HEALTHCARE

Hospitals, distributors make huge profits on knee implants

knee-implants-reuters Knee replacement surgeries have gone up by ten-fold in the last decade | Reuters

NPPA analyses trade margins; a price cap will benefit poor patients

Soon, the cost of a knee replacement surgery may come down drastically. At least that is what the National Pharmaceutical Pricing Authority's intent seems to be. The regulatory body has released an analysis of trade margins on different components of a knee replacement surgery, and asked stakeholders to respond with their comments, within a week. 

The analysis shows that until now, patients have been bearing the burden of the huge trade margins on various components of the knee implants. For instance, for the plastic insert (one of the components used in the surgery), the analysis shows that the margin to the importer, distributor and hospital added up to a whopping 449 per cent of the original price. 

The document shows that on this single component, the importer makes a 100 per cent margin, and the distributor and the hospital make a margin of 163 per cent. On each of the other components (femoral, tibial, patella) used for the knee replacement, the average margin is more than 200 per cent, according to the analysis. The price of the entire implant ranges from Rs 59,091- Rs 4,13,059, it said. 

"A price cap will be a welcome move. The corrupt practices and the unfair hike in prices has made the implant surgery out of reach for many patients. In fact, even in government hospitals such as AIIMS, the patients have to buy their own implants. How can a poor patient afford an implant that costs over a lakh? If prices are brought down, the government might also be able to pitch in for them," said Dr Yash Gulati, senior consultant orthopaedic surgeon at Indraprastha Apollo Hospitals, and honorary surgeon to president of India. 

Gulati says that in the last decade, knee replacement surgeries have gone up by ten-fold, and with an aging population, the numbers would bound to increase. Thus, a price cap would benefit a lot of patients, he said. 

In some cases, especially in younger patients, a need for replacing the implant might arise in 10-15 years, said Gulati. "In such cases, a price cap would benefit even more because revision implants cost even higher," he said.

The NPPA's memorandum on trade margins on knee implants follows its move to cap prices of coronary stents earlier this year. In February, the drug price regulator had issued a price cap on coronary stents, slashing their prices by almost 85 per cent. The ceiling price of bare metal stents had been fixed at Rs 7,260, and that of drug-eluting stents and biodegradable stents at Rs 29,600. 

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