Staff Correspondent:

Bangladesh has made unprecedented progress over the past few decades in treating adult heart disease. Surgeons have achieved success in cardiac operations and patients as a result rely less on treatment abroad. Progress in treating children’s heart conditions, however, has lagged. Treatment costs remain high and the country faces a shortage of paediatric cardiologists. No measures have lowered the cost of stents used for children despite several revisions in adult heart stent prices. As a result, expensive treatment for paediatric heart diseases leaves many children without care.

Manufacturers show little interest in exporting paediatric stents to Bangladesh because demand is low and prices are out of reach for most families, industry sources say. In many cases, families with means seek treatment abroad while marginalised households cannot afford care. This often leaves treatment incomplete, worsening conditions and reducing chances of recovery.

A cardiologist, speaking on condition of anonymity, told journalists, “Critical blood vessels in children’s hearts, especially coronary arteries, sometimes narrow or become blocked, requiring stents. This can result from congenital defects, surgical complications, or Kawasaki disease. Stents restore normal blood flow. The types used for children are not readily available in the country and are comparatively expensive. Adult stents are available in various sizes and models. But for children, we need smaller stents tailored to specific conditions. Some families cannot afford these costs. Wealthier families travel abroad for treatment. Many parents even sell assets to pay for their child’s treatment.”

The number of children with heart disease is rising. According to the Kids Heart Foundation, a charity working on paediatric cardiac care, Bangladesh sees around 8,000 births daily. At least 200 of these children are born with heart defects, translating to roughly 73,000 newborns with heart disease each year. Currently, roughly 500,000 children in the country live with heart conditions.

Rural areas have more children under five with heart disease than urban areas, according to the Bangladesh Bureau of Statistics’ Health and Morbidity Status Survey (HMSS) 2025. The report, published on November 30, finds 238 of every 1,000 infants with heart disease live in cities, compared with 226 per 1,000 in rural areas. Between ages one and four, 166 per 1,000 children in villages suffer from heart and other diseases, slightly higher than 159 per 1,000 in cities. The report says one in 1,000 children was born with a heart condition in the 90 days before the survey.

Only one company this year has registered to import equipment for paediatric cardiac care: Rahman Medical Service. Its owner, Md Mizanur Rahman, told journalists, “Demand for the specific stents used for children is very low in Bangladesh. We need only eight to ten per year. Exporters avoid appointing local dealers because volumes are so small. High prices also discourage traders from taking the risk. Our market is very small. We usually import a few stents alongside other medical products. Sometimes we bring them from India, where the market is larger. There, companies appoint dealers. With higher demand, treatment costs are lower in that country.”

Bangladesh imports adult coronary stents from three companies: Medtronic, Boston Scientific, and Abbott. On October 1, government reduced prices for ten stent types from these firms. Medtronic’s Resolute Onyx stent dropped from BDT 140,500 to BDT 90,000, and the Onyx Trucor from BDT 72,000 to BDT 50,000. Boston Scientific’s Promus ELITE now costs BDT 72,000 instead of 79,000, Promus PREMIER BDT 70,000 instead of 73,000, Synergy BDT 90,000 instead of 117,000, SYNERGY SHIELD BDT 90,000 instead of 120,000, and SYNERGY XD BDT 100,000 instead of 188,000. Abbott’s XIENCE Prime fell from BDT 66,600 to 50,000, while XIENCE Alpine and XIENCE Sierra dropped from BDT 140,500 and 140,000 to BDT 90,000.

Dr Md Akter Hossain, director of the Directorate General of Drug Administration, told journalists, “No company imports heart stents or rings specifically for children. That’s because prices exceed the purchasing power of most parents. One company has registered to import paediatric stents this year. Although the price is not yet fixed, we expect it to cost around BDT 400,000–500,000. Few families can afford that. If importers wish, the directorate will fully support bringing in other equipment for treating children’s heart disease.”