As the one-year validity of capping of prices of coronary stents by the National Pharmaceutical Pricing Authority (NPPA) is coming to an end on February 13, the drug price regulator is holding a crucial meeting on February 12 for revisiting the ceiling prices of coronary stents in the country.

The NPPA had fixed the ceiling prices of coronary stents on February 13 last year which was valid for one year. This decision has to be revisited now and in this connection, the NPPA had held several round of meetings with various stakeholders, the last one being on February 5, 2018. On February 5, the NPPA had heard all the stakeholders including industry associations and NGOs working in the health arena. They included AdvaMed, Mtal, AIMED, ISMA, AMCCI, AMCHAM, Assocham, CM, FICCI, PHDCC&I, multinational stent manufacturing companies, Indian stent manufacturing companies, ADEH, AIDAN, CAI, ORF, Oxfam India and PHFI. Before that, the NPPA had a meeting with eminent intervention cardiologists in the country.

Meanwhile, the Delhi-based lawyer who prompted the government to take on the country’s multi-billion dollar medical devices industry has emphatically rebuffed any attempt to increase prices or further categorise the products.

The Medical Technology Association of India (MTaI) and other industry stakeholders are urging the Ministry of Health and Family Welfare to reconstitute the National List of Essential Medicines (NLEM) committee to “give it a real chance to review its previous decision on price capping”. They also mooted a sub-category for advanced cardiac stents to ensure that “significant technological innovations remain commercially rewardable”.

The NPPA top brass and industry stakeholders have already met twice to discuss the issue but a final decision remains elusive. Last year’s price cap is valid only till February 13. So the regulator has to settle price revision discussions soon.

“Any attempt to increase the prices is absolutely uncalled for. In fact, many cardiac patients are still not getting the benefit of price cap because of overcharging by hospitals. The authorities should look into these aspects instead of raising prices,” Advocate Birender Sangwan, who filed the public interest litigation in the Delhi high court that triggered the government action and price capping, told Pharmabiz.

A section of doctors have pointed out that high-end and new generation stents are disappearing from the shelves after the price cap. They also pitch for three categories of stents depending on technological efficacy, safety and performance.

However, Sangwan, who is dubbed ‘the lawyer with a heart’ for his single-handed efforts to slash the price of heart surgery in India, doesn’t agree with their view saying the move will be counter-productive. “We need only two categories, bare metal stents (BMS) and drug-eluting stents (DES). Any effort to introduce sub-categories won’t be beneficial for patients,” he added.

According to the NPPA, the price capping on stents has enabled poor patients to afford new generation DES instead of old BMS. “Use of BMS is reduced by 30 per cent and replaced by DES. Affordability matters,” NPPA Chairman Bhupendra Singh stated in a tweet on February 7.

As of now, a price cap of Rs.7,260 exists for bare metal stents (BMS) and Rs.29,600 for modern drug-eluting stents (DES). The latter have a polymer coating, which gradually releases a drug, to ensure that the blockage doesn’t recur.