PRELIMINARY SUMMARY OF FINDINGS OF THE CHR HANSEN

1
Action for increased accessibility of
incontinence care products in India Need for
rationalization of import duties on Urinary
Incontinence pads
Supporting Organisations The Indian Continence
Foundation
2
Urinary Incontinence Background Information
World Scenario

• Urinary Incontinence is a condition where
  involuntary loss of urine is a social or hygienic
  problem, and is objectionably demandable. It is a
  common disease that concerns highly vulnerable
  group mainly elderly men and women.
• The World Health Organization (WHO) has described
  incontinence as a problem that has serious
  implication for the well being of individuals
  both physical and psychological.
• Urinary Incontinence has been increasingly
  recognized as a significant problem for the past
  decade. It is common and potentially
  debilitating.
• Urinary Incontinence causes great distress to the
  patient attributed to loss of personal hygiene,
  social isolation and loss of self esteem. These
  factors cause embarrassment to admit to
  incontinence. Due to this around 1 of affected
  patients die premature deaths every year.
• Urinary Incontinence problems affect gt 250
  million people world wide and profoundly affect
  the quality of life of those who too often
  silently suffer from its life disrupting
  consequences.

3
Prevalence of Incontinence highest among
Geriatrics
Male
Female
85
85
80-84
80-84
75-79
75-79
70-74
70-74
65-69
65-69
60-64
60-64
55-60
55-60
50-54
50-54
45-49
45-49
40-44
40-44
35-39
35-39
30-34
30-34
20-29
20-29


-20
-20
0
10
20
30
40
50
0
10
20
30
40
50

• Incontinence, Abrams, Khoury Wein,
• summation of the 2001 WHO sponsored a
  conference, - 2nd Consultation on Incontinence.

• Prevalence of incontinence in male and female in
  the age above 50 is high. This is primarily due
  to diseases like Parkinson's, Long term diabetes,
  Multiple sclerosis and other neurological
  diseases.
• Geriatricians all over the world treat these
  patients.

4
Problems Associated with Urinary Incontinence -
Impacting Quality of Life

• Social isolation due to the embarrassment to
  disclose the disease due to the lack of awareness
  of Urinary Incontinence.
• Social isolation - fewer contacts with friends
  and relatives and loss of desire to work.
• Emotional disturbance causing distress and even
  leading to premature deaths.
• Sleep disturbance

5
Current Status of Urinary Incontinence in India

• According to WHO most research papers the
  prevalence rate of urinary incontinence is around
  8 in India. However this includes all kinds of
  incontinence mild, moderate and severe.
• Lack of awareness of urinary incontinence is
  causing to only nearly 30 33 of patients
  seeking consultation.
• In spite of the adoption of National Policy on
  older persons for implementation as a priority
  area of Government action, given the burgeoning
  number of the aged, the elderly with incontinence
  continue to be neglected by the healthcare
  system, and by society. As a a result the social
  burden of this neglect is going to be enormous.
• Heavy burden on medical professionals and Para
  medical staff engaged in the care of such persons
  due to the following
• Systems and tools required to evaluate the
  problem of urinary incontinence are few
• Pharmacologic agents used in treating urinary
  incontinence are in erratic supply.
• Continence aids are virtually unheard of in our
  country.
• These are available in Grey- Market exploiting
  the patients.

6
Urinary Incontinence Treatment and Cost
Involved

• Treatment Options Following devices can be used
  to manage incontinence
• Absorbent Pads Available in wide among of
  shapes sizes and degree of absorbing
• Bed protection pads
• Collection Devices Include penile sheath
  dribble pouch drip collectors etc.
• Catheters Tubing of latex or silicon material
• However except absorbent pads all other devices
  are cumbersome to use , cost more and have to
  handle with extensive care resulting in in other
  associated costs and problems.
• Typical Cost of Incontinence treatment in India
  at current duty structure
• The cost of a pad varies from Rs. 45 to Rs. 65.
  Assuming an average cost of Rs. 45 (MRP) for a
  pad and 2 3 pads usage per day amounts to the
  patient spending close to Rs. 100 a day. If the
  patient ahs to use this for a period of 3 months
  he is poorer by Rs. 9,000. The longer the usage
  the higher is the expenditure. It is a
  significant amount when equated to a per capita
  income of Rs. 20,000.
• It becomes virtually impossible for the average
  elderly Indians apart from the rich class to use
  these products which can provide substantial
  contribution to improved quality of life for
  sufferers

7
Import Duty on Incontinence Diapers vis-à-vis
Hearing Aids
The following shows disparity in Import duties
for products used by Geriatrics in India
Existing Import Duty Structure on Incontinence
Diapers
Incontinence aids can provide substantial
contribution to improved quality of life for
sufferers and improved economy for the health
care providers. Incontinence aids can facilitate
the care of the elderly in the same way as
hearing aids.
Exim Code Item Description Basic Duty () CVD () SAD () Total ()
481840 10 Baby and Clinical Diapers 25 Nil 4 30
Existing Import Duty Structure on Hearing Aids
Exim Code Item Description Basic Duty CVD () SAD () Total ()
9021 40 Hearing aids 5 0 0 5