Domestic stent market on a healthy growth track despite price controls

The stent market here is on a healthy growth track despite price caps. While domestic stent makers seem to have grown overall market share, multinational companies (MNCs) selling more expensive stents are growing too.

According to industry estimates in 2018 calendar year the overall Indian cardiac stent market grew by 16-18 per cent in terms of volumes.

Prices of coronary stents were capped in February 2017 (prices were slashed by nearly 80 per cent). In terms of value, thus, the growth is 4-6 per cent. Before the cap, the MNCs enjoyed a 65 per cent share of the stent market, which has now reduced to 40-45 per cent, sources said. The total stent market size is estimated to be Rs 2,000 crore.

 

Surat-based SMT (Sahaj­anand Medical Techn­ologies), the indigenous leader in stents, said that around 220 cath labs were added in 2018, many in the hinterlands. Such labs have equipment that can detect problems in heart arteries. "The tier-II and -III cities saw a healthy growth in demand last year, perhaps helped by Ayushman Bharat. States that had no major government health insurance schemes saw the maximum growth in terms of demand. Uttara­khand is a case in point. From 100-150 stent implantation cases, the market grew to 500 stents in 2018," Ganesh Sabat, chief executive of SMT, said.

According to domestic market estimates, SMT ranks second, with a 21 per cent share. The market leader continues to be US giant Abbott Healthcare, with a 26-27 per cent share. Abbott's stent division, in fact, grew by 20 per cent in 2017-18, according to reports. This is when the US firm’s overall growth was 5.87 per cent.  In 2016-17 the company saw a 7.4 per cent year-on-year dip in revenues from the stent division. While the 20 per cent growth is on a shrunk base, the firm has definitely managed to expand its reach.

An Abbott spokesperson said: "Public-private partnerships will be key to the success of Ayushman Bharat, and Abbott is open to working with the government. For the scheme to be successful, it will be essential to have infrastructure and processes that allow appropriate reimbursement of quality products."

While the market leaders have done well, the overall market has also bounced back on the growth path after a slowdown in 2017 forced 40-50 cath labs to be shut. 2018 was different. The year saw a healthy clip in demand with a run rate of 55,000-60,000 stents per month from January to December (which translates to 6,50,000-7,00,000 stents for the year).

Gujarat-based Meril Life Sciences has around 12 per cent share of the domestic market, while Translumina is estimated to enjoy roughly 18 per cent share. MNC firm Boston Scientific revenues grew around 12 per cent year-on-year in FY18 to Rs 478.9 crore. Stents are around 45 per cent of the total turnover of the company. How the segment per se has grown could not be determined.

On the whole, domestic players managed to garner a larger share of the pie even as MNCs continued to grow. The price cap (stents cannot be priced over Rs 31,000 or so) definitely helped. "The market is growing with greater affordability. And, the cake is getting bigger. Indian players have a larger share of the cake due to our competitiveness. As the playing field gets even, MNCs should also be satisfied with sustained growth even if (they’re not getting a bigger share)," said Rajiv Nath, forum coordinator, Association of Indian Medical Device Industry (AIMED).

Apart from Abbott withdrawing its Xience Alpine stents, there has been no withdrawal of medical technology due to the price control. Abbott had also withdrawn its Absorb Bioresorbable Vascular Scaffold (BVS) stents from the market, but that was part of a global recall.