IRDAI issues guidelines on including peritoneal dialysis in health insurance policies

Until now, only conventional haemodialysis was covered under insurance policies

To address the increasing number of kidney failure patients in India, the Insurance Regulatory Development Authority of India (IRDAI) has released 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 on a monthly basis 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 only hemodialysis to aid the kidney failure population in the country. This will also enable both doctors and patients 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.

 “IRDAI’s decision of including Peritoneal Dialysis under insurance policies will eliminate the exorbitant expenditure associated with carrying dialysis at home as until now, only the conventional haemodialysis was covered under insurance policy. Around 63 million people on dialysis are pushed in debt due to expenditure related to health. At times patients miss their dialysis as they fear incurring out-of-pocket expenses. It is critical to understand that every dialysis session matters when a person is suffering from kidney failure. Patients should not be given a single reason to withdraw from the treatment at any point” Now doctors can prescribe the best therapy method to ensure patients receive the best treatment without compromising on quality of life,” opined Dr Sunil Prakash, Director & Head, Nephrology and Renal Transplant Service, BLK Superspeciality Hospital, New Delhi.

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 requires a patient to visit a hospital 3-4 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 pertaining to accessibility and quality healthcare in the country to reach even the vulnerable and the marginalised sections of the society.