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STENT PRICING STALEMATE

P A Francis
Wednesday, May 10, 2017, 08:00 Hrs  [IST]

National Pharmaceutical Pricing Authority issued an order on February 14 fixing ceiling prices for cardiac stents with the intention to bring an end to the practice of huge profiteering in this life saving product. NPPA fixed the price for all drug eluting stents at Rs 29,600 and Rs. 7,500 for bare metal stents. Heart patients have been helplessly paying a price which is nearly 1000 times of the actual manufacturing cost of these products. Most of the patients and their relatives were either unaware of the actual cost of stents or they were forced to accept whatever the surgeons used to advise them in this matter. And it was known that stent makers and hospital managements are likely to oppose any government initiative to bring a price control on this life saving product. It is obvious that the major beneficiaries of overcharging of cardiac stents are stent makers and hospital authorities with the support of surgeons. For stent makers, and hospitals, price fixing has turned out to be a big blow on their profitability. Most of the leading stent makers are, therefore, not in a mood to comply with the order. The benefit of price fixing for cardiac stents has not yet reached the patients. As NPPA has no enforcement powers or machinery, the responsibility of implementing the price fixation order is on the drug control departments of each state. Some state drug control departments are trying their best to enforce the order but most are not.

Now, NPPA has received written complaints against 24 major hospitals in the country including some government hospitals for continued overcharging of stents after the price capping order. The notification stated that all medical establishments such as hospitals, nursing homes and clinics using stents should separately mention the cost of the coronary stent along with its brand name, name of the manufacturer, importer, batch number and other details in their bills. This is not happening in most of the hospitals. It was noticed that from the bill copies received along with the complaints from patients that hospitals are not complying with the instructions specified in the NPPA direction. At the same time, two leading stent suppliers namely US based Abbott and Medtronic approached NPPA seeking withdrawal of their drug eluting stents from the market after the price cut order. Both the companies want a better price for their stents as they claim their products are much superior than locally produced stents. NPPA rejected the Abbott plea for withdrawal of its stent from the market. The price of    Rs 29,600 fixed for all the drug eluting stents in last February despite opposition from multinational stent makers including Abbott. In fact, US FDA recently issued an advisory over Abbott’s fully absorbable stent, Absorb, which the company has been marketing in India. Absorb was approved by the US FDA only in July last year and the company claimed that it is a novel product as it does not leave behind any residue as other stents do. Whatever may be the superiority of a particular stent, one has to believe that NPPA did work out the cost of production and reasonable profit for the product and took a decision to cap the price. Now the issue is to see that the order is enforced so that patients are benefited at the earliest.

 

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