The Indian government’s decision to cap the price mark ups imposed on cardiac stents was feared by some for its potential to cause foreign companies to simply stop marketing their stents in India. These fears appear to have come to fruition as Abbott Healthcare have recently sent requests to the National Pharmaceutical Pricing Authority (NPPA) to withdraw two of their stent products.
These removals were permitted by the NPPA. This comes four months after the NPPA had blocked requests for removals of various other stents. These requests followed the government’s decision to cap the price of stents.
The cap is hugely unpopular among pharmaceutical companies. It has rendered numerous cardiac stent products, particularly those that are imported by foreign pharmaceutical companies, unprofitable.
The initiative was received in India with mixed reviews. Some took a nationalistic approach, claiming the overwhelming market share of foreign imports was bad business for domestically produced products. While Indian companies are known for producing cheaper stents, some rebutted this point that the quality of products made in India was seen as inferior to imports. With the reduction in profitability of the stents, cheaper production methods may become commonplace to compensate.
Some claim that the market may become dominated by cheaper, Chinese-imported stents. This would further raise concerns that the price cap, while making the product more affordable, has led to more poor-quality products.
One of the Abbott stents was removed from the Indian market because of safety concerns. This has coincided with Abbott publicly announcing that global sales of their dissolvable scaffold stent ‘Absorb’ will cease. The stent has been condemned in the media f on multiple occasions. This may, to some degree, dispel the idea that international pharmaceuticals are withdrawing their products over pricing concerns.
Abbott had also noted that in India that commercial uptake of the product was slow but it was seen on a global level too. This would imply that rather than the price cap being the causative factor, it may have been the bad publicity surrounding the stent.
The precedent that two withdrawals of products sets has experts concerned. “This was the worry that many had expressed that high-end stents won’t come to India. It’s unfortunate and a loss of new technology to India,” said Dr Shirish Hiremanth, president, Cardiac Surgeons of India in comments to Firstpost.
Abbott have agreed to maintain a supply of the stent for sale within India for a year following the NPPA’s decision to allow the withdrawal. However, concerns are currently abundant that this may be the start of a trend of major importers withdrawing their products from the Indian market.