Aditi Tandon
Courtesy THE TRIBUNE
Tribune News Service
New Delhi, February 14
The government today capped the prices of coronary stents at levels that will reduce their market rates by 80 per cent, bringing relief to heart patients who undergo implantation for clogged arteries.
The National Pharmaceutical Pricing Authority (NPPA), the Centre's drug pricing wing, fixed the ceiling price of bare metal stents (BMS) at Rs 7,260 against their previous MRP of Rs 45,000. Drug eluting stents (DES) and biodegradable stents cannot be sold at more than Rs 29,600 as against their previous MRP range of Rs 80,000 to Rs 1,21,000.
These caps mark 83.8 per cent price reduction in the BMS category and 75.53 per cent reduction for DES stents which release drugs into arteries long after the implant. DES is preferred over BMS as the latter are known to cause a higher recurrence rate of blocked arteries, thereby raising the risk of heart attacks.
NPPA's notification says stent price reduction will apply immediately and will cover stents in trade channels. Stent manufacturers will have to revise prices downward and hospitals billing stents directly to patients will have to reimburse overcharged amounts. The NPPA stent pricing will apply for a year initially.
Capped prices are, however, exclusive of VAT and other taxes. Since most states have 5 per cent VAT on stents, BMS stents will cost around Rs 7,623 per unit and DES around Rs 31,080.
NPPA’s notification follows the Health Ministry’s 2016 move to include coronary stents in the National List of Essential Medicines which automatically come under drug pricing.
Cardiologists, however, have concerns. Dr Purshottam Lal, Indian cardiologist who introduced stents 26 years ago, said, “A reduction in prices will help patients, but putting all stents in one category is unacceptable and will compromise their quality. Latest generation US FDA-approved stents will stop coming to India and patients who can afford these will go abroad for implants. NPPA should have graded the prices based on the quality and efficacy of stents.”
Lal, a former member of BoG of the MCI and also member of the first government panel on medical devices formed under then Health Minister Anbumani Ramadoss, said “In the US, 12 lakh stents are implanted annually and there are just three approved manufacturers. In India, four lakh stents are implanted, but there are 60 approved stent makers! Our drug controller lacks the infrastructure to regulate stent firms. I have firsthand experience of how things work,” he said. Punjab-based Dr GS Grewal said, “The price capping is historic though I wish it was permanent and not for just one year.”