospital
including charitable/not-for-profit hospitals to reduce the price. Cost of an
operation is not decided by the hospital, it is decided by the equipment
manufacturer and suppliers of these devices. TABLE below shows the four
important life-saving equipment and which account for 75% of total cost of all
medical equipment in a hospital. Table shows number of medical equipment in
above categories, procured in past one year. The total import duty works out
to be around Rs. 220 crores. It is small amount in the overall context of central
budget, but its impact on saving of precious human lives is huge.Such an
initiative will really be hailed as pro-people.
S.No
1
2
3
4
Average
sales
Equipments
price(ASP)
Magnetic Resonance Imaging (MRI) 3.5 Cr
Computed Tomography (CT)
1.2 Cr
Cathlab
2 Cr
Linear Accelerator
5 Cr
TOTAL
Units
sold in
2012
200
500
150
65
Custom
Duty @
Total
11.64%
value(in (in
Crores) crores)
700
81.48
600
69.84
300
34.92
325
37.83
1925
224.07
India can become the first country in the world to dissociate healthcare from
affluence. We believe that it is going to happen within the next 5-10 years. It
is mainly because we are privileged to be living in a country which produces
the largest number of doctors, nurses and medical technicians in the world.
Outside the United States we have the largest number of US-FDA approved
drug manufacturing units. We have everything required for a fantastic
healthcare delivery mechanism to the common man. However, this cannot
happen unless government helps the non- government hospitals to reduce the
cost of the procedures. This can only happen by incentives from the
government in the form of import duty waiver on medical equipment.
We will be ready to provide any information in support of our contentions
which are primarily aimed at providing universal health coverage in general
and to common man in particular.