Impact of Coronary Stent Price Regulation on the Interventional Cardiology Landscape of India: An Assessment of Health Economics Outcomes

Abstract

Introduction: The cases of Coronary Artery Diseases (CAD) are on the rise in India, this can be attributed to various factors such as ageing, lifestyle, smoking, food habits, and higher income levels. Although, a large proportion of India’s population has access to some form of health insurance but the out of pocket expenditure is still extremely high as a percentage of total health spendings. Aim: To assess the impact of coronary stent price regulation on the interventional cardiology field in India. Materials and Methods: In this retrospective study, data was collected from online search at google and various other external data sources such as websites and published reports of World Health Organisation (WHO), Niti Aayog, National Pharmaceuticals Pricing Authority (NPPA) and Economic Times (ET) Health World. Line graphs for the percentage change in the number of percutaneous coronary intervention procedures, usage of Drug Eluting Stents (DES) pricing for government and private hospitals for the period 2016-2021 were plotted using Microsoft excel. Results: A high cost of coronary stents ranging from Indian Rupee (INR) 40,000 to INR 1,25,000 was a major contributor to a very high out of pocket expenditure in the field of interventional cardiology. In order to curtail this cost, a ceiling limit of INR 29,600 was imposed with respect to the prices of coronary stents in the year 2017 by the NPPA. Ever since a ceiling limit was imposed on the prices of coronary stents in India, there has been an annual increase of 3.7%, 13.1%, 12.6%, and 12.9% in the number of coronary intervention procedures for the years 2017, 2018, 2019 and 2021, respectively. Similarly, the usage of DES has also shown an annual increase of 8.9%, 14.7%, 10.5%, and 13.3%, respectively for the same years. Conclusion: At this juncture when the burden of CAD is on a rise in India, the efforts to make coronary stents more affordable will go a long way in the efficient management of CAD in the country.

Keywords

• coronary angiography
• national pharmaceutical pricing authority
• percutaneous coronary intervention
• stent pricing