Government takes the step to reduce the knee implant prices

India’s drug pricing regulator National Pharmaceutical Pricing Authority (NPPA) capped the prices of knee implants, in a move that is expected to reduce product prices by as much as 69%. These prices were made applicable with effect from 16-Aug-17.

The most widely used complete knee implant (cobalt chromium) will now cost Rs 54,720 excluding goods and services tax (GST) as against Rs1.58 lakh earlier for a single knee implant (Unilateral), according to a notification issued by government’s price regulator. The implant cost will double for a bilateral knee replacement. Prices of special metals that are used in treatment, such as titanium and oxidized zirconium, have been capped at Rs76,600 from Rs2.49 lakh earlier. Any hospital overcharging patients will attract punitive actions, which may include heavy penalty and even revoking of license.

What is TKR (Total knee replacement)?

Total knee replacement is a complex procedure that requires an orthopaedic surgeon to make precise measurements and skilfully remove the diseased portion of your bone, in order to shape the remaining bone to accommodate a knee implant. TKR-Unilateral means Knee replacement on single knee where as TKR-Bilateral implies replacement on both the knees.

As per W.H.O, Osteoarthritis is likely to become the fourth leading cause of disability by the year 2020 and India is likely to be one of the leading countries of such immobilized citizens in terms of numbers.

Types of Implants used in the surgeries: According to Arthritis and Sports Medicine Clinic, total knee replacement prosthesis has four components:

  • Femoral component (made of metal), which is fixed to the cut surface of the femur (thigh bone);
  • Tibial component (made of metallic tray), which is fixed on the cut surface of the tibia (leg bone);
  • Polyethylene liner (made of plastic), which is interposed between the femoral and tibial component and acts as an articulation; and
  • Patellar component (made of plastic), which is fixed on the cut surface of the patella (knee cap).

These components are usually fixed to bone using bone cement (polymethyl methacrylate).

The cost breakup  for cobalt chromium implant  hereafter will be:

  • Tibial component- Rs:16,990
  • Femoral component- Rs:24,090
  • Polyethylene liner- Rs:9,550
  • Patellar component- Rs:4,090

List of revised prices are as follows

Source: NPPA

A Typical TKR bill includes Room rent 5-6%; Surgeon fees 36-37%; OT charges 18%; Medicines and Consumables; Investigations 2-3%; Implants 31-34% for TKR-Unilateral and Bilateral respectively.

Example of a Knee replacement surgery cost breakup before the regulation:

 

 

 

 

Source: ICICI Lombard GIC Ltd claims data. The figures may vary as per cities and hospitals.

However, the non-implant charges at the hospital may differ hereafter the govt. regulation.

Health Advisor says

It is important to reconsider before undergoing such surgeries with a second opinion.There is a possibility that you may have been misdiagnosed or the doctors may not be able to comprehend the most current information on treatment options. If the decision on knee replacement surgery is finalized, you can ask the hospital for a cost breakup and check the rates as per government guidelines.

Click here to view NPPA Gazette notification

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