How Covid is demystifying medical technology

An inherent characteristic of technology is that it evolves in the direction towards solving a problem or overcoming a hurdle or challenge. Given the right impetus and adequate environment, there is no problem too great or hurdle too high for technology. This is most apparent in the healthcare sector; something the Covid pandemic has put the spotlight on. Technology is critical in the healthcare sector but is often overlooked and underappreciated.

In the early stages of the ongoing pandemic, there were no therapeutic remedies or vaccines. Medical technology or MedTech played a pivotal role. Helping experts understand the spread of the disease through diagnostic testing, reducing the risks for frontline health workers through personal protective equipment (PPE) and saving the lives of people through intensive care technologies, MedTech has been the mainstay in handling the coronavirus.

This critical role of MedTech is not new. Pandemic anthropology is replete with instances that help us understand the vital importance of MedTech. The cholera pandemic of the early 19th century brought with them sewage and zoning systems that were adopted to distance houses from one another towards tackling the spread of the disease. Later, the Bubonic plague helped identify rats to be disease carriers and drainage systems were up-graded and houses were reconstructed.

Once the person to person transmission of microbes was firmly established, the powder room emerged as a ubiquitous addition to the map of the home, to “scrub” the “boys” who were bringing the frequent supplies of coal or ice to homes, right at the threshold. Similarly, white tiles, common to modern-day bathrooms came in with tuberculosis as their surfaces were easy to clean. That was the pre 20th century medical technology, effected mostly through the agency of construction.

By 1918, the Spanish flu spread across continents devouring nations in its wake. There was no cure, so technology was used to create a physical barrier between the cause of the disease and man responded by developing PPEs, masks, gloves and other preventive equipment. The Covid pandemic witnessed the arrival of the ventilator, the RTPCR machine and the oxygen concentrator to common consciousness.

Black fungus

We also saw emergence of the Black fungus along with the Covid-19 outbreak in India. ‘ Black Fungus’ or ‘ Mucormycosis’ is a fungal infection characterised by fungi growth in various parts of the body like sinuses, brain, lungs and other organ systems. The fungus invades the sinus and makes its way into the intra-orbital and intracranial regions.

The cases of Black fungus are being detected mostly among the patients who have been treated with steroids, especially those with existing health conditions such as diabetes and cancer. It has a mortality rate of more than 50 per cent if its progression is not checked early. Medical technology once again finds itself at the forefront. Endoscopic examination of the nose, biopsy and usage of imaging technologies like MRI and CT scans have made detection possible at an early stage.

Medical devices like micro-debriders and shaver systems are used to surgically remove the infected tissue. Whether Covid leads to micro-thrombi induced gangrene which needs amputation or hearing loss, medical technology is the saviour.

Intricate sector

MedTech is an intricate sector. For MedTech to be able to keep delivering, it needs a conducive environment that encourages innovation and facilitates access. The government has acknowledged the MedTech industry as a ‘sunrise sector’, recognising its vital role and its growth potential which was well on its way to become a $10 billion market by 2022 until Covid struck.

However, this growing industry has also borne the brunt of some sub-optimal policy decisions in the past which though may have been well-intentioned have done a big disservice to the industry. Policies like cost-based price capping which has been implemented on stents and orthopaedic knee implants disregards the innovative nature of the medical technology sector which is constantly evolving. It can spawn market distortions and unintended consequences like discouraging companies from introducing new products as the price cap does not allow them to recover costs spent on research and development, marketing costs and various other costs.

This could further lead to treatment implications on patients, who may need different and innovative products for their individual and evolving medical needs which they no longer may have access to.

Trade margin rationalisation

On the brighter side, the government is now taking cognisance of these concerns and has considered taking a more nuanced approach to curbing high prices without hurting the industry. On June 5, 2021, the NPPA implemented trade margin rationalisation (TMR) from the first point of sale, that is, the distributors, to control high prices of oxygen concentrators which had skyrocketed during the Covid second wave.

As per reports, this move resulted in a significant reduction in margins of oxygen concentrators. Following this, trade margin rationalisation was also implemented for pulse oximeter, glucometer, BP monitor, nebulizer and digital thermometer which has led to a reported downward revision of MRP by up to 88 per cent.

This consistency in the mechanism adopted by the NPPA will bring in predictability and transparency in pricing regulations, which could also help India retain its attractiveness as a destination for both domestic as well as international investments.

As the government envisions and makes efforts towards making healthcare affordable for the masses, we look forward to such nuanced mechanisms being adopted going forward. This will usher in affordability without asphyxiating the industry’s ability to innovate; for technology needs nurturing and encouragement if we are to solve the problems of the future and navigate the uncharted.

The writer is Chairman & Director General, Medical Technology Association of India

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