Shortage of Orthopaedic Implants: AIIMS Delhi to partner with Govt subsidiary HLL Lifecare

New Delhi: The premier institute, All India Institute of Medical Science (AIIMS) Delhi, has decided to sign a contract with HLL Lifecare, a central government subsidiary, to procure all orthopaedic implants via Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy depending on the patients needs and recommendation of the doctors. 

The decision, which was notified through an office memorandum, was reportedly taken to help patients availing emergency implant surgeries and to deal with the shortage of medical implants in the orthopaedic department.

Also Read:AIIMS Delhi decides to transfer vacant fellowship seats for 3 consecutive sessions to other departments

AMRIT is an initiative of the Ministry of Health and Family Welfare (MoHFW) selling more than 5200 drugs, implants, surgical disposables, and other consumables at average discounts of up to 60% of Maximum Retail Price (MRP). HLL Lifecare Limited is the government's subsidiary dealing with various forms of healthcare services across the country, of which AMRIT is also a part. They aim at providing an affordable pharmacy network across the nation, healthcare services outlets, vaccine security of the nation etc. AMRIT are outlets which are opened in partnership with Centre and state government medical institutions. 

AIIMS Director Dr M Srinivas issued an office memorandum that read, "It has been noted that there is no rate contract for procurement of orthopaedic implants at AIIMS. The matter has been discussed with faculty from the department of orthopaedics, and it is understood that as the needs of patients are varying (in terms of size, type, fresh / revision, etc.), it is not possible to plan the procurement in advance and indent needs to be raised patient wise."

The order directed the Medical Superintendent (MS) of the hospital to sign a contract with HLL by November 30 for acquiring orthopaedic implants, following which the contract would come into effect from January. The letter stated, "Accordingly, it has been decided that w.e.f. January 1, 2023, all orthopaedic implants at AIIMS shall be procured via AMRIT Pharmacy only as per the need of the patients and recommendation of the doctor concerned. Medical superintendent shall in consultation with Dept of Orthopaedics finalise the requirements of AIIMS New Delhi and enter into a necessary agreement with M/s HLL Lifecare Ltd by 30th November 2022."  

The AMRIT pharmacy would be provided the required space and facilities in the main hospital and Jai Prakash Narayan Apex Trauma Centre to help them to stock and supply the required implants to AIIMS. 

Dr Srinivas observed in the letter that institutions like PGIMER Chandigarh, Safdarjung Hospital, and AIIMS Rishikesh have been availing the AMRIT Pharmacy facilities to acquire orthopaedic implants according to the needs of patients and the recommendation of the doctor, reports the Indian Express. 

Days after the AIIMS administration issued a circular banning the entry of private pharmaceuticals agents into the campus, the orthopaedic surgeries started getting affected as most of the patients rely on these agents to acquire implants required for surgeries and AIIMS doesn't stock the medical implants. 

According to a media report in The New Indian Express, the decision was taken after private agents were banned entry to the hospital because of reports of these agents acting as middlemen between patients and hospitals to make a profit, which was earlier reported by the Medical Dialogues team. A senior official said, "The situation led to delay in planned orthopaedic surgeries which prompted the hospital to formally enter into a contract with HLL." However, the security officer has been reportedly directed to allow the entry of private agents on a temporary basis till the contract with HLL comes into place. 

A senior doctor associated with the hospital stated that this would help poor patients who come to the emergency for implant surgeries, adding that patients have been procuring orthopaedic implants from outside since AIIMS doesn't have that facility. The doctor said, "Nails and plates used in arthroplasty were not available in the hospital. The move will help patients if the implants are available in AMRIT Pharmacy." 

Another senior doctor observed that a third party would help in maintaining more transparency, adding, "Ideally, it should have been free of cost, and with the arrival of third parties, we will require more transparency. We will get to know more once an elaborate plan is laid out."