Patients slated for coronary angioplasty are in for a big relief as the National Pharmaceutical Pricing Authority (NPPA) on Monday fixed the ceiling price of all drug eluting stents (DES) and bioresorbable scaffolds at ₹29,600 and that of bare metal stents at ₹7,500.
The prices will be effective from the date of issuing the notification on Tuesday. (February 14).
The cost of a DES currently ranges between ₹23,600 (Central Government Health Scheme-CGHS rate) and ₹1.5 lakh and bioresorbable scaffolds, a technological innovation, were priced upwards from ₹1.5 lakh. But, DES contributed to over 90 per cent of the total stents used in angioplasties in the country. It is estimated that over five lakh stents were used in 2016.
Exhaustive consultation
According to the NPPA notification, the prices were fixed after an exhaustive exercise of consultation with stakeholders from January 4 to 6 this year, following the notification given on December 23 last.
It says, “during deliberations, it was found that huge unethical mark-ups 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.”
According to data put out by the NPPA, the ceiling price for DES, based on the average of prices to hospitals, was ₹67,272 and the ceiling price using the average of prices to distributors was around ₹40,000. This is in contrast to the ceiling price based on the average landed price with a 35% mark-up, which is only ₹21,881.
Based on limited data available with the NPPA, an estimate of the ceiling price arising from the cost of production plus a 35% mark up is ₹10,699. This shows that the formulae relying on data supplied by manufacturers cannot ensure affordability.
Ministry notifies
The committee set up by the Union Health Ministry notified the inclusion of stents in the National List of Essential Medicines in July last, after a Delhi High Court sought ruling.
In December, the Department of Pharmaceuticals notified stents to be brought under Schedule-I of the Drug Price Control Order (DPCO) 2013, clearing the way for fixing the price.
