No shortage of stents after price caps as Indian, Chinese firms fill void

Belying the fear that there would be a shortage of coronary stents in the market after India imposed a price ceiling last year, which it further lowered this week, India faces no such shortage, according to data from the National Pharmaceutical Pricing Authority (NPPA).

The data reflects that while there was decreased distribution of imported stents, domestic manufacturers more than made up by increasing supply.

According to a DNA report, the data shows that the availability of stents in the Indian market, both from domestic and multinational manufacturers, has risen over the past three years.

In 2016, Indian manufacturers had recorded an opening stock of 1,16,108 stents which rose to 1,42, 267 in 2017, an increase of 22 per cent. US-based multinationals like Abbott, Medtronic, Boston Scientific and Umbra Medical Products recorded a 14.95 per cent rise in their opening stocks from 54,574 in 2016 to 62,733 in 2017.

To this, the MNCs further added 3,59,516 stents in 2017, the year in which NPPA introduced the price capping.

The NPPA on Monday further lowered the maximum prices of bare metal and drug-eluting stents (DES) to Rs7,660 and Rs27,890 from Rs8,000 and Rs31,000 respectively (See: NPPA lowers ceiling on stent prices further).

While earlier DES cost anywhere between Rs1-2 lakh, after the latest price revisions a DES costs Rs29,284. US-based MNCs had raised a huge ruckus and threatened to stop distribution in India.

In fact the price caps seem to have given a fillip to Prime Minister Narendra Modi's pet 'make in India' project. NPAA chairman Bhupendra Singh tweeted on Tuesday, a day after he announced the further cut in stent prices, that 61 per cent of the stents distributed in the country in 2017 were manufactured by Indian companies.

The popular perception is that foreign companies enjoy almost a 70-per cent of the stent market share in India. But as per the NPPA, last year, imported brands, including Abbott, Medtronic and Boston, made up for only 33 per cent. In 2016, Indian firms accounted for 57 per cent of the stents distributed, which rose to 61 per cent following price capping, according to a report in The Times of India.

Chinese stents had risen from nil in 2016 to 7,656 - or 1 per cent of the total distributed stents - in 2017, tweeted Singh, who also put out a table showing that 5.4 lakh India-made stents had been distributed in 2017 as against 5.1 lakh the previous year.

Officials said that no patient suffered because of the decreased distribution. The data states that while 9, 00,477 stents were distributed across India in 2016 (this includes Indian companies, US-based MNCs, non-US companies, and a Chinese company), this dipped by a marginal 0.9 per cent to 8,92,358 stents in 2017.

While in 2016, US MNCs had distributed 3,48,594 stents in India, the figure plummeted to 2,99,531 in 2017, a dip of close to 14 per cent. However, NPPA officials said that this did not create a scare of shortage as the domestic manufacturers jumped in to fill the void and their distribution increased from 5,13,229 in 2016 to 5,44,853 in 2017, an increase of 5.80 per cent.

And there was also an influx of stents from China's Microport as well as non-US MNCs like German-based Biotronik and B Braun, Japan-based Terumo, UK and UAE-based Vasmed Technologies Ltd, Singapore-based Biosensors Interventional Technologies Pvt Ltd and Spain-based Lifevascular Device Biotech Ltd.

Overall, 0.9 per cent less stents were distributed in 2017 as compared to 2016, states the NPPA data, a marginal dip.