National Pharmaceutical Pricing Authority’s (NPPA) focus on orthopaedic knee implants
has made the industry jittery. The multinational corporation like Johnson and Johnson, Zimmer Biomet, Smith and Nephew, Vygon that manufacture these implants
are willing to work towards self-regulating prices
instead of letting the government do it. Last time, the National Pharmaceutical Pricing Authority (NPPA) stepped in was to bring down prices
of cardiac stents. The way in which the NPPA
priced stents shook the entire industry.
The Medical Technology Association of India (MTAI) met has proposed to form a proposal for making medical devices more affordable. Sushobhan Dasgupta, managing director, Johnson and Johnson India said," Price the same implants
are sold in the European market thrice the MRP at which they are sold in India." These makers of knee implants
have told the NPPA
that they will submit a proposal for self-regulation.
After capping the prices
of cardiac stents and proving that huge margins at various levels of the supply chains are why the prices
of stents were sky high, the NPPA
has started monitoring the prices
of other medical devices as well.
A recent report is on the margins in the supply chain for various orthopaedic knee implants
said that the average margin on a full set of orthopaedic implants
seems to be 313%. The total trade margin is essentially the maximum retail price (MRP) minus the import price. In this, distributor and hospital get a margin of 335%; the company importing these implants
earns a margin of 76%.
put orthopaedic implants
into four categories — femoral, tibial plate, insert and patella. The total margin in the case of femoral implants
is 287%. That to distributor and hospital is 120%; the importer gets 76%.
The margins for tibial plate and patella are on the same lines. For the former, the importer gets 67%, while distributor and hospital get 137%. The tibial plants can cost a patient anywhere between Rs 20,000 and Rs 122,336. The distributor buys at prices
between Rs 7,538 and Rs 46,555. These are imported at a price anywhere between Rs 8,352 and Rs 17,492.
can cost a patient anywhere between Rs 4,000 and Rs 17,900. The price to the distributor is between Rs 675 and Rs 5,807, while the landed price is between Rs 1,178 and Rs 4,748. Almost the same types of margins are maintained in the case of femoral implants.
The margins for inserted implants
are higher than in any other category. The total trade margin is 449% and for distributor and hospital, it is 163%. The minimum retail price is Rs 9,091, while the MRP is Rs 1,03,700. The landed price is Rs 3,263 and Rs 14,071.
Apart from orthopaedic implants, state Food and Drug Administration (FDA) have done studies on other devices. These show hospitals sell oxygen bags at 300% more than what they procure at. The urinary bags are sold 500% higher.
The trend is the same for intraocular lenses. The difference between the price to the hospital and the MRP is between 200% and 300%. In India, there are 1,20,000 knee implant procedures conducted every year.