The Indian Medical Device Industry
The Indian Medical Device Industry
The Indian Medical Device Industry
March 2017
March 2017
MUMBAI SILICON VALLEY BANGALORE SINGAPORE MUMBAI BKC NEW DELHI MUNICH NEW YORK
Contents
EXECUTIVE SUMMARY 01
1. INTRODUCTION 02
I. Authorities 07
II. Licenses Required For Import, Sale, Manufacture And Loan Of
Medical Devices Under The Rules 09
III. Manufacturing A Notified Medical Device In India 10
IV. Importing A Notified Medical Device Into India 10
V. Manufacture/Import Of New Notified Medical Device 11
VI. Clinical Trials 11
VII. Product Standards 12
VIII. Labeling 12
IX. Good Manufacturing Practices (Gmp) 12
X. Penalties 12
XI. Export Import Restrictions 13
XII. Advertising And Sales Promotion 13
XIII. Drugs And Magic Remedies (Objectionable Advertisement) Act, 1954 13
XIV. The Competition Act, 2002 13
XV. Patent Protection 14
XVI. Data Exclusivity 15
XVII. Trademarks 16
XVIII. Government Control Over Prices Of Medical Devices 16
XIX. Medical Device Rules 2017 An Analysis 18
6. TAXATION REGIME 26
I. Direct Taxes 26
II. Indirect Taxes 32
CONCLUSION 35
ANNEXURE A 36
ANNEXURE B 37
ANNEXURE C 38
ANNEXURE D 39
ANNEXURE E 40
Executive Summary
The Indian medical device sector is worth out returns, and determine the degree of profitabil-
approximately USD 5.5 Billion and is growing ity. A peculiar feature of regulation in India is pro-
at 15% CAGR.1 The medical device market is hibition on advertisement or promotion of medical
dominated by imported products, which com- devices claiming diagnosis/cure/mitigation of cer-
prise of around 75% of total sales. The domestic tain notified diseases or ailments.
companies are largely involved in manufacturing
The regulatory framework in India applicable to
low-end products for local and as well as inter-
medical devices borrows heavily from the regulatory
national consumption. Lately, many multina-
framework applicable to drugs. At present, only 15
tional companies have established local presence
types of medical devices are regulated (unfortunately,
by acquiring established domestic companies or
as drugs). The rest are unregulated. After a lot of
starting a new business.
efforts of various stake holders, the government has
There are few key factors about operating in India that notified the Medical Device Rules, 2017, which are
every serious player should be aware of. Foreign Direct to come into effect from the 1st of January, 2018
Investment in medical device manufacturing sector is unless a different date is notified. These rules will
now possible without any prior approval. The Indian regulate a much larger set of medical devices under
legal regime is robust and promotes innovation and a framework customized for medical devices. This
commerce. Being a signatory to the TRIPS Agreement should boost the confidence of all stakeholders,
(Trade-Related Aspects of Intellectual Property Rights), especially those who have been hesitant to enter into
India todays boast of strong patent, trade mark and Indian market because of lack of regulation.
copyright protection within its territory. India has
In 2017, the biggest challenge that the medical
a competition law regime that ensures a fair playing
devices industry will be facing is that of price control
field to all interested in Indias domestic market.
and the uncertainty about the effect of new Medical
The Indian Government has introduced various fiscal
Device Rules, 2017. Both these themes are discussed
measures to promote research, development, manu-
in the paper in some detail
facturing and import of medical devices. There is no
.
import duty on certain medical equipment. Similarly,
Overall, it should come as surprise to no one that the
a number of lifesaving medical equipment are exempt
Indian medical device industry presents an exciting
from payment of excise duty. The Indian government
opportunity to foreign and domestic players alike. It
has incentivized scientific research and development
is hoped that this research paper will act as a guide to
by providing weighted deduction.
all stakeholders.
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1. Introduction
The approximate USD 5.5 Billion worth Indian Economic growth leading to higher disposable
medical device sector is Asias fourth largest market, incomes
and presents an exciting business landscape and
opportunities for both multi-national and domestic Increased Public Spending in Healthcare
players. Till the early 1990s, the medical device sector
Increased Penetration of Health Insurance
was significantly dominated by domestic players.
