Medical devices: Follow one offering through the chain
Syringes, implants, scanners, monitors and diagnostic tests for hospitals and clinics
Follow one offering through the chain
A drug-eluting heart stent made in India
Follow a coronary stent from cobalt mine to cath lab, and the price cap in between.
A cobalt-chromium tube, laser cut
74%DR Congo's cobalt share, 2025 (calculated)A modern stent begins as a fine cobalt-chromium alloy tube, laser cut into a mesh that expands inside an artery, and the tube must be implant grade with tightly controlled purity and wall thickness. The cobalt itself is highly concentrated: DR Congo mined about 230,000 of the world's 310,000 tonnes in 2025, roughly 74% (calculated).1
Constraint Cobalt comes overwhelmingly from one country, and switching an implant-grade tube supplier needs fresh biocompatibility and validation data. Co CobaltCr ChromiumNi NickelW TungstenAr ArgonMetal productsA drug in a thin polymer coat
99.81%cases using drug-eluting stentsThe metal mesh is coated with a drug such as everolimus or sirolimus, held in a thin polymer that releases it over weeks to stop the artery narrowing again, then crimped onto a nylon balloon catheter. Drug-eluting stents have all but replaced bare metal ones in India: a 2026 report on national registry data put their share at 99.81% of cases.2
Constraint Each polymer and drug grade is validated into each stent, so changing a supplier means months of testing and fresh regulatory filings. PTFE Fluoropolymers (PTFE, PVDF)PA Nylon (PA6, PA66)API Small-molecule APIsPlastic and rubber productsPharmaceuticalsIndian makers take on global brands
70%India's devices imported, by valueCompanies such as Meril in Vapi, Sahajanand Medical Technologies in Surat and Translumina design, test and make stents in India, competing with Abbott, Boston Scientific and Medtronic. Stents are a bright spot in a sector that, the government told Parliament in July 2025, still imports about 70% of its devices, including US$5.3 billion of electromedical equipment in 2024-25.3
Constraint New stent designs need clinical trials and years of follow-up data before doctors and regulators accept them. Rgt Reagents and high-purity lab chemicalsHVAC AC transmissionEducation and researchSoftware and IT servicesClass D: the strictest licence
Oct 2023all Class C and D licensedA coronary stent sits in Class D, the highest-risk group under India's Medical Devices Rules, 2017, and the Central Drugs Standard Control Organisation must license its manufacture or import. From 1 October 2023 licensing was extended to every Class C and D device, so factory audits, testing and clinical evidence now apply across high-risk products.4
Constraint No stent can be sold without a CDSCO licence, and any change of material, coating or plant needs approval first. Public administration, defence and securityProfessional servicesSterilised with ethylene oxide gas
~50%US sterile devices using EtO, 2019Packed stents and catheters are sterilised before shipment, usually with ethylene oxide gas, which passes through packaging without the heat or radiation that could harm a drug coating or polymer. The method is a quiet chokepoint: an FDA official said in 2019 that it accounted for roughly half of all devices supplied sterile in the US.5
Constraint Ethylene oxide is toxic and carcinogenic; the FDA warned in 2019 that more plant closures over emissions could severely cut device availability. EO Ethylene oxideCO2 Carbon dioxideH2O2 Hydrogen peroxideWaste and recyclingDistributors stock every size
₹16,000top guidewire price, uncappedDistributors keep many lengths and diameters of stents, balloons and guidewires at hospitals, because the cardiologist picks the size mid-procedure. Unlike the stent, these accessories carry no ceiling price: prices reported in Kerala in 2026 ran from ₹3,000 to ₹7,000 for a balloon and ₹4,000 to ₹16,000 for a guidewire, so angioplasty bills vary widely.2
Constraint Demand data is patchy: Kerala distributors estimate 16,203 stents a month against 9,722 in registry data, complicating stock planning. Bld Energy in buildingsICV Combustion road vehiclesTransport and logisticsWholesale and retail tradeA price ceiling of ₹39,186
₹39,186drug-eluting stent ceiling, April 2026India's National Pharmaceutical Pricing Authority caps the price of coronary stents. Under its notification of 25 March 2026, from 1 April a drug-eluting stent may be sold for no more than ₹39,186 and a bare metal one for ₹10,762, before GST, after a 0.65% rise for wholesale inflation. The same ceiling applies in any hospital, public or private.6
Constraint One national ceiling binds every stent sold, so makers' prices move only with a yearly inflation adjustment, 0.65% for 2026. Finance: banking, insurance, marketsPublic administration, defence and securityEleven lakh stents a year
11.3 lakhstents used in a yearFinally the stent reaches a catheterisation lab, where a cardiologist threads it to a blocked artery. Labs reporting to the National Interventional Council used 11.28 lakh stents in 7.92 lakh patients last year, as reported in October 2026, about 1.4 per patient (calculated). Coverage is partial: 1,130 labs report, while the atomic energy regulator lists 1,994.2
Constraint Registry data covers 1,130 of about 1,994 labs, so true use is higher, and cath labs cluster in cities and private hospitals. W TungstenBld Energy in buildingsHVAC AC transmissionHealthcare servicesFinance: banking, insurance, marketsWaste and recyclingWhat the chain shows
India makes and caps the stent, but its alloy tube, coating chemistry and sterilant still come through a few suppliers, many abroad.
Sources
- Mineral Commodity Summaries 2026: Cobalt US Geological Survey, 2026
- God's Own Country lives on stents; Kerala 3rd in India for cardiac implants (National Interventional Council data) Onmanorama, 2026
- Medical device imports still at 70%, India spent over USD 25 billion in 5 years: Parliament informed (Rajya Sabha reply, 29 July 2025) Medical Dialogues, 2025
- Class C and D non-notified medical devices to require licensing under Medical Devices Rules, 2017 from October 1, 2023 S.S. Rana & Co., 2023
- FDA Innovation Challenges webinar on sterilisation alternatives and ethylene oxide emissions (transcript) US Food and Drug Administration, CDRH, 2019
- NPPA notification S.O. 1587(E), 25 March 2026: revision of ceiling prices for coronary stents (reproduced) National Pharmaceutical Pricing Authority, via TeamLease RegTech, 2026