With recent government notification to bring stents under the country's drug price control order, the prices of the life saving device would be regulated and capped by the National Pharmaceutical Pricing Authority (NPPA).
In view of the latest notification and its wider implications on healthcare technology providers, Healthcare Federation of India (NATHEALTH) has suggested that the government needs to form a Health Technology Assessment Board for standardising and regulating the stent quality in India.
"Medical procedures in India are among the most affordable in the world, which is a combination of cost of devices and services. Any notification should be considered only if it can bring down the overall cost of treatment for the patient without denying them the options to avail the treatment of their choice. Additionally, such notifications significantly impact the 'Make in India' attractiveness of the country," Mr Rahul Khosla, President, NATHEALTH, said.
"Recently announced formation of a Medical Technology Assessment Board (MTAB) by the Government would go a long way in standardising and regulating the stent quality in India and usher in the much needed transparency which would also enable pricing standardisation in a more rational manner," Mr Anjan Bose, Secretary General, NATHEALTH, said.
On December 21, 2016, the Ministry of Chemicals and Fertilisers - Department of Pharmaceuticals notified that the Central Government includes Coronary Stents in the Drug Prices Control Order Schedule-1. The notification categorises Coronary Stents into two - Bare Metal Stents (BMS) and Drug Eluting Stents (DES) which include metallic DES and Bioresorbable Vascular Scaffold (BVS)/ Biodegradable Stents.
NATHEALTH has also expressed its concern that the notification may hamper procedural complexity based choice - both for the treating doctor and the patient.
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"We are also concerned that this may disincentivise technology companies from launching newer, safer and more efficacious Drug Eluting Stents in India. Since the latest globally accepted technology will not be available to international patients, they may abandon Indian hospitals. This may also cause the flight of 'high quality' seeking Indian patients to overseas hospitals in neighboring countries," Mr Bose added.
"The Government also needs to consider the impact of complex tax structure, and a high inventory cost based consignment supply chain model, which escalates the stent price. We should leverage proposed GST model law to rationalize the pricing and have requested government to consider the same favorably," Mr Probir Das, Governing Council Member and Vice Chairman, Medical Technology Forum - NATHEALTH, emphasised.
"Unlike delivery of medicine, stent delivery requires hospitals to invest in developing and maintaining quality infrastructure, skilled resources, and operative overheads," Mr Bose said.
"Exact requirement can be ascertained at the time of procedures, which requires hospitals to maintain high inventory (different size, quality and type) and thereby, incur holding costs. It takes 60 days for hospitals to recover charges from TPAs and 200+ days from CGHS. This delay adds significant capital costs," Mr Anjan Bose, Secretary General, NATHEALTH, said.
NATHEALTH recommends that the government allows for differential pricing for discrete generation stents as the new generation stents are believed to have better long-term outcomes (low thrombosis and low restenosis rates) for patients. This is imperative to keep the innovation momentum going.
NATHEALTH represents the entire eco-system of healthcare including Healthcare Providers/hospitals/Nursing Homes, Diagnostic Laboratories, Health IT firms, along with Medical Technology enterprises, Homecare, Health Insurance, Health Education and Health Start-up Companies.
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