IRDAI issues insurance policy guidelines on peritoneal dialysis

A large number of patients are likely to be benefited

The Insurance Regulatory Development Authority of India (IRDAI) has recently released the much-awaited policy guidelines to include Peritoneal Dialysis (PD) in the ambit of private insurance coverage. According to the guidelines, patients taking treatment of PD can make reimbursement claims every month through an approved pre-authorisation procedure. The provisions of the new guidelines have been in effect from October 1, 2020. 

According to Pradhan Mantri National Dialysis Programme (PMNDP), in India, 2.2 lakh people get affected by ESKD who are on dialysis or transplant for treatment. Dialysis becomes the only option for these patients who are waiting for the transplant. There is a demand of 3.4 crore dialysis with only 4950 dialysis centres approximately in India.

The recent development allows kidney patients to avail the benefits of the home-based and cost-effective PD therapy which can enable both patients and nephrologists to put patients on PD rather than the only hemodialysis to aid the kidney failure population in the country. This will also enable both doctors and patients to analyse and choose their choice of dialysis treatment based on the patient’s lifestyle. The insurance companies’ long-awaited approval of PD’s inclusion in health insurance plans also comes at an opportune time when the public is cautioned to stay indoors owing to the COVID-19 pandemic and avoid hospital-acquired infections in a healthcare setting. 

Dr Mahesh Eswarappa, Professor and Head Department of Nephrology, MS Ramaiah Medical College, Bangalore, commented, “Insurance policies covering PD under their ambit will save millions of lives residing in remote areas of India. Dialysis demand is growing at a rate of 31 per cent in the country. Even though most of the patients suffering from end-stage renal disease start dialysis, about two-third of them withdraw due to financial barrier. Earlier IRDAI had recognised the only haemodialysis under insurance schemes but now with PD’s inclusion in insurance policies, we will be able to look at both the treatments at par in terms of coverage. The country has seen less adoption of PD through the years due to high costs. As we are covering it under insurance schemes, treatment through PD should increase now”.

Earlier, only haemodialysis was covered by health insurance policies but now, the latest revisions in the health coverage can be proven to be more comprehensive and efficient for the policyholders. PD allows patients to move freely at home and maintain a flexible lifestyle. One can perform the therapy as per convenience without having to worry about visiting a hospital, unlike the conventional haemodialysis which demands a patient to visit a hospital three to four times a week. PD saves patients multiple clinic visits and is generally more cost-effective and scalable as it can be carried out at home and has lower infrastructural requirements.

Despite PD’s potential advantages, its penetration in the country is very poor. According to a report, there were just about 8,500 patients on PD in India in 2019. However, with effective reforms in our healthcare system, such progressive decisions can address challenges on accessibility and quality healthcare in the country to reach even the vulnerable and the marginalised sections of the society.