Kidneys are one of the most vital and complex organs of human body. The Kidneys act as a filtration system that helps the body to get rid of toxins and waste products and ensures that required fluid levels are maintained for smooth functioning of the body organs. So, it is quite understandable that if it stops working, it can prove to be extremely dangerous for the system. If the kidneys fail, a person has to go either for transplantation or dialysis in order to stay alive.
Every year more than 2,00,000 people suffer get added to the pool of patients requiring dialysis in India. The number of patients suffering from End Stage Renal Disease (ESRD) is increasing at a rapid pace across the world thus increasing the demand of Dialysis services. In 2020, India alone was estimated to have around 1.3 million ESRD patients and it is rising at a rapid pace. Access to dialysis remains poor since only around 10 per cent of CKD patients can avail of dialysis services successfully in India mainly because of two factors- unavailability and unaffordability.
Kidney Dialysis is lifesaving and quite a lengthy process. Generally, a patient who is on dialysis requires around 13 sessions in a month till the time they can get a transplant. This means that the dialysis treatment can go on for several months in fact even years. The average rate of dialysis per session is around Rs. 1500 to Rs. 3000 in India which amounts to around Rs. 15000 to Rs. 40,000 per month which can upset the monthly budgets of even middle-class households.
Currently, dialysis services are exempted from GST but the service operators do have to pay GST on their input costs. This includes GST on dialysis machines, consumables and rent etc. Since there is no GST refund on input costs these costs are directly passed onto the paying customer. This directly translates into an additional burden of Rs. 2000- Rs. 3000 for the paying customer. Recently in the central budget several items such as dialyzers etc. have seen a hike in import duties further exacerbating this situation. Any increase in input costs often gets directly passed onto the customer.
Looking at the essential nature of dialysis services for survival a solution is needed. While it is important to encourage Make in India goods for dialysis to bring down the costs of dialysis products it is also important to ensure that the paying patients directly benefits from those initiatives. It will be beneficial for the ecosystem as a whole if the dialysis service input costs are either exempted or dialysis service operators be allowed to claim an input refund like what happens in other industries such as with exporters. This will ensure that the input costs of some of the items come down and it will directly benefit the patients.