India’s drug pricing regulator has capped the prices of knee implants to control “excessive trade margins” in public interest, nearly six months after it brought coronary stents under price control.
The National Pharmaceutical Pricing Authority fixed the cost of a primary knee replacement implant between Rs 4,000 and Rs 38,740, according to a list notified by the regulator. Earlier, the prices could go up to Rs 9 lakh, it said.
The NPPA found that while the average margin for the importer of knee implants varied between 42 and 65 percent, it rose to 89 to 200 percent for distributors depending on the type of implant. Average total trade margin varied between 182 and 269 percent by the time it’s sold to the patient, the regulator said.
The regulator had capped prices of coronary stents in February, a move that was backed by Prime Minister Narendra Modi. Doctors, including leading cardiac surgeon Devi Prasad Shetty, chairman of Narayana Health, had warned that high-end cardiac stents won’t be available in India due to the price caps and new stents won’t be introduced in the country.
The regulator had cited “unethical markups” at each stage in the supply and “irrational” pricing for the caps on stents. Its reasons for price ceilings on knee implants are similar.
The NPPA cited “failed and exploitative market because of asymmetry between patient and healthcare delivery systems” as reasons to cap margins on knee implants. The regulator also emphasised the urgent need to impose price ceilings in NPPA “in view of extraordinary circumstances”.
The regulator said all hospitals or any healthcare facility undertaking an orthopaedic knee transplant will have to adhere to the new pricing, in case they are selling it to patients directly. Hospitals should not solicit any patients to purchase knee implants in case they decide to procure such implants from third-party sources, the regulator added.