Knee implant firms bat for self-regulation of prices

The National Pharmaceutical Pricing Authority’s (NPPA’s) focus on orthopaedic knee implants has made the industry jittery.

Multinational firms like Johnson & Johnson, Zimmer Biomet, Smith & Nephew, and Vygon that manufacture these implants are willing to work towards self-regulating prices, instead of letting the government decide them.

Last time the NPPA had stepped in to bring down the prices of cardiac stents. The way in which the Authority priced the stents shook the entire industry. Sushobhan Dasgupta, managing director, Johnson & Johnson India, says, “The same implants are sold in the European market thrice the MRP at which they are sold in India.” The manufacturers of knee implants have told the NPPA that they would submit a proposal for self-regulation.

After capping the prices of cardiac stents — and proving that their prices were sky-high because of huge margins at various levels of the supply chain — the NPPA has started monitoring the prices of other medical devices as well.

A recent report on the margins in the supply chain for various orthopaedic knee implants says the average margin on a full set of orthopaedic implants seems to be 313 per cent. Total trade margin is essentially the maximum retail price (MRP) minus the import price. In this, the distributor and the hospital get a margin of 335 per cent; the company importing these implants earns a margin of 76 per cent.

The NPPA put orthopaedic implants into four categories — femoral, tibial plate, insert and patella. Total margin in the case of femoral implants is 287 per cent. The margins for tibial plate and patella are on the same lines. For the former, the importer gets 67 per cent, while the distributor and the hospital get 137 per cent. Tibial plants can cost a patient anywhere between ~20,000 and ~122,336.