The Indian government has declared that within 10-15 days (as of the 18th January) the price of cardiac stents is to be capped. This announcement follows a host of condemnation over the high cost of stents along with the corresponding cardiac operations. Criticism had also been aimed at the fact that Indian-produced stents were costing roughly the same as foreign imports.
The Financial Express recently reported that chemicals and fertilizers minister Ananth Kumar had contacted the drug price regulator National Pharmaceuticals Pricing Authority (NPPA) regarding the matter (the Authority is the responsibility of the Ministry of Chemicals & Fertilizers). The response from the NPPA being that the issue of overpriced stents has long been overlooked and that a price cap will be enforced to bring down costs. Requests have previously been sent to manufacturers and marketers of the stents to disclose pricing data.
Cardiac stents were added to the list of essential medicines in July 2016, followed by a classification as Schedule-I drugs under the Drugs Price Control Order as of December yet no notable reduction in price ensued.
Despite efforts to bring down the cost, quite the contrary has occurred. Data released by the NPPA revealed that profit margins from the manufacturer to the patient were as high as 1000 percent. This encompasses sales from the manufacturer to distributors, to hospitals and, from there, to the patients themselves. The largest part of the profit margin, around 650 percent, was from the hospital to the patient.
It is no coincidence then that the cardiologists and other doctors were often the most critical of price capping. Their efforts delayed, the price capping process well beyond the date when stents were listed as an essential medication. With heart disease showing a consistently rising trend in India, this product and service presents itself as massively profitable.
Previous articles on Health Issues India noted the development of domestically-produced stents, and the potential for production of cheaper alternative stents while also making a profit for Indian companies.
The costs to the patient indicates this potential cheaper option has not come to fruition, with reports showing that indigenous drug eluting stents (DES) are showing maximum prices of around Rs 1.5 lakh (150,000). This price range rivals the latest DES produced by top international pharmaceutical companies such as Abbott.
With heart disease on the rise in India, the price cap will be an essential factor in ensuring operations such as coronary angioplasties are not priced above all but the wealthy. Of particular concern is that heart disease is showing a marked rise in Indians at a younger age than other populations, as such this is an issue that needs to be addressed rapidly.