PUNE: The Maharashtra government has allowed an “unlimited package” for the treatment of patients with mucormycosis, mainly a post-Covid fungal complication.
The package covers cost of expensive anti-fungal medications including liposomal amphotericin B injections. The scheme extends to everyone, irrespective of financial ability.
Mucormycosis treatment is hugely expensive and can last weeks or even months. The cost of injections (liposomal amphotericin B) alone can be as high as Rs 25,000 to Rs 60,000 per day. Doctors have reported instances of families mortgaging belongings to pay for patient care.
The government has put together various treatment components — medical as well as surgical — under the state-sponsored health scheme, Mahatma Phule Jan Arogya Yojana (MPJAY). It has also created a corpus of Rs 30 crore if treatment costs for certain patients at an advanced stage of the disease run into lakhs, crossing the limits fixed under the health cover.
Nearly 80 big multispecialty hospitals (private and government-run), including 56 medical colleges in the state, are set to be designated as mucormycosis care hubs under the scheme. The state currently has at least 2,000 patients with mucormycosis.
Sudhakar Shinde, CEO of MPJAY, said, “The scheme will offer free treatment to each and every patient of mucormycosis in Maharashtra at empanelled public and private multispecialty hospitals and attached medical colleges. There are no riders; every patient who holds a ration card can avail of this benefit.”
The state Covid task force has been roped in to pick medical facilities that can be designated as mucormycosis care hubs. “A list of 75 to 80 big private and public hospitals, mainly medical colleges, is in the process of being finalized,” Shinde said.
The treatment includes medical management, repeated clearance (debridement) of affected sinus tissues, ICU stay and radical surgeries.
The scheme, however, is meant only for patients in whom the diagnosis of mucormycosis has been confirmed. It does not include suspect cases. "Unlike treatment, diagnosis of mucormycosis is not an expensive affair," Shinde added.
The scheme also covers expensive anti-fungal medications, including liposomal amphotericin B jabs. Procurement of this drug, however, has been a challenge because of short supply nationwide.
"The state government has floated a global tender to procure liposomal amphotericin B injections from other countries as the two major Indian manufacturers of the injection have very limited production capacity. We intend to provide the injections to the designated hospitals for free, where patients are availing treatment under the scheme," Shinde said.
T P Lahane, director of the Department of Medical Education and Research (DMER), the state's apex body overseeing hospitals attached to state-run medical colleges, said, "The state government has also created a social responsibility corpus of Rs 30 crore for mucormycosis patients who need prolonged hospital care, including advanced treatment and surgeries."
There are 56 medical colleges attached to hospitals in Maharashtra, including 19 state-run facilities. "Since these are teaching institutions, they have multispecialty experts available. The treatment of mucormycosis involves a multidisciplinary approach," Lahane said.
Sanjay Patil, chairman of the IMA's Hospital Board of India, Pune branch, said, "The free treatment scheme will certainly help many. Currently, many patients' relatives are mortgaging belongings or borrowing money to cover treatment expenses, which can run into lakhs."
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