Govt mulls setting CGHS price of stent as cap under NLEM

NPPA also proposes a 10% hike in stent prices if the CGHS model is adopted

The National Pharmaceutical Pricing Authority (NPPA) has proposed a few options for capping stent prices, just before its three-day consultation with all stakeholders, which starts tomorrow.

In July, stents were brought under National List of Essential Medicines (NLEM) which led to capping of their prices. For this, the exercise of consultations began in August, with industry lobbies at loggerheads over how drug-eluting stents that vary in quality should be treated. In December, the Department of Pharmaceuticals included stents under the Drug Price Control Order (DPCO), 2013 following which, the pricing authority started the pricing process, which it now wants to complete by February.

"In case of coronary stents, hospitals / nursing homes are acting as de-facto retailers," said NPPA in its notification to justify the options it has come up with. One of the options is to apply Central Government Health Scheme (CGHS) rates for stents with an annual increase of 10 per cent in prices. At present drug-eluting stents are priced at around Rs 23,000 while bare-metal stents are priced at about Rs 12,000.

Another option the authority is considering is to provide a 35 per cent trade margin over the cost of production in the case of domestic manufacturers and 35 per cent trade margin over the cost at which stents are imported by foreign manufacturers. However, Pavan Choudary director general, Medical Technology Association says, "This formula did not work in the case of drugs and is unlikely to work for medical devices."

Domestic and multinationals stent makers have also been at loggerheads over differential pricing of drug-eluting stents depending on their quality. Some of these are fully dissovable while others are not. According to the order all kinds of drug eluting stents including Abbott's fully dissolvable stents come under one category now. The multinational manufacturers have already criticised this move.

Vivek Jawali, chief cardiothoracic and vascular surgeon at Fortis says, "While price capping is essential to ensure availability of stents to all strata, unreasonable capping may lead to compromise in quality."