But after India opened up its markets in 1991, tables Improving Medical infrastructure
have turned. The technological advancement and
expertise that the global market leaders offered has Increasing affordability due to growing income
proved to be an advantage. Today, Indias medical
Increasing number of ailments
device sector is dominated by multi-national
companies, which is evident from the fact that Increasing demand due to Medical tourism
about 75% of the sales are generated by imported
The sector is also witnessing strong Foreign Direct
medical devices. The domestic players, on the other
Investments (FDI) inflows, which reflects the
hand, were quick to adapt the winds of change and
confidence of global players in the Indian market. As
started to focus on low cost devices. It will come as a
per official data, the medical and surgical equipment
surprise to many that the domestic players in India
sector received a total of INR 8344 Crore (approx. USD
export more than 60 percent of their output as Indian
1452 Million) between 2000 and 20162. In 2013 alone,
markets are dominated by such imported medical
the FDI inflow was almost INR 920 Crore (approx. USD
devices. Over the years, many multi-nationals have
138 Million). In 2015, this number jumped to a new
set up operations in India. However, the nature
high of INR 1019 Crore (approx. USD 153 Million).3
of majority of the operations is to only distribute
imported devices and provide support function. Few
The major players in Indian market are
multi-nationals have started domestic production
(in no particular order): Hindustan Syringes &
too. Some multi-nationals have also entered India
Medical Devices, Opto Circuits (India), Wipro
by acquiring domestic manufacturers. For example,
GE Healthcare, 3 M, India Medtronic, Johnson
in 2008, Netherland-based Royal Philips Electronics,
& Johnson, Becton Dickinson, Abbott Vascular,
a leading manufacturer of General X-Ray acquired
Bausch & Lomb, Baxter, Zimmer India, Edwards Life
Alpha X-Ray Technologies, a leading manufacturer of
Sciences, St. Jude Medical (now a part of Abbott),
cardiovascular X-Ray systems.
Stryker, Baxter, Boston Scientific, BPL Healthcare
India, Sushrut Surgicals, Trivitron Diagnostics,
The sector is at present growing at around 15%
Accurex Biomedical, Biopore Surgicals, Endomed
Compound Annual Growth Rate (CAGR) for
Technologies, HD Medical Services (India), Eastern
a plethora of reasons. A significant percentage of
Medikit, Harsoria health care, Nidhi Meditech
purchasers of medical devices are private medical
System, Philips Medical, Wipro Technologies, HCL
institutions and hospitals. Due to increased
Technologies and Texas Instruments.
competition in Tier I cities, private enterprises have
started to focus on Tier II and Tier III cities, a market
Some of the major industry associations are:
which is until now untapped in India. As private
Advanced Medical Technology Association
enterprises expand in lesser explored markets,
(ADVAMED), Association of Indian Medical Device
the demand for medical devices will expand
proportionally. Other reasons for strong growth 2. Department of Industrial Policy and Promotion; Cumulative
prospects of the industry are: FDI Flows into India; available at: http://dipp.nic.in/English/Pub-
lications/FDI_Statistics/2016/FDI_FactSheet_April_Sep_2016.
pdf
3. http://dipp.nic.in/English/Publications/SIA_Newsletter/2016/
jan2016/index.htm
Industry (AIMED), NATHEALTH, Association of meaning there is no government oversight on its man-
Diagnostics Manufacturers of India, All India Plastics ufacture, import, distribution and sale. The Medical
Manufacturers Association, Medical Disposables Device Rules, 2017, which is to come into effect from
Manufacturers Association, Society of Biomaterials & 2018, is expected to fill the legislative void that is cur-
Artificial Organs, National Biomedical Engineering rently present, due to the absence of a medical device
Society and Medical Surgical and Healthcare specific legislation in India.
Industry Trade Association.
The multi nationals looking to invest in the Indian
One peculiar feature of the Indian medical device sec- medical device sector must strategize their entry
tor is that it is largely unregulated. The Indian govern- on the basis of certain key factors which will influ-
ment has regulated only a few types of medical devices. ence profitability of the investment. These key fac-
All other types of medical devices are unregulated, tors are listed and discussed next.
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Organisation Chart
Central Drugs Standard Control Organisation
II. Licenses Required For licenses or permissions, as the case may be. In
specific instances such as manufacture or import
Import, Sale, Manufac- of new Notified Medical Devices (discussed later),
ture And Loan Of Med- both, a permission from the central drug licensing
authority and a license from the state drug licensing
ical Devices Under The authority is required. The required licenses and
permissions are described more specifically in the
Rules table below.
