By Vaibhav Chadha
With a mission to provide Affordable and Quality Healthcare for all, the Modi Government on 14th February, 2017 fixed the ceiling prices of coronary stents in India. This move is likely to bring down the cost of coronary stents by up to 85 percent. While announcing the decision, Union Minister for Chemicals & Fertilizers and Parliamentary Affairs, Shri Ananth Kumar stated that the cost of coronary stents were currently hiked by about 380% and further also clarified that the new prices are applicable with immediate effect.
The ceiling prices notified are applicable to manufacturers and distributors of stents and also hospitals billing patients for stents. The Government has also asked for the prices of all stocked stents to be revised according to the new ceiling price. The National Pharmaceutical Pricing Authority (NPPA) has made it mandatory for hospitals, nursing homes and clinics performing cardiac procedures using stents to disclose separately the cost of the stent while billing a patient.
A coronary stent is basically a tube-shaped device that is placed in the coronary arteries supplying blood to the heart for keeping the arteries open for treatment of the coronary heart disease. Earlier, the average maximum retail price for Bare Metal Stent (BMS) was Rs 45,000 and for Drug Eluting Stent (DES) was Rs 1.21 lakh. The ceiling price of BMS and DES, exclusive of any VAT and other local taxes, has been capped at Rs. 7,260 and Rs. 29,600 respectively. Most states in India generally have 5% VAT on stents, thus, making the MRP of BMS Rs.7623 and DES Rs. 31,080 inclusive of the taxes.
In India, BMS have 10% market share while DES have 90% market share. As per the Government estimates, due to price reduction, heart patients are likely to get a benefit of Rs 80-90 thousand per stent eventually resulting gross relief of Rs. 4450 crores annually.
Coronary Stents were included in the National List of Essential Medicines, 2015 (NLEM, 2015) of Ministry of Health and Family Welfare on 19th July 2016 and in Schedule I of the Drug Prices Control Order (DPCO), 2013 of the Ministry of Chemicals and Fertilizers on 21st December 2016.
The Union Minister, Shri Ananth Kumar also stated “manufacturing cost of imported BMS is Rs. 5415 and for DES is Rs. 16,918, hence the ceiling prices have been set taking into account the ethical profit margins and R&D costs of each member of the supply chain of coronary stents.” He further said that the step will help in curbing ‘unethical margins’ charged at each stage in the supply chain of coronary stents. Government has already started two mobile apps, namely Pharma Jan Samadhan and Pharma Sahi Daam, on which the public can register complaints. In case of violations of the ceiling prices, the National Pharmaceutical Pricing Authority (NPPA) can recover the overcharged amount along with 15% interest. The move will also promote ‘Make In India’ initiative of Central Government as now the foreign firms in order to reduce their cost of production may look for options of setting up their production units in India. As per the PIB notification of 14th Feb 2017, “Cardiovascular Diseases (CVD) are major cause of death in India, about 25% of total deaths. Out of these, 90-95% CVD deaths happen due to coronary artery diseases. As per the report of National Commission on Macroeconomics and Health, prevalence of CAD in India is about 61.5 million as per 2015 report. As per Health Ministry report, more than 3.5 lakh procedures were done in 2015 which used 4.73 lakh stents. In 2016, the figure of cardiac stent must have been above 5 lakhs.”
This bold decision by the Modi Government to fix the prices of coronary stent is another pro –poor step after the Government had earlier launched AMRIT outlets where 202 cancer drugs, 186 cardio-vascular drugs and 148 types of cardiac implants are being sold at 50 to 60 percent cheaper prices than the open market to bring such life saving drugs in the reach of poor. The latest move is likely to help millions of Indians suffering from cardiovascular diseases to get coronary stent treatment at a very low cost. With such pro-poor decisions in the health sector the Government seems to have reiterated its stand of Sabka Saath Sabka Vikas.
(Writer is an Advocate and Research Associate at Dr. Syama Prasad Mookerjee Research Foundation, New Delhi)