Patients with debilitating knee problems, requiring joint replacement surgeries, would soon regain spring in their steps. The National Pharmaceutical Pricing Authority (NPPA), which capped the prices of coronary stents in February, may cap the prices of knee implants soon.

According to a source in the know of the developments, the price of knee implants is likely to be capped with just a 35 per cent margin over the landed price. The Chairman of NPPA, Bhupendra Singh, however, could not be reached.

Huge margins

Late last week, the NPPA revealed detailed data of its market analysis on the prices of various components of knee implants, which revealed massive margins, as high as 449 per cent in some components. Capping of prices at landed price and an additional 35 per cent margin could, potentially, bring down the cost of these individual parts, or even the price of the total knee system, by as much as 70 per cent, according to some calculations.

Sources said a consultative meeting between the NPPA officials and the industry is expected on Wednesday.

The industry and other stakeholders have been asked to submit their comments on the trade margins on implants by Friday.

In the case of coronary stents, the trade margin was kept at 8 per cent, over and above the margins of the manufacturer/importer.

“Considering the high-end value market of coronary stents, this 8 per cent margin would cover margins across the trade channels,” the NPPA had said in February.

MTaI’s call

The industry, however, has been protesting the display of trade margins by the NPPA, calling it, ‘misleading’. In a statement, the industry body Medical Technology Association of India (MTaI), said, “The MRP of the implant highlighted in the article as ₹4,13,000 is used in rare cases, where the original implant has failed and a revision procedure needs to be carried out. These implants are expensive and have limited volumes of manufacturing globally; they require a large inventory as well as advanced instrumentation.”

The NPPA’s office memorandum, which revealed the prices of knee implant components, placed the maximum price of a ‘total knee system’ at ₹4,13,000. The first surgery involves a complete replacement of the joint with prosthetics involving all the four components — femoral, tibial plate insert and patella.

However, in case of wear and tear over years of use, a revision surgery, involving only one or more of the individual components, takes place.

“The maximum price is merely the sum of the max MRPs of each component, which can be from different companies and different constructs.

Taking this price point as benchmark for the entire industry is incorrect as well as misleading,” the association further said.

The NPPA, however, indicated that the data on prices and trade margins of revision surgery knee implants were being analysed by the body currently.

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