Dr KK Aggarwal
Early this week, the National Pharmaceutical Pricing Authority (NPPA) fixed and notified
the ceiling prices (inclusive of trade margins) of orthopedic implants used in
knee surgeries, both primary knee replacement surgery as well as revision
surgery, under para 19 of Drugs (prices control) order (DPCO 2013) with
immediate effect.
In 2005, orthopaedic implants
were notified as ‘drugs’ by the Ministry of Health and Family Welfare vide its
S.O. 1468 dated 6th October 2005. Consequent to this, Drug (Prices Control)
Order
(DPCO) 2013 became applicable
to these implants, which also came under the purview of the NPPA, which is
mandated to monitor the prices of all notified drugs including notified
devices.
An estimated 1.5 to 2 crores
patients require arthroplasty; however, out of these which only about 1 lakh
plus well off patients are in a position to pay for it every year because of
the very high cost of orthopedic implants (NPPA Notification, August 16,
2017).
As per WHO estimates,
osteoarthritis will be the fourth leading cause of disability by the year 2020.
The ceiling price of different
materials and components used in the implant in primary knee replacement system
has been fixed between Rs. 4,090/- to Rs 38,740/-. Similarly, the ceiling
price of different materials and components used in the implant in revision
knee replacement system has been fixed between Rs. 4,090/- to Rs 62,770/-.
As per the notification, “All
manufacturers/marketers of knee implants having MRP lower than the ceiling
price specified plus goods and services tax as applicable, if any, shall
continue to maintain the existing MRP in accordance with paragraph 13 (2) of
the DPCO, 2013”.
The earlier average MRP of
cobalt chromium, the most commonly used knee implant has reduced by an average
of 65%. The MRP has been capped at Rs. 54,720/- now Wfrom the earlier
1,58,324/-Knee implants made up of special metals like titanium and oxidised Zirconium
has been capped at Rs 76,600/- with price reduction by 69%. The price of
high flexibility implants have been capped at Rs. 56,490/-, again with a price
reduction by 69% (Press Information Bureau, August 16, 2017).
All hospitals/nursing
homes/clinics performing orthopedic surgical procedures using knee implants are
now required to comply with the ceiling prices notified. The patients cannot be
charged any additional charge over and above the ceiling price notified “except
applicable goods and services tax, if any, paid or payable”.
The Indian Medical Association
(IMA) welcomes this move of the govt. to fix the ceiling price of knee implants
as now these implants have become more affordable and within reach of the
common people. Many more patients will now be able to undergo the procedure,
which earlier they could not because of the very high costs of the implants.
Earlier this year, the Govt.
had fixed the ceiling prices of coronary stents, which also came as a relief to
the general public.
Disclaimer:
The views expressed in this write up are entirely my own.
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