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Anuradha Varanasi
Anuradha Varanasi

Health

Breather for heart patients as govt caps prices of cardiac stents

ECG [File photo] The ceiling price of bare metal stents has been fixed at Rs 7,260, and that of drug eluting stents and biodegradable stents at Rs 29,600

In a major relief for heart patients, the National Pharmaceutical Pricing Authority (NPPA) today passed a notification to cap the prices of life-saving cardiac stents. Stents are small tube-shaped devices used during coronary angioplasties to unblock arteries. 

The pricing regulator slashed the ceiling prices of stents by nearly 85 per cent after consulting with various stakeholders. While the ceiling price of bare metal stents has been fixed at Rs 7,260, that of drug eluting stents and biodegradable stents is at Rs 29,600. 

“Huge unethical markups are charged at each stage in the supply chain of coronary stents resulting in irrational, restrictive and exorbitant prices in a failed market system driven by information asymmetry between the patient and doctors pushing patients to financial misery,” the NPPA notification observed. 

At the same time, the new notification permits stent manufacturers to add local taxes or Value Added Tax in the calculation of maximum retail price (MRP), provided they have actually paid taxes or if it is payable to the government on the ceiling price. 

On December 22, 2016, the Delhi High Court had ordered the government to fix a ceiling price and maximum retail price of cardiac stents by March 1, after Advocate Birender Sanghwal moved a public interest litigation where he questioned why manufacturers and hospitals did not display the MRP of stents along with the ceiling price. 

The NPPA has also asked hospitals to mention the costs of stents separately in the bill along with other details like the stent's brand name and also the name of the manufacturer. The notification further states that in any case where the stents manufacturer or institution does not comply with the ceiling price, they will be liable to deposit the overcharged along with interest under the provisions of the Drugs (Prices Control) Order, 2013, read with Essential Commodities Act, 1955.

“The notification passed by the NPPA will at least enable patients to ask details of their medical bills following an angioplasty. This is a very positive move because it will finally stop stent dealers from bribing the doctors,” former president of the Punjab Medical Council Dr G S Grewal told THE WEEK

However, not everyone is happy with the new order. 

Expressing deep disappointment, Advanced Medical Technology Association (AdvaMed), a medical device trade association based in the US said, “This notification completely disregards all stakeholders' representations on the need to differentiate stents, based on their technological differences.” 

While the intent is to cap prices in patients' interest, the industry is concerned that the new pricing has the potential to prevent innovations and limit access to world-class medical care and choices to deserving patients. According to AdvaMed, the decision also disregards the evolution of coronary stents over the last four decades, and blocking innovation might set the health care sector back by at least a decade. “The singular focus on controlling ceiling price of stents, without attempting to address the larger picture and correct inefficiencies in the health care ecosystem will not achieve its stated benefit, in the long run,” the association spokesperson added. “Unavailability of choices and access to the latest generation of stents might mean an exodus of patients to other or neighbouring countries, thus defeating the intent of making heart care more affordable,” said AdvaMed.

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