The regulation of Notified Medical Devices is The Rules have prescribed the standard format of the
overseen by both, the central government and the application forms for relevant licenses for the benefit
state governments. Under the applicable regulatory of the applicants. It has also prescribed the standard
framework, the functions of manufacture, import, form (template) of the licenses that may be issued for
distribution and sale of medical devices require the benefit of the regulatory authorities and the appli-
cants.
License for or Registration Cer- Form (tem- Application Relevant Licensing Timelines (from
tificate plate) of the form Rule Authority the date of
License application)
Certificate of registration of the for- Form 41 Form 40 Rule 24-A Drugs Controller 9 months
eign manufacturer and the medical General of India
devices to be imported (Registration (DCGI)
Certificate)
Import of Notified Medical Devices Form 10 Form 8 Rule 21 DCGI 3 months once Reg-
istration Certificate
I s granted
Import of Notified Medical Devices Form 11 Form 12 Rule 33 DCGI No time period pre-
for examination, test or analysis scribed
Permission to import new Notified Form 45 Form 44 Rule 122-A DCGI No time period pre-
Medical Device for clinical trial or scribed
marketing
Permission to conduct clinical trial Form 45 Form 44 Rule 122-DA DCGI Six months
using new Notified Medical Device
Permission to manufacture/import Form 45 Form 44 Rule No time period pre-
new Notified Medical Device after scribed
satisfactory clinical trials
Retail sale of Notified Medical Form 21 Form 19 Rule 61(2) State Drug No time period
Devices Licensing prescribed (usually
Authority between three to
six months)
Whole sale of Notified Medical Form 21-B Form 19 Rule 61(2) (Same) No time period
Devices prescribed (usually
between three to
six months)
License to manufacture Notified Form 28 Form 27 Rule 76 For Notified No time period
Medical Devices certain spec- prescribed (usually
ified Medical between three to
Devices5 the six months)
DCGI. For other
Notified Med-
ical Devices
the State
Drug Licensing
Authority
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IV. Importing A Notified agent in India, either having a valid license under the
Rules to manufacture for sale of a Notified Medical Device
Medical Device Into or having a valid wholesale license for sale or distribu-
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VII. Product Standards to other countries are exempted from certain labe-
ling requirements and are instead required to adopt
the requirements of the law to which the device is
No Notified Medical Device can be imported, manu-
being exported. The labelling requirements for med-
factured, stocked, sold or distributed unless it meets
ical devices under the Rules have been described in
the quality and other standards defined in the Act
ANNEXURE B and ANNEXURE C.
and Rules. For instance, Schedule R-1 of the Rules
has prescribed standards for the following Sterile
The Legal Metrology (Packaged Commodities)
Disposable Hypodermic Syringes, Sterile Disposable
Rules, 2011, which are applicable to all medical
Hypodermic Needles and Sterile Disposable Perfu-
devices, have identical requirements. One important
sion Sets. Similarly, Schedule M-III of the Rules lays
additional requirement prescribed by the said rules
down a Quality Management System (QMS) that
is to publish the name, address, telephone number,
is to be followed during the manufacture of medical
e-mail of the person or office to contact in case of
devices and in-vitro diagnostics.
consumer complaints.
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by providing specific inclusions under Section 3(5) of Act carves out an exception for medical, surgical, cura-
the Competition Act. Horizontal agreements in the tive, etc., processes or other treatments for humans
medical devices sector would involve agreements and animals and does not regard them as inventions,
entered at same level between medical device manu- thereby rendering these processes and treatments
facturers to restrict supply/fix prices whereas vertical incapable of being patented. However, the carve out
agreements are entered between players at different does not extend to medical devices. Thus, invention of
levels in the supply chain being manufacturers and a medical device (or process) is granted patent in India.
hospitals in the form of tie-in arrangements.
The patent rights with respect to any invention
Cartels by industry associations have been wide- are created only upon grant of the patent by the
spread across jurisdictions to set standard prices for Patent Office following the procedure established
both stockists and retailers but the same has often by the Patents Act and the Patent Rules. India
led to restricting prices. Although the provisions of follows a declarative system with respect to patent
the Act recognize protection granted under IP legis- rights. Patents are granted on a first to file basis.
lations, yet associations formed to exchange data and The patent application can be made by either
information serving purposes other than protection (i) the inventor or (ii) the assignee8 or (iii) legal
of the right holders could invite possible competi- representatives9 of the inventor.
tion law violations.
