Exactly one year after lowering the coronary stent price by as much as 85 per cent, the National Pharmaceutical Pricing Authority (NPPA) has done it again, this time marginally. According to the notification issued by the pricing authority, drug-eluting stents will be priced at Rs 27,890 and bare metal stents at Rs 7,660, excluding the goods and services tax (GST).
The authority has not broadened the categories of coronary stents, though there was industry demand for that. The order mentions only two categories of stents.
In a recent meeting with stakeholders, the NPPA had told multinational stent makes that the regulator would consider sub-categories for drug-eluting stents only if they could prove superiority of their next-generation stents. In fact, the government had set up a committee to assess if sub-categories of drug-eluting stents should be considered by the NPPA.
At several platforms, multinational stentmakers like Abbott, Boston Scientific, and Medtronic had been pushing for better prices for their next-generation stents. But the NPPA has not entertained their request to form categories. In fact, manufacturers including Abbott, Medtronic, and Boston Scientific decided to withdraw their stents after price control, Chinese stentmaker MicroPort entered India with its target-eluting stent after price capping.
While multinational firms have been upset with the way cap was imposed, domestic stent manufacturers felt the price made it unviable for them to sustain. At the time of discussions with the NPPA on revising stent price this year, domestic manufacturers argued for a higher ceiling price.
“The decision is disappointing. It will limit patient choice and the availability of innovative technologies in the market. The only saving grace in the order is the NPPA’s expression that it is open to receiving stakeholder views. Taking that in earnest, we will stay engaged,” said Pavan Choudary, director general, Medical Technology Association of India.
According to the NPPA, following the price cap on coronary stents, the share of domestic stentmakers has risen. Preliminary data suggests a 4 per cent shift in favour of domestic manufacturers.
Last year, on February 14, the pharma watchdog cut the price of coronary stents to Rs 29.600 from as high as Rs 200,000, a reduction of around 85 per cent. However, the price of another category of stent - bare metal stent - was capped at Rs 7,260. Trade margins were capped at 8 per cent along the complete supply chain as the NPPA observed unethical mark-up in fixing the maximum retail price by manufacturers. The NPPA used its extraordinary power of Para 19 of the Drug Price Control Order (DPCO) 2013 to cap the price of coronary stents. The NPPA had invoked the Section 3 (i) of the DPCO, restricting companies from bringing down manufacturing and import of stents to ensure there is no shortage of the device. Rajiv Nath, forum coordinator, Association of Indian Medical Device Industry, said, “We are happy with the NPPA’s new decision to continue with its directive on price cap by not falling to the lobby of multinational manufacturers.
Single category on drug-eluting stents is scientific and the continuation of the above stand gives confidence to the manufacturers. The manufacturers could have welcomed a higher pricing to accommodate inflation. But the government can be assured of support from manufacturers.”
First Published: Mon, February 12 2018. 22:36 IST