This Article is From Feb 22, 2017

Price Cap On Stents Hailed By All, But Serious Concerns Remain

The drug pricing regulator has directed that in cases of evidence of artificial stent shortage, the state governments can proceed against the manufacturers and seize their stent stocks as per the provisions of the Drug Price Control Order, 2013.

The recent reduction in the price of cardiac stents has brought relief to lakhs of patients.

The recent reduction in the price of cardiac stents has brought relief to lakhs of patients, but the concerns over its scarcity in the market loom large.

According to a notification issued by the National Pharmaceutical Pricing Authority last week, price of a drug eluting stent has been fixed at Rs 29,600, while a bare metal stents would cost Rs 7,260. Prior to the notification, the prices of drug eluting stents ranged between Rs 40,000 and Rs 1.70 lakh.  

In some hospitals, however, the doctors are being discouraged to use high end stents, Dr TS Kler, Head of Cardiology, Fortis Escorts said.

Dr Kler told NDTV, “There is corruption in the Indian healthcare system and that can only change if the system of medical audit is implemented.”

Despite a clarification by the National Pharmaceutical Pricing Authority that stent manufacturers don’t need to re-label their products and can submit the revised price list online to both the authority and the hospitals, the cardiologists at Sir Ganga Ram Hospital in Delhi told NDTV that the manufacturers have withdrawn stents for relabeling and re-pricing.

The drug pricing regulator has directed that in cases of evidence of artificial stent shortage, the state governments can proceed against the manufacturers and seize their stent stocks as per the provisions of the Drug Price Control Order, 2013.

It also said that the capped prices of coronary stents included an 8 per cent trade margin for manufacturers and importers.

Bhupinder Singh, Chairman, NPPA said, “In the supply chain of cardiac stents, there are no retailers. So the hospitals can only demand a margin. They need to take a license and then sell the products. Legally and ethically, hospitals cannot expect any margins in the trade channels.”   

Mr Singh further said that manufacturers should not worry about losing their profit margin. “We have provisioned an 8 per cent trade margin and left it to manufacturers to distribute it as per their own business models.”

Mr Kumar (name changed), a 65-year-old Delhi resident had received a cardiac stent implant at AIIMS last year. Earlier, he had consulted a private hospital in South Delhi. He was advised to get three stents for blockages in his heart. The procedure would have costed him Rs 4 lakh, five times the cost at AIIMS. He said that price cap on stents is a good move to curb unnecessary stenting.

Harish, a businessman from Delhi, however, differs. “I can afford the most advanced stent and can pay Rs 1 lakh 70 thousand for it. I would like the best treatment. Pro-poor policies should not leave me short-changed,” he said.

The hospitals are not trade entities, said Malini Aisola of the All India Drug Action Network, adding that this is a positive step towards ensuring hospitals and manufacturers do not overcharge patients. However, she has a caveat. “We have received some complaints about hospitals bumping up their procedural costs and angioplasty packages after the price cap, something that the government needs to address,” she said.
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