Implants in repeat knee surgeries can cost as much as Rs 9 lakh: Pricing Regulator

NEW DELHI: An imported knee implant used in revision surgery—a repeat surgery in case of a failed knee surgery—can cost a patient as much as Rs 9 lakh, according to a new set of data released by India’s drug pricing watchdog. At the same time, global knee implant makers that supply these implants to India claim the data provided by the regulator may be inaccurate. A revision knee surgery requires a completely different implant and instrument set, according to companies that manufacture knee implants. Average trade margins on imported knee implants used in total revision knee surgeries are as high as 369%, according to data released by the National Pharmaceutical Pricing Authority on Wednesday. The data comes a few days after the regulator released information that showed the average trade margins on total knee implants are over 300%. The average margin for importers of total knee systems was 56% while for distributors and hospitals, it was 200%, according to the data. The joint components of a knee system used in a revision procedure ranges between Rs4.35 lakh and Rs9 lakh, while import prices range between Rs91,967 to Rs1.99 lakh, the regulator said. Distributors and hospitals on average mark up the prices of components like the femoral, tibial plate, insert and patella between 89% to 139%, according to NPPA’s data. “We have just seen the office memorandum relating to revision knee implant system, which has been issued by NPPA today. As an initial reaction: this demonstrates a lack of understanding of the revision knee system and the data seems inaccurate,” stated the Medical Technology Association of India (MTaI), a lobby group for multinational knee implant companies like Stryker, Smith & Nephew, Zimmer Biomet and Johnson & Johnson. “Our member companies will review this document and then issue a detailed and thoughtful response.” These companies together capture over 90% of India’s knee implants market, according to MTaI. According to MTaI, the cost of a knee implant system used in revision surgeries generally ranges from Rs 3-5 lakh, depending on the number of components used. Only around 2% of the total knee implant surgeries conducted in India every year are revision knee surgeries, the body added. Around 3 crore patients in India are estimated to be suffering from osteoarthritis currently, and only around 1.2 lakh of them go in for knee implants, an industry official told ET on condition of anonymity. It is not confirmed whether NPPA has released its latest data because it intends to cap the prices of knee implants and revision knee implants. The regulator had earlier this year asked companies to submit trade data on 19 classes of medical devices, including knee and hip implants, catheters, heart valves and eye lenses used in cataract surgeries. At the same time, the health ministry is currently considering a proposal by the Central Drugs Standard Control Organisation (CDSCO) to set up a committee to decide whether heart valves, intraocular lenses and orthopaedic implants should be brought under the National List of Essential Medicines (NLEM)–a move that would allow the Department of Pharmaceuticals to notify them for price control. NPPA chairman Bhupendra Singh could not be reached for comment.
Source: ET