Coro­nary Stents Set to be Cheaper by About .₹ 1 Lakh

Af­ter Tuesday’s price cap or­der, stents may cost in the range of .₹ 7,623 to .₹ 31,080

The Economic Times - - Companies: Pursuit Of Profit - Our Bureau

New Delhi: Heart pa­tients who re­quire coro­nary stents stand to get an av­er­age ben­e­fit of close to ₹ 1 lakh af­ter the coun­try’s drug pric­ing author­ity on Tuesday fixed a cap on stent prices, chem­i­cals and fer­tilis­ers min­is­ter Ananth Ku­mar has said. The move, which has upset do­mes­tic and multi­na­tional stent mak­ers alike, would en­cour­age com­pa­nies to make in In­dia to cut costs, the min­is­ter said.

Ear­lier in the day, Na­tional Phar­ma­ceu­ti­cal Pric­ing Author­ity (NPPA) slashed prices of coro­nary stents by over 75%, cap­ping the ceil­ing prices of drug elut­ing stents (DES) and biore­sorbable vas­cu­lar scaf­folds (BVS) at ₹ 29,600, and bare metal stents (BMS) at ₹ 7,260. In­clud­ing VAT, these stents are ex­pected to cost ₹ 31,080 and ₹ 7,623, re­spec­tively.

A coro­nary stent is a wire mesh tube used to clear block­ages in the ar­ter­ies and pre­vent heart at­tacks.

The ceil­ing prices no­ti­fied by the body are ap­pli­ca­ble to man­u­fac­tur­ers, distrib­u­tors and hos­pi­tals billing pa­tients for stents ef­fec­tive February 14, ac­cord­ing to NPPA’s no­ti­fi­ca­tion. It has also made it manda­tory for hos­pi­tals to bill cardiac stents sep­a­rately from the pro­ce­dure pack­age billed to pa­tients.

The reg­u­la­tor claimed that “huge” and “un­eth­i­cal” markups were charged on the de­vices through­out the sup­ply chain.

The min­is­ter claimed these stents “were be­ing sold with a 400% profit mar­gin”. Over 90% of stents im­planted in In­dia are DES, sold at an av­er­age price of ₹ 1.21 lakh, while BMS are sold at an av­er­age price of ₹ 45,095, he said.

Ku­mar claimed that the price caps have been fixed af­ter tak­ing into ac­count man­u­fac­tur­ing, R&D and mar­ket­ing costs as well as “eth­i­cal” profit.

The Stent Busi­ness

were sold with a

400%

profit mar­gin

Drug elut­ing 29,600

Stent man­u­fac­tur­ers, how­ever, said the move will kill the in­dus­try by dis­cour­ag­ing com­pa­nies to in­no­vate and bring in new tech­nolo­gies into this space.

The num­ber of stent pro­ce­dures in In­dia has tre­bled over the last five years and close to five lakh stents were im­planted in over 3.5 lakh pro­ce­dures in 2015, ac­cord­ing to Na­tional In­ter­ven­tional Coun­cil (NIC) reg­istry.Global com­pa­nies said club­bing all DES and BVS into one cat­e­gory dis­re­gards tech­no­log­i­cal dif­fer­ences among these stents and would de­ter stent mak­ers from launch­ing fur­ther in­no­va­tions in this space.

“The sin­gu­lar fo­cus on con­trol­ling ceil­ing price of stents with­out at­tempt­ing to ad­dress the larger picture and cor­rect in­ef­fi­cien­cies in the health­care ecosys­tem will not achieve its stated ben­e­fit in the long run,” said a spokesper­son from Ad­vaMed—a lobby group for multi­na­tional stent mak­ers like Ab­bott In­dia, Medtronic and Bos­ton Sci­en­tific.

The per­son also warned that lack of ac­cess to the lat­est gen­er­a­tion of stents may force pa­tients to go to other coun­tries for treat­ment.

There is a clear dif­fer­ence be­tween dif­fer­ent types of stents and their ben­e­fits and the gov­ern­ment should have taken this cat­e­gori­sa­tion into con­sid­er­a­tion, the Ad­vaMed spokesper­son said.

NPPA said clin­i­cal su­pe­ri­or­ity of most new gen­er­a­tion stents is not proven.Do­mes­tic stent man­u­fac­tur­ers said the ceil­ing prices of stents have been fixed too low for In­dian com­pa­nies to step in and meet the grow­ing de­mand. “This move may ap­pear pop­ulist but will ul­ti­mately kill the ecosys­tem where In­dian man­u­fac­tur­ers shall keep man­u­fac­tur­ing low end tech­nolo­gies,” said Gurmeet Chugh, man­ag­ing di­rec­tor of Trans­lu­mina Ther­a­peu­tics, an In­dian stent com­pany.

He added that the pric­ing reg­u­la­tion has not taken into ac­count.

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