China Daily has published a lengthy op-ed article by Dwight Clark, medical director of US-Sino HeartCare, which argues that stent implants are too widely used and often unnecessary in China and elsewhere.
Clark said that physicians in China are financially rewarded according to the number of procedures they perform--whether patients need stents or not, according to the article in China Daily, which says it is an independent source of insight on Greater China.
Clark works in partnership with heart disease diagnosis firm iKang Evergreen Medical International, a unit of U.S.-listed iKang Healthcare ($KANG), which has recently announced that it wants to go private in a management-led $1.1 billion offer. He said that about 500,000 stents are implanted in Chinese patients annually.
"Almost 100% of these procedures use drug-eluting stents to treat patients with angina," Clark wrote in the Sept. 7 article. "Unfortunately, many stents are overused for asymptomatic patients identified as having a 'blockage' through CTA (coronary computed tomography arteriography) screening."
He added that "this problem has come to the attention of the National Committee of the Chinese People's Political Consultative Conference (CPPCC)."
Clark cited CPPCC member Dong Xieliang as saying that local hospitals pay RMB3,000 ($456) for a domestically made heart stent and sell it to the patient for RMB27,000.
However, Clark did say that research shows stents are appropriate in cases noted in guidelines from the American College of Cardiology Foundation and the American Heart Association, "where I've been a member for over 40 years."
But he said the focus on misuse of stents in China is part of an effort to "change the focus to one of prevention."
"Heart attacks and strokes can be prevented and this is the message we have dedicated ourselves to promoting, and in the process, stopping all of the unnecessary interventional procedures," Clark said.
Stents have also drawn flak in India, with the government looking at price caps, while companies such as Abbott Laboratories ($ABT) see the business as a growth area as diet and other lifestyle factors that can raise cardiovascular risks change rapidly in the region.
- here's the article from China Daily