6. Section 2(1) (ja) of the Patents Act: inventive step means a feature
of an invention that involves technical advance as compared to the 8. Section 2(1) (ab) of the Patents Act: Assignee includes an assignee
existing knowledge or having economic significance or both and that of the assignee and the legal representative of the deceased assignee
makes the invention not obvious to a person skilled in the art. and references to the assignee of any person include references to the
7. Section 2(1)(ac) of the Patents Act: capable of industrial application assignee of the legal representative or assignee of that person.
in relation to an invention means that the invention is capable of being 9. Section 2(1) (k) of the Patents Act: Legal representative means a
made or used in an industry. person who in law represents the estate of a deceased person.
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Government has accepted the recommendations on Any registered trademark must fulfill certain condi-
data exclusivity and may offer protection against tions. The TM Act 1999 has set forth absolute and rela-
disclosure to the pharma/medical device companies. tive grounds of refusal of trademark registration. These
However, the Government may take some more time grounds are akin to the provisions of the UK Trade Mark
to announce its decision on Protection against unfair Act of 1994. The trademark can be registered even if the
commercial use as the Union ministry of health and mark is proposed to be used in India i.e. even if prior to
the Department Of Pharmaceuticals wants further the date of application no goods have been sold under the
discussions with stakeholders. applied trademark. The term of registration and renewal
is 10 years. Foreign companies can license trademarks
in India under the appropriate license / Registered User
XVII. Trademarks Agreement.
11. http://support.dialog.com/techdocs/international_class_codes_
as essential commodity. To control prices of medi-
tmarks.pdf
cal devices, the Central Government will have to first unit respectively. This effectively means that no patient
notify medical devices as an essential commodity. (consumer) in India will have to pay more than the afore-
stated amount for purchasing those stents in India. The
Interestingly, drugs as a class of commodities have
importers and manufacturers will also have to structure
been notified as essential commodities. Thus, the Cen-
their margins and business models to meet the fixed price.
tral Government has the power to fix prices of drugs. In
fact, in furtherance of the said notification, the Cen- The price fixation of Coronary Stents may appear at
tral Government has issued an order called the Drug first glance to hurt the interests of the importers and
(Prices Control) Order, 2013 (DPCO), which provides manufacturers of Cardiac Stents and could make
a framework for controlling the prices of drugs. The importers and manufacturers of other medical devices
main objective of the DPCO is to ensure the availabil- wary about a threat of potential price control. However,
ity of essential, lifesaving and prophylactic medicines on a detailed analysis, a very different picture comes out:
specified in National List of Essential Medicines, 2015
1. The government decided to fix prices of Cardiac
(NLEM) at affordable prices. The government agency
Stents only after an expert committee found them
under DPCO, which is responsible for controlling the
to be essential for the Indian population;
price of drugs, is called the National Pharmaceutical
Pricing Authority (NPPA). The DPCO also provides
2. The government held several meetings with manu-
for controlling the prices of non-NLEM drugs in two
facturers, importers, distributors and hospitals and
other situations:
took into account their feedback;
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It is also possible for importers and manufacturers of d. Substances used for in vitro diagnosis
Cardiac Stents and other Notified Medical Device to avail
e. All substances intended to be used for or in the
certain relaxations available in DPCO for patented devices
diagnosis, treatment, mitigation or prevention
and/or devices with specific therapeutic rationale.
of any disease or disorder in human beings or
By using the relaxation, the manufacturers and importers
animals.
of Cardiac Stents could limit the impact of price control.
XIX. Medical Device Rules medical devices is that only those products that are
covered by the definition of medical devices will be reg-
2017 An Analysis ulated by the 2017 Rules.
d. High (Class D)
b. Specific substances intended to affect the
structure or any function of the human body
The method of classification is described in detail in the
which are notified by the government. At
first schedule of the 2017 Rules (first schedule attached
present, the substances notified are mechanical
as Annexure E). It is important to note that unlike
contraceptives (eg. condoms, intra-uterine devices,
other countries which give liberty to manufacturers/
tubal rings) and disinfectants.
importers to classify their product for the purpose of
registration, the 2017 Rules do not provide this liberty
c. Surgical dressings, surgical bandages, surgical
and the manufacturers/importers will have to follow
staples, surgical sutures, ligatures, blood and
the classification decided by DCGI.15 This classification
blood component collection bag with or without
will be made available on a publicly accessible website
anticoagulant;
on a later date.16 The classification, once done, appears C. Single window clearance
to be non-appealable.
