In February 2013, India’s Central Government Health Scheme (CGHS) cut its reimbursement prices for drug-eluting stents (DES) by as much as 60 percent. US FDA approved stents that had been reimbursed at a rate of $1,191 will now be reimbursed at a rate of $458. Previous reimbursement rates for EU approved DES ($916) and Indian approved DES ($733) have also been dropped to $458.
This move comes as the CGHS is cutting reimbursement for other cardio products, including angioplasty procedures and bare metal stents. CGHS reimbursement for coronary angioplasties went from $1,157 to $1,007 (with balloon) or $917 (without balloon) in early February. Bare metal stent reimbursement was cut from $367 to $183.
These rates apply only to the three million central government employees and pensioners covered under CGHS. However, hospitals caring for non-CGHS patients may take this as a signal to negotiate down their own rates with device makers.
Already, top stent makers are struggling to sell at the new prices. Indian patients and cardiac surgeons are fearful that they will have to turn to cheaper, low-end brands of DES to meet the new requirements. Many doctors say the new prices were designed to support local manufacturers, whose products do not always meet the same rigorous standards of US FDA and EU approved devices.