India and the Coronary Stent Market: Getting the Price Right

On February 13, 2017, India's National Pharmaceutical and Pricing Authority (NPPA) made a landmark decision to fix price ceilings for coronary stents at 7260 rupees for bare metal stents and 29 600 rupees for drug-eluting stents (US equivalents of $108 and $444, respectively).1,2 Stents had been placed on the National List of Essential Medications (NLEM) in July 2016 by the health ministry.1 In India, stents turned out to be subject to substantial price markups on their journey from manufacturer to patient, at times exceeding 4 times their original imported value.1,2 The recent decision by the NPPA precipitated immediate price cuts of up to 85% in some cases, which has been lauded by consumers and patient advocates, but drawn criticism from others who are concerned that it may lead to shortages and stifle innovation.3