Price Capping of Stents

National Pharmaceutical Pricing Authority (NPPA) has capped the ceiling prices of drug eluting stents (DES) and bio-reabsorb able  vascular scaffolds (BVS) at Rs 29,600 and bare metal stents (BMS) at Rs 29,600 and bare metal stents (BMS) at Rs 7,260. Including VAT, these stents are expected to cost Rs 31,080 and Rs 7,623, respectively. 

The government has made it clear that companies, distributors and hospitals have no choice but to comply with its order slashing prices of cardiac stents by over 75%.

Companies, distributors and hospitals found violating NPPA’s order by overcharging patients for the devices would be penalized.

What is a Stent?

A coronary stent is a wire mesh tube used to clear blockages in coronary arteries and prevent heart attacks. It is inserted into clogged arteries to keep the blood flowing well. The clog is crushed with a balloon and the device inserted.

Pros

  1. Saving lives: Stents save thousands of life every year globally. It is a medical boon that should be made readily available to people so that they have a chance at surviving cardiac arrests with the least amount of expense. In India, where majority of the population is below poverty line, this is a positive step in the right direction.
  2. The decision, expected to make the life-saving devices more affordable, also signals a shift in the way stent suppliers will operate in the country.
  3. With far higher chances of survival, stent is a crucial option for patients and capped prices have helped patients afford it without burning a bigger hole in their pockets.
  4. While some companies said they are still figuring out how they may adapt to the decision, others are already considering cost-cutting options like discarding the middlemen who supplied their products to hospitals.
  5. According to Indian stent company Sahajanand Medical Technologies, one of the biggest cost in this business is the cost associated with the supply chain and most of the margins made by stent makers goes into paying the distributor. The Stent manufactures can get a drug distribution license to save on the working capital cost.
  6. Stents in any case are supposed to be used in emergency angioplasty instead of making it the only option.  Capping of prices will curb unnecessary use of stents

 

Cons

  1. The government should facilitate innovation in medical technology, not regulate it.
  2. There’s enough and more to be done in designing devices which will help doctors in diagnosis and treatment.
  3. Companies are ready to pump in millions of dollars for research & development, so it’s only natural they’ll price their products with an eye on offsetting their expenditure and ploughing back profit for more research.
  4. It’s up to the government to step in with subsidies and take the burden of patients. The rising cost of healthcare is a huge concern but innovation shouldn’t be put on the back burner because of it.
  5. Expansion of price controls on medical devices will not resolve the country’s long-term health challenges and can lead to shortages, delays in the introduction of new devices, and quality concerns for price-controlled devices.
  6. Capping prices would do more harm than good for achieving the goals of the government, patients and the industry.
  7. Coronary stents have halved the number of patients dying from heart attacks and implantable cardiac defibrillators have raised the chances of surviving a sudden cardiac arrest from 5% to 98%.
  8. Arbitrary price restriction will discourage innovators and manufacturersfrom coming up with newer generations of stents, thus limiting the choice of doctors and patients alike.
  9. Patients do not need access to any stent, but access to the best quality stent.
  10. Patient choice and clinical outcomes will be negatively
  11. Price capping will increase the entry of inferior quality, outdated products in the market, resulting in substandard care to patients.
  12. Policy decisions should be driven by patients’ need for quality and safety. Affordability at the cost of patient access to quality is not desirable in the long-term interest of the patient.
  13. The journey of the Indian medical fraternity towards global recognition might slow down.

The government should aim at improving access with a focus on quality and efficacy of medical devices. While making such policy decisions, the government should adopt a consultative approach and involve all the stakeholders — Indian researchers, clinicians, local and global device manufacturers — to ensure best results and a progressive way !!!

 

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