Implants in revision knee surgery cost as high as 277%: NPPA

Drug price regulator NPPA on Wednesday said it has found average trade margins on various knee implants used in revision surgery to be as high as 277 per cent after analysing available market data.

The National Pharmaceutical Pricing Authority (NPPA) said it analysed trade margins in the orthopaedic knee implants used in revision surgery cases based on available data from official sources, manufacturers and importers.

Sharing the data from the preliminary analysis on its website, the NPPA said the average total trade margin was found to be the highest in the case of the tibial plate at 277 per cent with MRP ranging from Rs 51,000 to Rs 1.65 lakh.

The margin to the importer for the same was 65 per cent with landing price ranging from Rs 19,506 to Rs 32,032. The margin to distributor 128 per cent with minimum and maximum price to distributor ranging from Rs 22,293 to Rs 54,000.

The drug price regulator further found that the second highest average total trade margin was on patella at 219 per cent with MRP ranging between Rs 4,000 and Rs 20,000 although the landed price was between Rs 1,178 and Rs 5,022.

Similarly, the average total trade margin on femoral implant was 196 per cent with MRP between Rs 74,875 and Rs 2,67,500, while the landed prices ranged between Rs 27,877 and Rs 79,433.

The NPPA said the average total trade margin on Insert was 182 per cent priced between Rs 25,041 and Rs 57,583 whereas the landed price of the imported implant was between Rs 8,718 and Rs 18,234.

When contacted for comments, medical devices industry body MTaI said: "This demonstrates a lack of understanding of the revision knee system and the data seems inaccurate."

MTaI further said its members would review the NPPA data and "issue a detailed and thoughtful response".

In a revision knee surgery, previously used implants are replaced by new ones.

Last week, the NPPA had invited comments from stakeholders for discussion after it found that the average trade margin on orthopaedic knee implants to be as high as 313 per cent.