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    At last, India caps prices of stents

    Synopsis

    The number of stent procedures in India trebled over the last five years, according to the National Interventional Council (NIC) registry 2015.

    ET Bureau
    NEW DELHI: Prices of stents--tiny wire mesh tubes used widely by surgeons to unclog arteries and prevent heart attacks--are set to get cheaper. The government has included two categories of stents in the National List of Essential Medicines (NLEM), a step expected to lead to a steep drop in the prices of the device.

    The health ministry added drug-eluting Stents (DES) and bare metal stents (BMS) to the NLEM 2015 list in a notification released late on Tuesday. The decision was based on recommendations of a sub-committee of expert cardiologists that examined whether coronary stents should be included in the NLEM and will be implemented immediately.

    The National Pharmaceutical Pricing Authority—India's drug pricing watchdog—is expected to notify the new reset price for these stents after due deliberations. Most of the stents used in India are sold by multinational corporations and the decision is expected to bring relief to patients burdened by spiraling costs of stents.

    The number of stent procedures in India trebled over the last five years, according to the National Interventional Council (NIC) registry 2015. Close to five lakh stents were implanted in 2015.

    Prices of drug eluting stents, used in 95% cases, range between Rs 23,625 to Rs 1,50,000 in private hospitals. In government establishments, the same stent costs only up to Rs 60,000.

    According to the sub-committee, coronary artery disease has become a public health problem in India and there is an “enormous need” for procedures requiring stent implantations. At the same time, it added that the cost and quality of components other than stents needed regulation to reduce the overall cost of the procedures for patients.

    Coronary stents currently account for 25-40% of total procedure costs in private hospitals and 70-90% in government hospitals, said the sub-committee.

    “Once items get included in the NLEM, the natural consequence is that the price will come down,” a government official told ET, noting that allegations of high profit margins on stents can be curbed with the latest move. "Even private hospitals will not be in a position to charge beyond what is notified by the NPPA eventually,” the official added.

    The move has received mixed reviews from both global stent makers supplying to India and indigenous producers.

    The Confederation of Indian Industry has strongly criticised the move and said it contradicted the government's recent efforts to create a separate and "appropriate" law for medical devices. Price caps on such devices would not create a conducive environment for FDI, realising Make in India or investment in research and development, according to Himanshu Baid, Chairman, CII Medical Technology Division.

    “(The move) is detrimental to the nascent medical device industry committed to improve access to quality healthcare and medical devices in India. The quality of products and clinical outcomes do not seem to have been given a priority,” said the Advanced Medical Technology Association (AdvaMed), the lobby group for global medical device manufacturers like Abbott and Medtronic. According to a recent report by IMS Health on behalf of the group, prices of cardiac stents actually dropped in the last three years, but did not affect the overall cost of the procedure charged to patients.

    In contrast, the Association of Indian Medical Device Industry (AiMeD), a lobby group representing indigenous medical device makers, said the move may improve opportunities for Indian stent makers.

    Currently valued at Rs1,400 crore, India’s stent industry is heavily import-based, which has also added to the higher procedure costs here, according to AiMeD forum coordinator Rajiv Nath.



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