The US government’s report on foreign trade barriers has raised concerns on the India’s price controls on the medical devices, particularly the fixing of prices of coronary stents and knee implants. The report said that national pharmaceutical pricing authority (NPPA), which is the nodal agency for capping of prices of essential medicines and devices, has not taking into account factors like inflation and tech innovations while fixing the prices of these medical devices. “The US companies have raised concerns noting that the price controls have not been increased in line with inflation and do not differentiate on the basis of the cost of production or technological innovation, which dissuades US companies from serving the market,” the report said.
Since November 2022, coronary stents have been brought under the national list of essential medicines (NLEM) where their prices are fixed by NPPA that allows annual price hikes by taking into account WPI (wholesale price index). For instance, from April 1 this year, the government has allowed stent prices to be increased by 1.74%. Similarly, knee implants were put under price capping in 2017 via paragraph 19 of DPCO. The impact of the price capping was substantial as it reduced prices of knee implants in the range of 50-70%. Since then, knee implants have remained under price control with the only exceptions in August 2019, September 2022 and September 2023, when the product was moved to paragraph 20 for a period of one year, thereby making the industry eligible for an up to 10% annual increase only for those years.
Industry experts said that despite the price controls on these devices, the consumers have not benefitted to the extent envisaged. “Since the prices of stents are capped, the hospitals have found ways to charge more from the patients in the form of other procedural charges, and in some cases, hospitals resort to other expensive therapies and distort optimal treatment pathways,” said Pavan Choudary, chairman, Medical Technology Association of India (MtaI).