In late October, Sushant Patil was having one of those packed weeks. 

A cardiologist at Elixir Metro City Hospital in Nagpur, Patil performed a complex, high-risk angioplasty—a double-stent procedureA double stent procedure in an angioplasty, often called a two-stent technique, is typically used to treat a blockage at a coronary artery bifurcation—on a 75-year-old patient. Soon after, he wrapped up another angioplasty, this one on a relatively younger patient. 

Though both went successfully, the difference lay in the stents Patil used. 

In the first instance, the two stents were made by Indian medtech companies—one by Advanced Medtech Solutions and another by Meril Life Sciences. The procedure, undertaken for free under the Ayushman BharatThe national health policy of the Indian government that aims to achieve universal health coverage through 1) government-funded health insurance and 2) strengthening the primary healthcare system scheme, required the hospital to use Indian stents pre-bought by the government. Patil had no complaints, describing these as “pretty good”.

In the second, a private, paying patient, insisted on an imported stent from one of the global companies, Abbott, Medtronic, or Boston Scientific. The contrast is now routine: the state prefers Indian; patients prefer foreign.

Multinationals have noticed. In October alone, Medtronic launched its latest surgical valveA prosthetic heart valve that is implanted to replace a damaged or diseased native heart valve in India, while Abbott introduced a new dual-chamber pacemakerA type of permanent cardiac pacemaker designed to monitor and regulate the rhythm of two chambers of the heart. (They were introduced in the US in January 2024 and July 2023, respectively.) Such launches are part of a broader revival. After years of reticence, global medtech giants are once again crowding into India’s operating rooms.

That reticence began in 2017, when the National Pharmaceutical Pricing Authority (NPPA) capped the price of cardiac stents—both Indian and foreign—in response to rising costs. Hospitals safeguarded their margins by increasing the overall cost of treatment; but MNC stent makers were hit hardest.