The National Pharmaceutical Pricing Authority has revised the price of drug eluting stents (DES) downwards by about Rs 2300 to just under Rs 28,000, while marginally raising the cap on bare metal stents from Rs 7400 to Rs 7660. These caps are excluding GST. With DES accounting for about 95 percent of all stents used in India, this means most stents will become cheaper.
The authority, which had received several complaints about overcharging on catheters, balloons and guide wires used for angioplasty, also made public its analysis of trade margins on these consumables which ranged from over 150 percent to 400 percent over import price. In light of this, NPPA has asked for the price of catheters, balloons and guide wires to be mentioned separately in hospital bills.
With 5 percent GST, the new price cap on DES will be Rs 29,285 and on bare metal stents Rs 8,043. The trade margin allowed on stents remains the same at 8 percent. The revised price caps will be effective from from Tuesday and remain in effect till March 31, 2019.
On Feb 14 last year, NPPA had capped the price of bare metal stents at Rs 7,400 and of DES at Rs 30,180, bringing down prices by as much as 85 percent in an effort to make angioplasty affordable. There were howls of protest from hospitals which made huge amounts of money on stents alone.
The latest order sticks to categorizing stents as bare metal and DES, which will come as a huge disappointment to the stent industry, which has been demanding a separate sub-category under DES for ‘innovative’ stents. The request for a separate category had been sent to the health ministry where a committee of senior cardiologists had shot it down.
After the cap on stent prices, hospitals had jacked up charges for catheters, balloons and guide wires, making these consumables more expensive than the stent, thus minimizing the benefits of the price cap. The NPPA’s analysis of trade margins on these consumables has shown that the highest margin was on balloon catheter, where the MRP was on average 400 percent over the import price and 234 percent higher than the price to distributors. The NPPA has invited comments from stakeholders on the analysis by March 15. – TOI