It is more than two weeks after National Pharmaceutical Pricing Authority issued an order fixing ceiling prices for cardiac stents in a bid to bring an end to the practice of huge profiteering in this life saving product. There has been no check on the pricing of stents for several years and cardiac patients across the country were forced to pay very high price for this product. Although the government was aware of this racket involving stent makers, hospital managements and cardiac surgeons, no action was ever taken against them. And heart patients and their relatives have been helplessly paying the price which is nearly 1000 times of the actual cost of this product. Most of the patients and their relatives were unaware of the actual cost and the pricing of stents and they were forced to accept whatever the surgeons used to advise. The first initiative to check this organized loot of heart patients was taken by an advocate when he filed a PIL for overcharging of stents in the Delhi High Court in February 2015. He sought a direction to the NPPA to control the price and fix a maximum retail price for coronary stents. The petitioner also wanted a direction to the Drug Controller General of India to ensure adequate availability of the coronary stents at medical stores to enable patients to have an easy access to it. However, the NPPA order on February this year came only after a second petition from the advocate.
As expected NPPA order fixing the ceiling prices for bare stents and drug eluting stents has disappointed stent makers and hospital managements for obvious reasons. They now stand to lose exorbitant margins they have been collecting from the cardiac patients all these years. Now, they are trying to find all possible ways to circumvent the order. Most of the stent makers have not complied with the order. Since NPPA has no enforcement powers or machinery, the responsibility of implementing the order should be with the drug control departments of each state as stents are classified as drug. In Maharashtra, FDA has been quite active and its officials have been taking follow up action by inspecting many hospitals in the state. FDA investigations found that many hospitals are increasing the cost of services, other medical devices and tests patients undergo to make up the losses on account of stent price cut. And, medical insurance companies are suspected to be helping hospitals to get these inflated bills cleared. Until last week, NPPA received written complaints against 24 major hospitals in the country including government hospitals for overcharging of coronary stents. The notification had stated that all medical establishments such as hospitals, nursing homes and clinics using stents should separately mention the cost of the coronary stent along with its brand name, name of the manufacturer, importer, batch number and other details in their bills to patients or their representatives. But it was noticed that from the bill copies received along with the complaints from patients and complainants that hospitals are not complying with the instructions specified in the NPPA direction. This is a serious breach of a government order of public interest and needs to be dealt with due seriousness. State health departments should be directed to take criminal proceedings against such hospital managements.