National Pharmaceutical Pricing Authority last week issued a notification fixing for the first time the prices of coronary stents required for millions of heart patients across the country. The order says the price of drug eluting stent will now be Rs.29,600 while that of bare metal stents fixed at Rs.7,260. The hospitals have been charging patients between Rs.40,000 and Rs.1.98 lakh for drug eluting stents and between Rs.30,000 and Rs.75,000 for bare metal stents. The price fixing order takes immediate effect. With the notification, all stent manufacturers and importers would have to price their products below the notified ceiling prices. As per the data with NPPA there has been exorbitant overcharging of these life saving products by hospitals in collusion with cardiologists and stent makers all these years as there has been no price control. The NPPA action comes only after repeated protests and court cases by patient groups and NGOs against the organized exploitation of helpless cardiac patients by hospital managements. The NPPA data shows that by the time a patient gets the stent, the increase from the original cost of production of the stent is often in the range of 1,000 to 2,000 per cent.
By bringing stents under price control and fixing ceiling prices, NPPA has acted in public interest and upheld the fundamental right to health without succumbing to pressures from industry and private hospital managements. Stents were included in the National List of Essential Medicines in July last year and were added to the Schedule I of the DPCO 2013, in December, bringing these devices under price control. Prior to that Union health ministry had accepted the recommendations of an expert panel, set up to examine the issue of essentiality of coronary stents, and decided to include this life saving product in the NLEM. The health ministry’s decision is subsequent to a Delhi High Court direction to the government in February 2015 in response to a public interest litigation seeking relief to lakhs of heart patients in the country. It was after the Court order, the expert committee headed by Prof Y K Gupta was appointed to examine the essentiality and excessive profiteering in coronary stents. The NPPA order is certainly going to be opposed by the hospital managements and stent suppliers as this is the first step from the government to regulate stent prices and bring down the profiteering in these life saving products. Monitoring violation and circumvention of price fixing order by hospitals and stent suppliers are going to be a big task for NPPA as it has no officials in most of the states. Enforcement of ceiling prices may, therefore, have to be undertaken by the state drug control administrations as the NPPA is a Central body. In Maharashtra, the state FDA has already started acting on its own and is trying to enforce compliance of the NPPA order. It is important that all the state governments have to cooperate with NPPA by directing their state drug administrations to implement the price fixing order to make this patient friendly initiative a success.