New Delhi: As the medical devices industry battles an impending price cap on stents and the reduced margins the move implies, the health ministry intends to keep one key category of products out of the ambit of a price ceiling—at least for the near future.
This category comprises so-called bioresorbable vascular scaffolding, or bioabsorbable stents—stents that are absorbed by the body.
Stents are surgically embedded in constricted or blocked coronary arteries (blood vessels that supply blood to the heart) and used to ease the pathway for flow of blood.
The health ministry’s intent behind the move, which has been conveyed to the government think tank NITI Aayog, prime minister’s office and the office of the cabinet secretary is to foster competition in the manufacturing of the expensive bioresorbable stents and drive down prices, said two government officials.
The medical devices industry expects the stent prices to hover around the current range, pointing to the imminent price ceiling to be imposed on two varieties of stents (bare metal and drug-eluting) as the reason.
The price of a dissolvable stent in India is anywhere between Rs2 lakh and Rs3 lakh. Drug-eluting stents, which are inserted into diseased coronary arteries and release drugs to prevent cell proliferation, make up close to 95% of the market and are priced Rs30,000-80,000.
A bare metal stent costs anywhere between Rs10,000 and Rs20,000.
Bioabsorbable stents dissolve in the body in around 18-36 months. They differ from normal metallic stents as their usage reduces chances of potential inflammation while also leaving all options open for any future cardiovascular intervention.
“We do not intend to cap the prices of bioresorbable stents in the near future. The price cap will stay on only the two varieties of stents listed under the National List of Essential Medicines (NLEM)..,” said one of the officials cited above on condition of anonymity.
As of now, US-based Abbott Laboratories is the only one offering bioabsorbable stents in the country.
“Presently, the prices are extremely high because of fewer players in the market and the returns companies can expect on innovation. We have also made the PMO and cabinet secretary aware of our reasoning in this particular context,” said the second official, also requesting anonymity.
The health ministry, earlier this year, decided on the inclusion of stents—drug-eluting and metal—in the National List of Essential Medicines and cap their prices, raising the hackles of the industry at a time when a new medical devices bill was imminent.
One industry representative said price caps on stents could prove to be counter-productive and doubted whether sparing bioabsorbable stents from the price ceiling would help lower their prices.
“A price cap on stents does not equal a cap on treatment, does it? Will the government be able to cap treatment costs at hospitals which could just arbitrarily raise their costs of treatment to offset their losses because of the price cap on stents?” asked Himanshu Baid, chairman of the medical technology division at the Confederation of Indian Industry. “Apart from reducing options for patients, this price ceiling on stent also discourages innovation and foreign companies bringing newer technologies to India and competing because it will be financially unviable to do so. And if there’s no market competition, I don’t see how the price of bioabsorbable stents will go down.”