One-fifth of the deaths in India are caused by coronary heart disease and it is predicted that by 2020 it will account for one-third of all deaths. The disease is affecting both rural and urban Indians and the numbers are shockingly on the rise in young Indians. The exorbitant cost of coronary stent -a tube-shaped device placed in the coronary arteries to supply blood to the heart and used extensively to prevent heart-attacks – is a major deterrent in treatment of the disease, especially when it comes to saving the lives of the poor.
Sulagna Chattopadhyay, President, LIGHTS and founder G’nY magazine, submitted a petition to the Petition Committee of Rajya Sabha in July, 2015 praying to reduce the exorbitant price of coronary stent. The Chairman, Rajya Sabha, Mohd. Hamid Ansari realizing the importance of the issue admitted the Petition in the Parliament. After Parliament took cognizance the Ministry of Health and Family Welfare constituted a Sub-Committee of the Core Committee that reviewed the National List of Essential Medicines (NLEM), 2011 under the Chairmanship of Professor Y. K. Gupta, Professor and Head, Department of Pharmacology, AIIMS, New Delhi on October 15, 2015 to examine issues relating to essentiality of coronary stents.
After holding wide consultations with experts and stakeholders including manufacturers and industry associations and considering all relevant aspects, including economic issues, accessibility and affordability, the Sub-Committee, in its report, recommended that coronary stents be included in NLEM and may be considered under following categories:
(i) Bare Metal Stents (BMS)
(ii) Drug Eluting Stents (DES)
The Sub-Committee further recommended that various incremental innovations in technology of the coronary stents may be considered for sub-categorization if acceptable evidences are produced in terms of safety and benefits.
The Government, after examination of the report, has accepted the recommendations of the Sub-Committee and notified inclusion of stents in the NLEM on July 19, 2016.
However, inclusion of coronary stents in NLEM by itself does not reduce the cost of overall treatment procedure. It is believed that once the National Pharmaceutical Pricing Authority (NPPA) regulates prices of stents under Drugs (Price Control) Order (DPCO), 2013, the prices can be expected to go down.