Coronary stents stay on essential medicine list

Coronary stents, which help treat heart conditions by opening up narrowed arteries, continue to be retained in the National List of Essential Medicines, notified by the government this week. The NLEM 2022 has brought both bare metal stents (BMS) and drug eluting stents (DES) under price control thereby allowing the National Pharmaceutical and Pricing Authority the flexibility to further cap stent prices which the NPPA has already slashed significantly in the past.

The NLEM latest version includes metallic DES and bioresorbable vascular scaffold (BVS) apart from biodegradable stents.

The development comes at a time when the burden of ischemic heart disease (also called the coronary artery disease) is rising in India.

The latest World Health Statistics Report says the ischemic heart disease is the leading cause of death in India closely followed by the chronic obstructive pulmonary diseases and strokes.

Under the head “India’s Country Profile”, the report notes that Ischemic heart disease was responsible for 1215.4 thousand deaths (around 12 lakh) constituting 12.4 per cent of all deaths in the country followed by the chronic obstructive pulmonary disease which led to the 10.8 per cent of all deaths totalling 1061.9 thousand (around 10 lakh) in a year.

The NPPA had for the first time brought coronary stents under price control in 2017, slashing their costs by over 80 per cent. The original price of DES (before February 15, 2017) was Rs 1.21 lakh and that of bare metal stents Rs 45,000.

In December 2018, the government again withstood market pressures to further cut the upper price limit for DES from Rs 29,600 to Rs 27,890. With coronary stents continuing in the NLEM, the NPPA may consider further rate cuts.

The NLEM 2022 also includes four key anti-cancer drugs and four patented antivirals used in the treatment of tuberculosis, HIV and chronic Hepatitis C.

The list features 384 medicines as against 376 in NLEM 2015. It adds 34 medicines over the previous list and deletes 26. With the latest additions, NLEM 2022 lists 63 anti-cancer medicines enabling their price control and affordability.

The NLEM drugs cannot be sold above the NPPA’s ceiling prices. All other medicines are allowed a maximum yearly price increase of 10 pc. India: Tribune