India cardiac stent price caps closer after advisory review

An advisory body to India's health ministry has made a recommendation that favors price caps on cardiac stents based on price lists sent by manufacturers, the Economic Times reports.

The National Health Systems Resource Centre has suggested strong price control measures in a still unreleased report to the National Pharmaceutical Pricing Authority (NPPA), which will study them and make final recommendations, the Economic Times said, citing its review of the report.

The suggested price levels are expected to face strong opposition from both domestic and multinational players who have already questioned whether the government can use a particular law aimed at preventing commodity hoarding to set prices for medical devices.

The main recommendations are to cap bare metal stent prices at INR19,000 ($292.66) and the maximum price for drug eluting stents at INR28,000 ($431.29), the Economic Times said, adding that price ranges for bare metal stents run from INR12,000 to INR20,000 in India and drug-eluting stents cost from INR23,000 to INR120,000, depending on brand and specifications.

A key reason for the price caps, the Economic Times said, is because most patients in India do not have access to insurance and pay-out-of-pocket--even as industry estimates suggest stent prices in reimbursed markets like China, Singapore and Malaysia are roughly one and one-half times more than India.

The report also noted that drug-eluting stents are more than 1.5 times more effective than bare metal stents in reducing in the number of major adverse cardiac events, the Economic Times said.

In July, price checks by the NPPA on certain orthopedic implants, which followed requests for prices on stents, raised hackles by companies concerned they are being swept up in a law that was not meant for their industry, Business Standard reported.

In June, NPPA reportedly asked Johnson & Johnson ($JNJ), Zimmer ($ZMH) and Stryker ($SYK) to submit details of production and pricing of their products, including those for knee and hip.

But, according to Business Standard, some of the companies--no names were available--contended that authority to ask for medical device prices like these is not covered by India's Drug Prices Control Order of 2013.

The NPPA however shot back that it was clear the law could be used in these cases and again requested the prices be sent.

- here's the story from the Economic Times