During a period when China continues to battle with a chronic shortage of vital organs for patients on transplant waiting lists, the issue of heart-stent over-prescription has been publicized by the Global Times publication.
The news media outlet sought out numerous expert opinions, including an unidentified former medical sales representative, for Tuesday's in-depth article and the recommendations point toward the Asian country's government officials.
In technical terms, a heart-stent procedure is properly named a "percutaneous coronary intervention (PCI)," or balloon angioplasty. The medical intervention is complicated, but surgery is not necessary for patients who need treatment on their narrowed coronary arteries to stave off myocardial infarctions (heart attacks) or angina.
The process consists of the implantation of a stent in the troubled blood vessel, which is widened, so that support facilitates open blood flow through the biological passage on a long-term basis.
According to a Beijing-based cardiologist who was quoted in one of the capital city's youth publications, PCI treatments can lower the mortality rate of heart attacks by 3 to 4 percent.
However, the Global Times piece relays concerns from those Chinese people, including both professionals and members of the public, who are wary of the role that money plays in the PCI sector, including the way in which financial incentives motivate practitioners to over-prescribe heart stents.
The former sales representative reported that hospitals "prefer . . . doctors who can make money in heart stents operation," while an agent explained that:
"The price of heart stents increases by about 2 percent through each agent in the process [when the heart stents are sold to patients], the price could be eight or nine times when it left the factory."
According to the information obtained by the Global Times, some medical professionals and institutions are being rewarded with 45 percent of the sales price as a broker's fee. The complicated heart-stent sales process, whereby different-level agents and hospitals need to be involved, is beneficial for the bottom line--given that there were 408,000 PCI's in 2011, the amount of money at stake is considerable.
For Peking University's Hu Dayi, the problem is fairly clear. He said that 12 percent of China's PCI patients were "over treated," while 38 percent of heart stents implanted in the country were inserted unnecessarily.
In terms of a solution, Hu agrees with Zhong Zhiming, a doctor from Guangdong Province, who believes that governmental authorities should monitor clinical practice.