06 Feb 2018 13:53 IST

Differential pricing of stents, a moot talking point between industry and NPPA

This is a year after price control was first exercised on stents

Will the National Pharmaceutical Pricing Authority bring in a differential pricing on stents based on the benefits it brings to a patient? That seems to be the question that will get answered next week when the NPPA speaks, a year after price control was first exercised on stents.

But in a prelude to that development, medical device industry representatives had a slew of meetings on Monday with the NPPA to place their suggestions.

It does not look like sub-categorisation will be brought in, said Ganesh Sabat, Chief Executive of SMT or Gujarat-based Sahajanand Medical Technologies. Representing the Indian Association of Medical Stents Manufacturers (IAMSM) as well, Sabat said, the NPPA seemed inclined to leave the door open for discussions on innovation. But for that, the industry needs to be clear on how it defines innovation and the products would have to show a perceptible benefit to the patient if it wanted to command a different price, he told Business Line after meetings with the NPPA.

The pricing regulator is also believed to have pointed out that the Rs 31,000 cap on drug-eluting stents seemed to be attractive for companies, as the volume of stents deployed had grown, Sabat said. The Indian stent-maker did not agree with findings of a recent study that inferred that stent price cuts had not translated into a reduction of the overall procedure cost to the patient. In smaller cities, the price cut was getting passed on, he said.

Striking a different note, Medical Technology Association of India( MTaI) Chairman and Director General Pavan Choudary said in a statement after the NPPA meeting that the pricing regulator “should consider creating sub-categories for stents to ensure that significant technological innovation stays commercially rewardable. “

On the larger gamut of medical devices, he said, they were in line with the recommendations of the Department of Pharmaceutical's report on high trade margins on drugs (2016).

The Association however urged the Health Ministry to reconstitute the NLEM committee to include representatives from other sections of the healthcare ecosystem. “The broader constitution will give a real chance to the committee to review its previous decision on price capping. The committee, in its current form, is invested in the decision it took last year and the review would be fair if it is done by a broader panel," MTaI said.

Representing multinational companies in the medical technology segment, AdvaMed hoped that the “NPPA recognizes the need for rewarding incremental innovations.”

“Innovative medical device companies are driven by research and quality. Therefore, in the interest of preserving the environment for innovation and ensuring that the patients in India have access to high-quality stent technologies; we continue to urge the government to consider differential pricing for Drug Eluting Stents,” AdvaMed said.

“We believe that a singular focus on controlling price of devices without attempting to address the challenges of healthcare ecosystem will not improve patient access. Our key recommendations included the need to consider alternatives to price control such as trade margin rationalisation and more scientific approaches that facilitate differential pricing for innovative medical technologies and complement the government’s vision of providing quality and affordable healthcare for all,” it added.

Last February, the NPPA slashed prices on bare metal and drug-eluting stents to about ₹8000 and ₹31,000 respectively. The coming week will determine the annual price increase that the NPPA will allow on stents. And whether it will indeed differentiate between stents depending on the innovation they claim to bring to patients.

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