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In India, a call to halt financial incentives for stent use

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The global stent industry might have to brace for problems in India, where observers see surgeons increasingly overusing stents when cheaper drug treatments would work just fine. Some governmental pushback could be in the cards, as The Times of India says kickbacks and gifts are promoting the practice and the medical community is starting to clamor for changes.

A major cardiologist recently faced arrest in India for allegedly taking a bribe from a stent supplier, the article notes, adding that many others do the same and simply aren't caught. As a result, India's medical community wants some sort of a legal check to curb the practice.

More than 3 million stents are used in India annually, the story notes, including drug-eluting and bare metal stents, and now bioabsorbable stents, at least for the few who can afford them. They're designed to be used if patients face artery blockages greater than 70%. But a number of Indian doctors revealed a dirty little secret to The Times of India: Doctors in the country are still using stents even if the blockage is under 30%. That's a problem because stents in some cases can increase the risk of heart attack or stroke. But even with that in mind, manufacturers are giving cardiologists "incentives" for each stent used, cardiologists told the newspaper. And considering hospitals buy stents at bulk at a cheaper price and sell them for more to patients, there's plenty of money to be made.

The article doesn't name specific companies involved in the practice, other than noting that Abbott ($ABT) and Johnson & Johnson ($JNJ) are major stent sellers in India. But Medtronic ($MDT), Boston Scientific ($BSX) and others have also targeted India for major expansion efforts, even as Indian stentmakers themselves are seeking international expansion.

- read the The Times of India piece

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