Health
Doctors and medical device manufacturers say that capping stent prices discourages new and emerging products from being marketed in India.

The National Pharmaceutical Pricing Authority (NPPA) will soon meet various stakeholders to discuss the revision of price capping on stents. According to sources, differential pricing of stents would be one of the main changes sought by the stakeholders. 

The NPPA is all set to meet several stakeholders, including doctors and representatives from the medical devices manufacturing sector, on February 5. The meeting is likely to see participation from AdvaMed, MTal, AIMED, ISMA, AMCCI, AMCHAM, ASSOCHAM, CM, FICCI, PHDCC and I, ADEH, AIDAN, CAI, ORF, Oxfam India, multinational and Indian stent manufacturing companies, besides the PHFI. 

According to a medical representative from one of the stent manufacturing companies, they have sought that the union government introduce various slabs against which the stents are categorised, as against just two slabs currently.

It may be recollected that the union government had capped the prices of stents after classifying them under two categories: the bare metal stents and the drug eluting stents. This was followed by a notification from the NPPA.

Dr CN Manjunath, director, Jayadeva Institute of Cardiovascular Sciences and Research, expressed the view that having differential pricing for stents would pave the way for new generation stents to be imported into the country. He said that with the present capping, the number of third generation stents in the market have gone down in numbers.

While the price of the simple bare metal stents was capped at Rs 7,260 per unit, that of the drug eluting stent and biodegradable stents were fixed at Rs 29,600 per unit. Doctors and medical device manufacturers have in the past said that this would become a challenge as new stents could not be marketed in India. They also voiced concern that it would mean lesser room for products emerging out of the latest research to reach India.

Dr KK Aggarwal, president, Heart Care Foundation of India, said that they would seek that the NPPA introduce no such changes that would reduce the benefits that patients are getting at present.

 “I am seeking that, just like in the case of drugs, the stents also be classified under two broad categories under which different varieties are included. One of these categories would be the ones capped while the other would not be subject to any price ceiling and can be negotiated with the government,” he said.

 While capping of stent prices is itself a challenge, the Advanced Medical Technology Association (AdvaMed) said in a statement: “Alternatives to mechanisms such as price control should be explored, that facilitate differential pricing for innovative medical technologies. This will pave way for improved healthcare access in the country, making the healthcare ecosystem stronger.”

AdvaMed, one of the key players that is also taking part in the meet with NPPA, believes, “Singular focus on controlling price of devices without attempting to address the larger picture will not improve patient access. We need to consider alternatives to price control such as trade margin rationalisation and more scientific approaches that facilitate differential pricing for innovative medical technologies.

“Achieving UHC is a long-term vision that could potentially be addressed through thoughtful healthcare and pricing policies which benefit both patients and providers. In view of larger patients’ interest, AdvaMed takes cognizance of the draft report by the government’s “Committee on High Trade Margins in the Sale of Drugs” that recommends capping of margins from “Price to first level in the trade or Price to Distributor till MRP” to 50%.”