Lok Sabha Question No. 549 (UNSTARRED), answered on 2016-11-18
Subject: Affordable Treatment of Life-Style Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KRUPAL BALAJI TUMANE, BHAVANA GAWALI (PATIL)

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 549 TO BE ANSWERED ON 18 TH NOVEMBER, 2016

## AFFORDABLE TREATMENT OF LIFE - STYLE DISEASES

## 549. SHRI KRUPAL BALAJI TUMANE: SHRIMATI BHAVANA PUNDALIKRAO GAWALI PATIL:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  the  number  of  people  suffering  from various  Non - Communicable  Diseases (NCDs)  and those died there from during each of the last three years and the current year, State/UT - wise;
- (b)  the  details  of  number  of  heart surgeons/cardiologists  and  hospitals equipped  with infrastructure to deal with such emergencies and perform health surgeries and other treatments State/UT - wise;
- (c) whether the Government proposes to streamline and list the price of medical equipments and other devices used for heart surgeries so that the same could be availed at competitive rates by patients and if so, the details thereof; and
- (d) the other steps taken by the Government to make the treatment of aforesaid disease more affordable treatment?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

- (a )  :  Indian  Council  of  Medical  Research  (ICMR)  has  undertaken  a  survey  on  diabetes  v ICMR  India  Diabetes  (ICMR -INDAB)  Study  on  the  prevalence  of  diabetes.  It  is  an  ongoing study and current results available from 15 States/UTs indicate overall prevalence of Diabetes which varies from 4% to 13%.

ICMR  has  informed  that  according  to  the  Report  of  National  Commission  on Macroeconomics and Health, there were 380 lakh cases of Cardiovascular Diseases (CVDs) the year 2005 and these were estimated to rise to 641 lakh cases in the year 2015.  The number of deaths from CVDs was estimated to more than double during this period.

The data available from the Indian Council of Medical Research -India Diabetes (INDAB) Study Phase I done in the rural and urban setting s in 3 States and 1 Union Territory viz., Tamil Nadu,  Maharashtra,  Jharkhand  and  Chandigarh  for  hypertension  indicates  the  range prevalence of hypertension from 19.8% to 31.5 %.

State  wise  data  for  prevalence  and  mortality  of  lifestyle  diseases  is not  maintained centrally.

State/UT wise estimates of incidence and death due to cancer, as furnished by ICMR, last three years and current year are given in Annexure -I & II.

(b )  :  Data  regarding  number  of  heart  surgeons/cardiologists  is  not  maintained  cent However, a statement showing details of Cardiac Care Units established under NPCDCS  as 30 th September, 2016 is at Annexure -III.

(c) : As informed by National Ph armaceutical Pricing Authority, the medical equipments and other devices used for heart surgeries are not notified under the First Schedule of Drug Control) Order, 2013 (DPCO, 2013).

However, DPCO, 2013 provides for monitoring the prices of non - scheduled formulations, to ensure that no manufacturer / importer / distributor is allowed to inc MRP of a non - scheduled drug by more than ten percent of MRP during preceding twelve months and where the increase is beyond ten percent, it shall red uce the same to the level of ten percent of maximum retail price for next twelve months. The manufacturers / importers / distri shall be liable to deposit the overcharged amount along with interest thereon, from the increase in price in addit ion to the penalty.

The  Ministry  of  Health  and  Family  Welfare  has  also  started  AMRIT  (Affordable Medicines and Reliable Implants for Treatment) stores where essential life saving medicin implants including stents are being provided at a substantial discount vis - à- vis  the  Maximum Retail Price.

(d) : While Health is a State subject, the Central Government supplements the efforts of State/UT Governments to create awareness and provide health care facilities.

Government of India is implementing Nationa l Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) for interventions up to Dis level under the National Health Mission. It has focus on awareness generation for behavio life - style changes, scr eening and early diagnosis of persons with high level of risk factors their treatment and referral (if required) to higher facilities for appropriate managemen -communicable Diseases. Under NPCDCS, diagnosis and treatment facilities for major NCDs are provided  through  different  levels  of  healthcare  by  setting  up  of  NCD  Clinics  and  CCU District Hospitals and Community Health Centres (CHCs).

| Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes   |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |
|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|
| States                                                                                                          |                                                                                                            2013 |                                                                                                            2014 |                                                                                                            2015 |                                                                                                            2016 |
| Jammu &Kashmir                                                                                                  |                                                                                                           13404 |                                                                                                           14115 |                                                                                                           14864 |                                                                                                           15652 |
| Himachal Pradesh                                                                                                |                                                                                                            7140 |                                                                                                            7425 |                                                                                                            7722 |                                                                                                            8029 |
| Punjab                                                                                                          |                                                                                                           28835 |                                                                                                           30002 |                                                                                                           31214 |                                                                                                           32474 |
| Chandigarh                                                                                                      |                                                                                                            1110 |                                                                                                            1162 |                                                                                                            1217 |                                                                                                            1274 |
| Uttaranchal                                                                                                     |                                                                                                           10709 |                                                                                                           11240 |                                                                                                           11796 |                                                                                                           12381 |
| Haryana                                                                                                         |                                                                                                           26688 |                                                                                                           27933 |                                                                                                           29240 |                                                                                                           30611 |
| Delhi                                                                                                           |                                                                                                           17578 |                                                                                                           18356 |                                                                                                           19168 |                                                                                                           20015 |
| Rajasthan                                                                                                       |                                                                                                           72275 |                                                                                                           75642 |                                                                                                           79160 |                                                                                                           82836 |
| Uttar Pradesh                                                                                                   |                                                                                                          212075 |                                                                                                          222615 |                                                                                                          233659 |                                                                                                          245231 |
| Bihar                                                                                                           |                                                                                                          111572 |                                                                                                          117603 |                                                                                                          123949 |                                                                                                          130628 |
| Sikkim                                                                                                          |                                                                                                             462 |                                                                                                             467 |                                                                                                             473 |                                                                                                             479 |
| Arunachal Pradesh                                                                                               |                                                                                                            1212 |                                                                                                            1231 |                                                                                                            1252 |                                                                                                            1272 |
| Nagaland                                                                                                        |                                                                                                            1284 |                                                                                                            1288 |                                                                                                            1294 |                                                                                                            1300 |
| Manipur                                                                                                         |                                                                                                            2759 |                                                                                                            2836 |                                                                                                            2916 |                                                                                                            2998 |
| Mizoram                                                                                                         |                                                                                                            1552 |                                                                                                            1585 |                                                                                                            1618 |                                                                                                            1652 |
| Tripura                                                                                                         |                                                                                                            2110 |                                                                                                            2139 |                                                                                                            2169 |                                                                                                            2199 |
| Meghalaya                                                                                                       |                                                                                                            3121 |                                                                                                            3184 |                                                                                                            3246 |                                                                                                            3311 |
| Assam                                                                                                           |                                                                                                           30775 |                                                                                                           31124 |                                                                                                           31474 |                                                                                                           31825 |
| West Bengal                                                                                                     |                                                                                                           95316 |                                                                                                           99339 |                                                                                                          103532 |                                                                                                          107906 |
| Jharkhand                                                                                                       |                                                                                                           35206 |                                                                                                           37031 |                                                                                                           38947 |                                                                                                           40959 |
| Orissa                                                                                                          |                                                                                                           43882 |                                                                                                           45736 |                                                                                                           47666 |                                                                                                           49674 |
| Chhattisgarh                                                                                                    |                                                                                                           27310 |                                                                                                           28738 |                                                                                                           30239 |                                                                                                           31817 |
| Madhya Pradesh                                                                                                  |                                                                                                           77175 |                                                                                                           81034 |                                                                                                           85078 |                                                                                                           89315 |
| Gujarat                                                                                                         |                                                                                                           63884 |                                                                                                           66952 |                                                                                                           70171 |                                                                                                           73551 |
| Daman &Diu                                                                                                      |                                                                                                             299 |                                                                                                             339 |                                                                                                             385 |                                                                                                             440 |
| Dadra &Nagar Haveli                                                                                             |                                                                                                             389 |                                                                                                             421 |                                                                                                             457 |                                                                                                             497 |
| Maharashtra                                                                                                     |                                                                                                          117317 |                                                                                                          122256 |                                                                                                          127390 |                                                                                                          132726 |
| Telangana                                                                                                       |                                                                                                           36885 |                                                                                                           38494 |                                                                                                           40177 |                                                                                                           41939 |
| Andhra Pradesh                                                                                                  |                                                                                                           51462 |                                                                                                           53570 |                                                                                                           55776 |                                                                                                           58072 |
| Karnataka                                                                                                       |                                                                                                           64306 |                                                                                                           67237 |                                                                                                           70302 |                                                                                                           73511 |
| Goa                                                                                                             |                                                                                                            1522 |                                                                                                            1587 |                                                                                                            1655 |                                                                                                            1726 |
| Lakshadweep                                                                                                     |                                                                                                              71 |                                                                                                              77 |                                                                                                              82 |                                                                                                              89 |
| Kerala                                                                                                          |                                                                                                           35620 |                                                                                                           37550 |                                                                                                           39672 |                                                                                                           42004 |
| Tamil Nadu                                                                                                      |                                                                                                           73736 |                                                                                                           76091 |                                                                                                           78512 |                                                                                                           80999 |
| Pondicherry                                                                                                     |                                                                                                            1351 |                                                                                                            1428 |                                                                                                            1510 |                                                                                                            1596 |
| Andaman & Nicobar Islands                                                                                       |                                                                                                             389 |                                                                                                             402 |                                                                                                             415 |                                                                                                             429 |
| Total                                                                                                           |                                                                                                         1270781 |                                                                                                         1328229 |                                                                                                         1388397 |                                                                                                         1451417 |

