THIRUVANANTHAPURAM: Government health schemes such as Medisep and Karunya Arogya Suraksha Padhathi (KASP) will become unviable if a nationwide ban on reusing single-use medical devices is enforced strictly, doctors have warned. Keralam, with its large population of dialysis and heart patients, stands to be among the worst hit, they pointed out.
The ban, imposed by the directorate general of health services (DGHS) across public and private hospitals, has triggered strong opposition over escalating treatment costs and operational viability. Doctors argued that regulated reuse of select devices, under scientifically validated protocols, could help keep critical procedures affordable without compromising patient safety.
According to them, barring the reuse of items such as guidewires, balloons and catheters in cardiology, nephrology, oncology, cardiothoracic and vascular surgery, and neurosurgery would push costs beyond the reach of ordinary patients and the current health insurance schemes could not cover it.
Dr R C Sreekumar, president of the Vascular Society of India, said dialysis is already unaffordable for many in the state, and costs would double again, leading to denial of treatment. Around half of the patients, he claimed, cannot afford dialysis even now. “A good-quality wire can be used five or six times and a good balloon three to four times. Many hospitals already bill around 70% of the cost for the first case and 30% for the second, while some don’t bill the second case at all. The ban would hurt the middle and lower middle classes the most.” Dr Sreekumar said.
Western countries, he noted, permit reuse under mandated processes, inclusive of separate registers, labelling and completed sterilisation, and even the National Accreditation Board for Hospitals and Healthcare Providers (NABH) does not insist on single use but on proper reuse. Several medical bodies have taken up the matter with the Centre.
Public health expert Rajeev Sadanandan, former additional chief secretary, called the Union government’s decision impractical, saying it would make state schemes unviable and could shut down cath labs and dialysis units.
The concern is acute in Keralam, where dialysis patient numbers rose from 43,740 in 2020 to 2,18,410 in 2024, a more than fourfold jump. T T Basheer, chairperson of the Pratheeksha Organ Recipients Family Association Charitable Trust, which supports poor patients with dialysis, medicines and transplant assistance, voiced concern about the impact on the poor. Studies suggest around 8,000 kidney patients per 10 lakh people, over 80% of them from economically weaker backgrounds.
A cardiologists meeting at the annual conference of the Cardiological Society of India (CSI), Kerala Chapter, on November 8 sought a review of the restrictions. Organising chairman Dr Prathap Kumar N said select catheters, guidewires and other equipment could be examined for safe reprocessing under scientifically validated protocols, which could make advanced angioplasty more affordable. “Patient safety must remain paramount,” he said, stressing on validated sterilisation, functional testing and strict regulatory oversight.
He called for wider consultation among specialists, infection-control experts and regulators to frame an evidence-based policy.
Directives to states
DGHS banned the reuse of single-use medical devices in all hospitals.
The order targets cardiology, neurosurgery, nephrology, cardiothoracic and vascular surgery, and oncology
Authorities cited infection risks, device failures, and cost padding
State controllers must conduct strict inspections and enforce compliance
Doctors oppose the ban, warning it spikes patient treatment costs
