In April 2013, PBM noted in a newsbrief that India’s Central Government Health Scheme (CGHS) had reduced its reimbursement prices for cardio products — such as drug-eluting stents (DES) — by up to 60%. Stents that had been approved by the U.S. FDA and previously reimbursed at a rate of $1,200 were instead reimbursed at $460. EU and Indian approved stent reimbursement prices were also cut to $460.
While this rate cut only applied to the 3 million people covered by the CGHS, other hospitals, reimbursement agencies, insurance agencies and state governments utilize CGHS rates as a yardstick when determining their own rates. Therefore, it was expected that these other organizations would follow CGHS’s lead and negotiate down their own rates.
The government of Maharashtra state — where Mumbai is located — has done so. On February 5, 2014, the state government announced a state-wide deal for low cost stents. Because stents were priced from $830-$2,500, many could not afford them. So, the state government put out a tender for low-cost stents and has signed contracts with two companies to provide basic stents at a cost of approximately $415.
This low price applies to all public hospital patients. In the first 2 weeks after the program was implemented, over 100 patients received stents — compared with fewer than 80 people who had received stents over the previous 5 weeks. Other state governments, hospitals and agencies could follow the lead of CGHS and Maharashtra and also reduce stent prices.