Margin on Imported Knee Implant for Revision Surgery is 4.5x Cost: NPPA
Price of imported device is ₹ 91,967 to .₹ 1.99L, but revision procedure can cost a patient up to .₹ 9L, it says
New Delhi: The average trade margin on an imported knee implant used in patients with a failed previous procedure is more than four-and-a-half times its cost, data released on Wednesday by India’s drug pricing watchdog showed. According to the information, an imported device used in such revision surgeries can cost a patient as much as ₹ 9 lakh.
Global knee implant makers said this data may be inaccurate. The new information comes a few days after National Pharmaceutical Pricing Authority (NPPA) data showed the average trade margin on total knee implants at more than 300%, or four times the actual cost. The margin on imported implants used in revision surgeries, according to the latest data, is 369%. The average margin for importers of total knee systems used in revision procedures was 56%, while for distributors and hospitals, it was 200%, according to the data.
The cost on the joint components of a total knee system used in a revision procedure ranges between ₹ 4.35
lakh and ₹ 9 lakh. The import price can be ₹ 91,967 to ₹ 1.99 lakh, it said.
Distributors and hospitals on average mark up the prices of components like the femoral, tibial plate, insert and patella by 89-139%, the data showed.
“We have just seen the office memorandum relating to revision knee implant system, which has been issued by NPPA today. As an initial reaction: this demonstrates a lack of understanding of the revision knee system and the data seems inaccurate,” said the Medical Technology Association of India (MTaI), a lobby group for mul- NPPA says revision implants can cost as much as
Implants used in a revision knee surgery are completely different in design and the instrument set used by surgeons in this type of procedure is also different and more expensive than those used in primary knee implant procedures, according to an industry executive, who spoke on condition of anonymity.
Around three crore patients in India are estimated to be suffering from osteoarthritis currently, and only around 1.2 lakh go in for knee implants, the executive said. NPPA chairman Bhupendra Singh could not be reached for comment. It is not confirmed whether NPPA has released its latest data because it intends to cap the prices of knee implants and revision knee implants. The regulator had earlier this year asked companies to submit trade data on 19 classes of medical devices, including knee and hip implants, catheters, heart valves and eye lenses used in cataract surgeries.
At the same time, the health ministry is considering a proposal by the Central Drugs Standard Control Organisation to set up a committee to decide whether heart valves, intraocular lenses and orthopaedic implants be brought under the National List of Essential Medicines — a move that would allow the Department of Pharmaceuticals to notify them for price control.