Cost & Availability of Ventilators

The high cost of ventilators is a major impediment to the availability of ventilators in hospitals around the world. In India, a ventilator may cost anywhere from 7–18 Lakh INR (US$ 15,000–40,000) depending upon the company and product features. (Ref 1)

SVELTE is the most affordable ventilator at Rs. 25,000 while having features comparable to a fully equipped hospital ventilator that can cost anywhere between 10–25 Lakh INR.

Lack of Ventilators

There is an acute shortage of mechanical ventilators in India. Ventilators are required in seven major departments like medicine, pediatrics, pediatric surgery, surgery, orthopedics, chest medicine and TB, ENT and gynecology. Ideally, each of these departments must have 2-5 ventilators. Based on hospital bed to ventilator statistics, we are short of one million mechanical ventilators at the barest minimum. (Ref 2)

A major part of the total cost of patient care goes into the equipment and its maintenance. Often, despite being high in demand, high-end mechanical ventilators are lying unused in hospitals due to lack of proper maintenance which involves a very high cost and is thus, unaffordable to many. The expenditure of running an NICU unit for a patient (infant) is > Rs. 5000 per day a major part of which goes into maintenance of the ventilator, which includes highly trained medical professional. (Ref 3)

Primary Health Centre (PHCs), are state-owned rural health care facilities in India. They are essentially single-physician clinics usually meant to have facilities for minor surgeries too. There are 23,109 PHC’s in India none of which are equipped with a single mechanical ventilator.

Besides this, the parts of a mechanical ventilator are also very expensive.

Medical Significance

Respiratory illnesses are the 2nd largest cause of death in India. The leading causes being the big five; COPD, Asthma, Acute respiratory infections, Tuberculosis and Lung cancer. According to lung specialists, 10% of people living in the cities suffer from asthma and respiratory allergies in winter. This number is rising with the increasing pollution levels in large cities. Chulha smoke is one of the biggest causes of COPD in rural areas. WHO statistics show that 154 persons per 100,000 die each year from respiratory causes in India. This adds to more than 5000 people per day dying each day.

Premature deaths are another problem that can be prevented with better availability of mechanical ventilators. The worldwide high rate of infant mortality in pre-terms due to respiratory disorders can also largely be attributed to not being provided ventilatory support. Maiya et al. conclude in their paper that it is not "cost effective" to ventilate premature babies that weigh less than 1 kg. (Ref 4)

India is also the snakebite capital of the world with deaths by poisoning competing with organophosphorus poisoning in both rural as well as urban areas. Both these cases require mechanical ventilation for life support failing which, there is considerable risk of death.

Affordability of Ventilators

For mechanical ventilators, it is the cost that makes them unavailable in PHC’s and it is also the reason why mechanical ventilation is unaffordable for an average Indian. Moerer et al. found in a study conducted that the daily total cost for a non-ventilated patient was Rs. 6585 ± 932 (for medicines etc.), whereas that for a ventilated patient is Rs. 12,429 ± 9720. They concluded that in all levels of care, the most expensive patients were those needing mechanical ventilation or with a high severity of illness, or severe sepsis and in non-survivors. (Ref 5)

With SVELTE, these high demands can be met easily with costs lowered not just for the basic machine but also maintenance and operator salaries. The need for such a solution is desperate not just in India but all over the world. By tackling the issue of cost, mechanical ventilators can enter a new era where every hospital bed in a PHC can afford to have a ventilator and every respiratory distress suffering infant can now be considered worthy to have his life saved.

References

1) Jaypee Brothers, Pediatric and Neonatal Mechanical Ventilation.

Medical Publishers

2) OneBreath Inc. – 2014 TiE50 Company Profile

3) Narang A, Kiran PS, Kumar P:

Cost of neonatal intensive care in a tertiary care center.

Indian Pediatr 42(10):989-997, 2005.

4) Maiya PP, Vishwanath D, Hegde S, et al.

Mechanical ventilation of newborns: experience from a level II NICU.

Indian Pediatr 1995; 32: 1275-1280

5) Moerer O, Plock E, Mgbor U, Schmid A, Schneider H, Wischnewsky MB, el al.

A German national prevalence study on the cost of intensive care:

An evaluation from 51 intensive care units. Crit Care 2007;11:R69.