New Delhi: India’s drug pricing regulator capped the prices of knee implants on Wednesday, in a move that is expected to reduce product prices by as much as 69%.

The move may upset companies selling knee replacement products and comes six months after the National Pharmaceutical Pricing Authority (NPPA) capped prices of cardiac stents.

The most widely used complete knee implant (cobalt chromium) will now cost Rs54,720, excluding goods and services tax (GST) as against Rs1.58 lakh earlier, according to a notification issued by government’s price regulator.

NPPA has also capped prices of a second surgery, if required, to Rs1.13 lakh as against Rs2.76 lakh earlier.

Prices of special metals that are used in treatment, such as titanium and oxidised zirconium, have been capped at Rs76,600 from Rs2.49 lakh earlier. These prices are applicable with immediate effect.

The NPPA brought cardiac stents under price control in February to make them more affordable to patients. Stents are wire-like meshes that are used to remove blocks, largely in the heart.

The price of drug eluting or drug-coated stents were slashed by NPPA to about Rs30,000 from as much as Rs2 lakh. The move, which was preceded by several rounds of deliberations with companies, had upset manufacturers who said the new prices dissuade research and development.

Companies like Abbott Healthcare opted for a selective recall by withdrawing stents such as Absorb and Alpine from the market. The recall did not happen as it violates the Drug Price Control Order that prohibits withdrawal without adequate warning and notice, which might create shortage in the market.

NPPA, in its order on knee implants, said that all the manufacturers “will continue to ensure the availability of all the brands of implants" and “ensure that no disruption is caused in the supply chain because of printing new MRPs".

Dr P.S. Gill, senior consultant orthopaedics at Venkateswara Hospital, said the companies may pull their products out from the market.

“The move is likely to pinch the manufacturer. Though it is a good move by the government but companies may back out and stop selling their high-end products in India," Gill said, adding that 90% of the total knee implant market is imported.

Some of the companies that sell their products in India are Stryker, Smith & Nephew, Biomet, Zimmer and Johnson & Johnson.

An email sent to Johnson & Johnson India spokesperson seeking comments did not elicit any response till press time.

Justifying its decision to cap knee implant prices, the NPPA order said there are as many as 20 million patients who require arthroplasty, out of which only about 100,000 manage to afford it every year.

Citing a World Health Organisation report, the order said osteoarthritis is likely to become the world’s fourth leading cause of disability by the year 2020.

“It is noticed that orthopedic-knee implants are having unjustified, unreasonable and irrational high trade margins leading to their exorbitant prices, which affects the out of pocket expenses of patients and lakhs of patients are not able to pay for arthroplasty procedures because of these exorbitant prices and are suffering in pain," the order said. “Preventing such a scenario is essential in individual as well as national interest."

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