Ref: Three-year Report of the PBCRs: 2012-2014, Bengaluru, 2016

*Projected cancer cases for India were computed using a projected incidence rates and the population (person-years)

| States                    |   2013 |   2014 |   2015 |   2016 |
|---------------------------|--------|--------|--------|--------|
| Jammu &Kashmir            |   6782 |   7144 |   7525 |   7925 |
| Himachal Pradesh          |   3598 |   3742 |   3893 |   4048 |
| Punjab                    |  14580 |  15171 |  15784 |  16423 |
| Chandigarh                |    563 |    590 |    618 |    646 |
| Uttaranchal               |   5399 |   5667 |   5949 |   6245 |
| Haryana                   |  13505 |  14135 |  14797 |  15491 |
| Delhi                     |   8897 |   9290 |   9699 |  10127 |
| Rajasthan                 |  36495 |  38202 |  39985 |  41848 |
| Uttar Pradesh             | 107170 | 112514 | 118115 | 123985 |
| Bihar                     |  56372 |  59431 |  62651 |  66040 |
| Sikkim                    |    234 |    236 |    240 |    242 |
| Arunachal Pradesh         |    619 |    628 |    638 |    649 |
| Nagaland                  |    659 |    662 |    665 |    667 |
| Manipur                   |   1381 |   1419 |   1460 |   1500 |
| Mizoram                   |    791 |    808 |    824 |    841 |
| Tripura                   |   1079 |   1094 |   1109 |   1125 |
| Meghalaya                 |   1612 |   1644 |   1676 |   1710 |
| Assam                     |  15677 |  15853 |  16029 |  16206 |
| West Bengal               |  48075 |  50110 |  52231 |  54443 |
| Jharkhand                 |  17760 |  18683 |  19653 |  20671 |
| Orissa                    |  22105 |  23043 |  24019 |  25035 |
| Chhattisgarh              |  13751 |  14472 |  15231 |  16030 |
| Madhya Pradesh            |  38962 |  40917 |  42964 |  45110 |
| Gujarat                   |  32275 |  33832 |  35466 |  37182 |
| Daman &Diu                |    154 |    176 |    200 |    229 |
| Dadra &Nagar Haveli       |    198 |    215 |    233 |    254 |
| Maharashtra               |  59231 |  61732 |  64332 |  67035 |
| Telangana                 |  18573 |  19385 |  20235 |  21126 |
| Andhra Pradesh            |  25904 |  26970 |  28082 |  29244 |
| Karnataka                 |  32401 |  33881 |  35430 |  37052 |
| Goa                       |    767 |    799 |    834 |    870 |
| Lakshadweep               |     36 |     39 |     42 |     45 |
| Kerala                    |  17858 |  18827 |  19892 |  21062 |
| Tamil Nadu                |  37118 |  38310 |  39537 |  40796 |
| Pondicherry               |    678 |    717 |    759 |    802 |
| Andaman & Nicobar Islands |    196 |    203 |    210 |    217 |
| Total                     | 641455 | 670541 | 701007 | 732921 |

## National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)

As on 30th September 2016

## Cardiac Care Units (CCU) established under NPCDCS

| SL. No.     | State            |   CCU |
|-------------|------------------|-------|
| 1           | Andhra Pradesh   |     7 |
| 2           | Assam            |     5 |
| 3           | Bihar            |     3 |
| 4           | Chhattisgarh     |     1 |
| 5           | Goa              |     1 |
| 6           | Gujarat          |     5 |
| 7           | Haryana          |     4 |
| 8           | Himachal Pradesh |     2 |
| 9           | Jammu            |     2 |
| 10          | Kashmir          |     4 |
| 10          | Jharkhand        |     1 |
| 11          | Karnataka        |     5 |
| 12          | Kerala           |     4 |
| 13          | Madhya Pradesh   |     5 |
| 14          | Maharashtra      |    10 |
| 15          | Meghalaya        |     1 |
| 16          | Mizoram          |     2 |
| 17          | Nagaland         |     1 |
| 18          | Odisha           |     5 |
| 19          | Punjab           |     2 |
| 20          | Rajasthan        |     7 |
| 21          | Sikkim           |     2 |
| 22          | Tamil Nadu       |    15 |
| 23          | West Bengal      |     8 |
| 24          | Puducherry       |     1 |
| Grand Total | Grand Total      |   103 |