MUMBAI: KEM Hospital, Mumbai’s largest civic-run hospital, has been turning away patients with haemophilia, as it has run out of drugs to treat the condition. Among them was a young woman who couldn’t deliver her baby at the hospital, as it lacked Factor VII needed to arrest postpartum bleeding. The woman gave birth at Nanavati Hospital, a private hospital, on Thursday, after purchasing two vials of clotting factors, costing ₹46,000 each.
The crisis at KEM’s haemophilia department was triggered by a policy change, which saw the National Health Mission (NHM) halting funding to tertiary hospitals (Like KEM, those with medical colleges and other advanced facilities) in September last year. Since then, the central government has released funds exclusively for district hospitals, routed through state governments.
Ironically, even though the Maharashtra government recently procured 6,130 vials of extended half-life Factor VIII, the drug remains out of reach for the 980 haemophilia patients under KEM’s care. These include patients who receive Anti-Hemophilic Factor (AHF) regularly, for haemophilia and other coagulation disorders, as well as surgical and trauma care patients and pregnant women. KEM’s day care centre saw 15,438 patients in 2024.
The 6,130 vials, procured by the state for ₹4.49 crore, cost ₹7,339 each, compared to the exorbitant price in private hospitals. These vials will be distributed among 19 district hospitals across the state, including Thane, Pune, Satara and Kolhapur.
However, district hospitals lack designated haematologists and are not equipped to treat patients beyond the initial emergency dose. “None of these hospitals have doctors trained to treat haemophilia patients. After receiving factor treatment in a district hospital, there is no scope for continued treatment or monitoring complications. KEM is the only comprehensive treatment facility in the entire state,” said Jigar Kotecha, secretary of the Mumbai chapter of the Haemophilia Society, a non-profit.
More critically, these district centres cannot transfer the medication to KEM Hospital, thanks to the NHM’s policy shift, which marked tertiary medical colleges as “not recommended” for centrally funded AHF supplies.
After several requests from KEM’s dean Sangeeta Ravat, the Thane District Hospital wrote back on July 16, stating, “Since a large number of new patients are being registered at the District General Hospital, Thane, and a limited amount of Anti-Hemophilic Factors are being received from the state level, it will not be possible to continue providing these factors to KEM.”
The only recourse for KEM is to source AHF supplies through donations from NGOs and other organisations working with haemophilia patients. One patient, scheduled for knee surgery, procured the medication from a district hospital in Latur.
When the acute shortage of AHF medication at KEM Hospital was placed before the state health department, government authorities said it was the responsibility of the Brihanmumbai Municipal Corporation (BMC) to provide funds for the drugs, as it was a civic-run institution.
On January 3, joint director, National Health Mission in Mumbai, Dr Govind Patil Chaudhary, wrote to Dr Vipin Sharma, additional municipal commissioner (Health), BMC, requesting that the corporation provide funds and medicines to support haemophilia patients at KEM, as the hospital had been excluded from NHM eligibility.
“We want more state funding, like Gujarat, which has a ₹250-crore fund for 3,300 haemophilia patients, while we have none. We want the government to prioritise extended half-life factors over plasma-derived ones — they are more effective and cost-efficient — and most importantly, restock KEM with essential medication so we can receive life-saving care,” said another member of the Haemophilia Society.
Assistant municipal commissioner (health) Vipin Sharma and deputy municipal commissioner, Sharad Ughade, did not respond to phone calls or texts from HT.