PET-CT scans brought under Mahatma Phule and PM Jan Arogya schemes for cancer patients

The state government has decided to cover PET-CT scans, an expensive test, under the Mahatma Jyotirao Phule Jan Arogya Yojana and the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana. The test is needed to diagnose cancer accurately, to establish the stage of the disease and to check how well treatment is working. It has been included for 13 selected types of cancer, either as a standalone or as a regular primary diagnostic procedure. This will reduce the out-of-pocket expense cancer patients have to bear for the costly test.

The Public Health Department has issued a government resolution on the matter. Under it, the PET-CT scan has been included as an "additional diagnostic procedure" in 63 cancer treatment packages. It has also been approved as a "standalone diagnostic procedure" for 13 types of cancer treatment.

Because of the cost, patients often postpone or avoid PET-CT. This delays understanding the nature of the disease and planning treatment at the right time. In view of this, the public and hospitals linked to the scheme had been demanding that PET-CT be included in it.

Following this demand, a separate study committee was appointed on the instructions of Public Health and Family Welfare Minister Prakash Abitkar. The government took the decision after considering the committee's recommendations. The health minister said this would make cancer treatment easier and more timely, and would help reduce the financial burden of the costly test on patients.

The PET-CT scan has been taken up as an add-on diagnostic procedure in 63 packages related to cancer treatment. Earlier, the facility was available in 44 packages. The new decision has increased the number of such add-on packages, which will make the diagnostic procedures needed for treatment available on a larger scale. Approval has also been given to include the PET-CT scan as a standalone or regular (primary) diagnostic procedure for 13 selected types of cancer treatment found to be clinically beneficial.

The rates for PET-CT are Rs 20,400 for the whole body, Rs 14,650 for the brain, Rs 15,000 for Gallium-68 and Rs 9,400 for cardiac scans. Hospitals will have to follow strictly the conditions laid down in the government resolution.

For a PET-CT scan, a relevant specialist doctor must certify the medical necessity of the test. The accredited hospital must also have the required technical facilities, equipment and qualified staff, as well as its own in-house PET-CT centre. Prior approval before the test and submission of the required medical documents will also be mandatory. To ensure effective implementation, the State Health Assurance Society has been directed to take steps to make the necessary changes in the National Health Authority's TMS 2.0 system.

The health minister expressed confidence that providing PET-CT facilities to needy citizens under both schemes would help in accurate and timely diagnosis of cancer patients and in timely planning of treatment. He said including the test in the expanded Mahatma Phule and Jan Arogya schemes would be an important step in the state government's fight against cancer.