In keeping with India’s rising burden of non-communicable diseases (NCD), 40 per cent of all money sanctioned so far under the Pradhan Mantri Jan Arogya Yojana (PMJAY) is for four heart procedures — angioplasty, coronary artery bypass surgery, heart valve repairs and septal defects.
Launched on September 23 by Prime Minister Narendra Modi, PMJAY is a tertiary care programme under which an annual health cover of Rs 5 lakh has been given to 10.74 crore families across the country.
Analysis of claims data under the health assurance/insurance arm of Ayushman Bharat shows 22 per cent of total claims — Rs 1,289,710,000 — has been sanctioned under PMJAY for angioplasty, a process of opening clogged arteries around the heart. The total number of admissions sanctioned is 16,825.
The analysis also found that 9 per cent of all claims sanctioned are for coronary artery bypass graft — a process when a clogged artery is not possible to be cleared by angioplasty and the blood needs to re-routed through an alternate channel bypassing the blocked area. Heart valve repairs — which can happen as a result of uncontrolled hypertension, diabetes, obesity, and smoking — account for 6 per cent of all claims. Meanwhile, septal defects — congenital defects in the heart walls — account for 3 per cent of all claims.
However, cataract surgeries, which account for the largest number of procedures under the scheme, account for just 4 per cent of the payouts made so far — Rs 236,954,000 for 29,546 surgeries.
India’s NCD burden has been a matter of concern for some years now. An article in The Lancet Global Health journal noted that India’s burden of NCDs is escalating, and while NCDs typically present in individuals aged 55 years or older in many developed countries, their onset occurs in India a decade earlier.
The study noted: “The India GBD Collaborators found that leading cardiovascular diseases-ischaemic heart disease and stroke-made the largest contribution to the total burden of mortality in India in 2016, at 28.1 per cent. Furthermore, the contribution of cardiovascular diseases to mortality increased by 34.3 per cent from 1990 to 2016, which is not surprising given rapid population ageing and significantly increasing levels of the main risk factors for cardiovascular diseases-high systolic blood pressure, air pollution, high total cholesterol, high fasting plasma glucose, and high body-mass index-during that period.”
Prevalence of cardiovascular diseases and their share of mortality are predictably higher in the high and higher-middle Economic Threshold Level states of Andhra Pradesh, Goa, Himachal Pradesh, Kerala, Maharashtra, Punjab, Tamil Nadu, and West Bengal.