MNCs demand stent price revision

While multi-national companies are pushing for an increase in the price of cardiac stents, domestic manufacturers are more than happy with the price ceilings introduced by the Centre last year.

In less than two weeks, the National Pharmaceutical Pricing Authority (NPPA) will decide whether the prices of cardiac stents should be revised or not. In lieu of the impending decision, the pricing regulator held a stakeholders' consultation earlier this week with multinational companies, domestic manufacturers, importers and distributors as well as civil society representatives, to take in their views.

The price for the drug-eluting stents have been capped at a little less than Rs 32,000 while for bare metal stents the capping is at a little less than Rs 8,000. Earlier, the price of DES ran into over Rs 1-2 lakh.

Giving a lowdown on whether benefits of making stents cheaper have been passed on to the masses, NPPA Chairman Bhupendra Singh said, "Stent price capping has enabled poor patients to afford new generation Drug Eluting Stents (DES), instead of old Bare Metal Stents (BMS). Use of BMS drastically reduced by over 30% and were replaced by DES. Affordability matters, so do the poor."

The domestic manufacturers could not agree less. Upto 12 domestic manufacturers across India attended the consultation. While earlier MNCs commanded 70% of market share, while the rest 30% was catered to by domestic companies, after the price capping, the MNC shared has tanked to 60%, while the domestic companies have registered a rise to 40%. "After the price cap, a void was created in the Indian market, as MNCs stopped supplying stents because they did not want to reduce valuation of their brands," said Pratap Surve, CEO, Veritas Bioventions, a Gujarat-based stent manufacturing company. "We are fine with current stent prices. However we have told the NPPA to not discriminate between MNCs and domestic companies, if at all prices are being revised. There should not be differential pricing between the two."

While Surve's company had sold 4,000 stents two years back, he said after the price cap last year, the sales doubled to 8,000. The stent market in India is swelling, with annually five lakh angioplasties and six lakh stents being used, according to latest data and the trend only points to a year-on-year increase in stent use.

However, the MNCs and industry groups like Confederation of Indian Industries (CII), Federation of Indian Chambers of Commerce and Industry (FICCI) and others are unhappy with price ceiling. Upto 11 top representatives like Heads of Government Affairs and Directors or Associate Directors (Finance) of MNCs including Abbott Healthcare Pvt. Ltd., Biotronik Medical Devices India Pvt. Ltd., and so on were present for the NPPA consultation. Anil Sharma, Business Unit Head - Vascular of Berlin-based Biotronik Medical Devices India Pvt. Ltd. said that the price cap is choking innovation. "Clinical trials of Magnesium Scaffold stent, a new metal absorbable stent that we are developing have been stopped in India after the price cap. Ten centres including All India Institute of Medical Sciences (AIIMS), and Christian Medical College (CMC) were involved in the clinical trials. There is no point in conducting trials now as the price cap is unaffordable for us," Sharma told dna.

While earlier profit margins for MNCs and hospitals were huge, at 8%, MNCs say their profits have plummeted substantially. However, insiders in the manufacturing industry said that the production cost of a stent is not more than $100 or Rs 8000. "Even with the price cap, every manufacturer has a substantial scope for making profit," a domestic manufacturer, who did not wish to be quoted, told dna.

CII during the meeting even wished to submit a formula for revision of stent prices and demanded that the 'margin,' aspect of the formula be fixed by the industry. NPPA officials refused to accept any such proposal in the meeting and asked CII to mail their views through the formal channels.

FOR A HEALTHY HEART

• NPPA held a stakeholders’ consultation earlier this week with multinational companies, domestic manufacturers, importers and distributors to take in their views. 
   
• The price for the drug-eluting stents have been capped at a little less than Rs 32,000 while for bare metal stents the capping is at a little less than Rs 8,000.