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In a welcome relief to patients suffering from heart problems, it will now be cheaper and thus easier to avail treatment as the government finally fixed the ceiling price for coronary stents.

This revolutionary decision has been brought about by the constant and relentless efforts of Delhi based lawyer and social activist, Birender Sangwan. He filed a PIL to the same effect in 2014. This concern of his was prompted by his experience of visiting a person receiving treatment requiring the use of such stents. He found the stents used to be hugely overpriced.

So, after doing his research, he wrote a letter to the Union Health Ministry complaining about the same and also filed a RTI to ascertain under which category stents are classified in health sector - drugs or metals.

"The RTI reply bewildered me. Firstly, I came to know that cardiac stents are exempted from Customs duty. Secondly, stents are notified as drugs but not covered under any price control mechanism in India because they were not included in the National List of Essential Medicines (NLEM). I had to get it to that list," he said on the reply of his RTI.

The National Pharmaceutical Pricing Agency NPPA reacted to his efforts by carrying out consultations with stakeholders for fixing the ceiling price of coronary stents and considered all available information and data on prices.

“During deliberations, it was found that huge unethical markups are charged at each stage in the supply chain of coronary stents resulting in irrational, restrictive and exorbitant prices in a failed market system driven by information asymmetry between the patient and doctors pushing patients to financial misery,” NPPA said in the notification.

Sangwan continued to work rigorously to the completion of his mission. July 2016 brought some success his way when The Union Health Ministry, following the recommendations of an expert sub-committee, notified the decision to include coronary stents under the National List of Essential Medicines (NLEM) in July 2016. As per the law, drugs and devices listed in the NLEM must be sold at the price fixed by NPPA.

The final acclamation of his efforts came in February 2017 when the NPPA fixed the ceiling price of bare metal stents at Rs. 7,260 per unit and that of drug eluting and biodegradable ones at Rs. 29,600 per unit. The ceiling price is open to local tax and VAT and has already been brought into effect.

This move was also promoted by PM Modi as he spoke about it in one of his speeches and further tweeted the same. Strict regulations have been brought into work for the proper implementation of this directive. Union minister for chemical and fertilizers, Ananth Kumar even made assurances that any hospital or clinic found overcharging patients could even face criminal prosecution.

"If we come across any such incident, we will first send a notice to the hospital and then follow it up with criminal prosecution. We won't hesitate to shut down the hospital if there is evidence of profiteering," he said.

But, even though this might be a victory for Sangwan’s efforts at social betterment and a welcome relief to the patients of coronary diseases, the pharmaceutical industry is not very happy about this notification. They are cross about the price ceiling and call it out for being too restrictive.

They are of the opinion that the numerous types of stents can’t possibly be clubbed into just two categories. They say that there are many kinds of stents that just don’t fit in the two prescribed categories and that the rule doesn’t factor imported stents.

Further, the market saw a withdrawal of third and fourth generation stents after the implementation of the rule with little hope of their resurfacing. On this, they build up the argument that such a move would lead to deterioration in quality as it is quite impossible to provide high quality stents at the capped prices. Many were also of the opinion that it isn’t a complete victory as lowering of the cost of stents will only prompt the hospitals to increase the cost of the procedures arbitrarily, thus defeating the purpose.

Thus, it may be a victory for the efforts of Birender Sangwan who pledges to keep up the good work and to pick up other issues over time; it is still incomplete, with exploitation of loopholes and many changes to be expected.

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