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E. Certainty and rationalization manufacture, sixty (60) days for import, then such
of timelines approvals shall be deemed to have been granted.27
has been licensed to import certain products from a. Changes in name and/or address of Indian
a manufacturing site, all other products manufac- agent/ Importer or change in constitution after
tured at the same site are mandatorily required to be issue of Registration Certificate/ Import License
licensed to the same importer.29
b. Change in the Indications and/ or Intended use
of change in particulars Under the 2017 Rules, the above changes (excepting
contained in the license change in constitution) do not require fresh
application.
The 2017 Rules are clear about the consequences
There is one more welcome change.
of change in the particulars of a license. Any major
change requires a prior approval from the appropri-
Under the Rules, it is prescribed that the applica-
ate licensing authority (either DCGI or State licens-
tion for registration certificate for import of noti-
ing authority, as the case may be).30 Any minor
fied medical devices will be decided within nine
change only requires written intimation to the
months35 and for import license the application
appropriate licensing authority within a period of
is customarily decided within three months after
thirty days.31
grant of registration certificate. Thus, on an average,
a total time of around one year is spent in obtain-
What constitutes major change and minor change has
ing the import license. Since it is a considerably
also been specified.32 For instance, the change in name
long span of time, it is possible that certain changes
or address of the manufacturer (whether domestic or
may occur in the details that were submitted to the
foreign) or importer is a major change. A change in
licensing authority at the time of making of the
design which does not affect quality in respect of its
application. For instance, it is possible for business
specifications, indication for use, performance and
reasons that a different manufacturing site is sought
stability of the medical device is a minor change.
to be registered. Ideally, since the application has
This clarificatory inclusion in the 2017 Rules is not been decided, it should be possible for the appli-
greatly welcomed. cant to revise the application. However, the current
practice is that in case of such a change, even if the
At present, the Rules do not specify what constitutes
application has not been decided, a fresh applica-
a major change or a minor change. That is not
tion has to be made.36 Apart from loss of money
all. Whether a change in the manufacturing or in
and resources, this results in loss of valuable time
processing or in testing or in documentation is
and sometime delays imminent and time-sensi-
major or not is left to the discretion of the licensing
tive launch of products. This serious shortcoming
authority and triggers the requirement to make
appears to have been rectified in the 2017 Rules.
a fresh application.33 The challenges of making
Such a change now is required to be informed in
a fresh application are discussed later with the
writing to the licensing authority.37 Due to this
subject of change in constitution.
explicit requirement, it should not trigger require-
ment to make a fresh application.
In fact, at present, it is known that the following
changes will result in the requirement to obtain
a fresh import license:34
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commencement of 2017 Rules shall be deemed to be it has reasons to believe that a medical device is likely
valid for sale of medical devices as well.42 to pose risk to the health of a user or patient during
its use and therefore may be unsafe. The recall should
The 2017 Rules do, however, address a practical diffi-
aim to withdraw the medical device in question from
culty faced by many distributors in India. Implanta-
both the market as well as patients, indicating reasons
ble medical devices cannot be self-administered and
for its withdrawal. The manufacturer and importer
therefore are seldom bought at retail. They are stocked
initiating recall is required to inform the licensing
by hospitals for clinical use as and when required. The
authority about the details of the recall.
hospitals sell the medical device to the patient directly
on a unit basis or as part of treatment package. How- In contrast, the Rules do not obligate the manufacturer
ever, considering the medical devices are expensive or importer to recall medical devices upon knowledge
and its demand is difficult to predict, hospitals are hesi- of risk to user or patients.45 There is also no explicit
tant to purchase medical devices in large quantities. requirement to report the facts leading to a recall,
At the same time, some of the medical devices are crit- unless the medical device is new and is required to
ical and may be required on short notice, therefore it submit periodic safety update reports and have
is in hospitals and patients interest that the hospital a system of pharmacovigilance in place.46
maintains a large stock of medical devices. As a solu-
tion to this dilemma, the distributors transfer a sizeable
L. New thresholds for residual
stock of the medical devices to the hospital through
a stock transfer. A stock transfer is not a sale, it is
shelf life of imported
merely transfer of stock. As and when the hospital products
requires a medical devices, it uses it from the stock.
The distributor then charges the hospital on the basis The Rules prescribe that all imported products
of its use. All the unused stock is later re-transferred to should have a minimum residual shelf life of sixty
the distributor. The proof of stock-transfer of medical (60) percent on the date of import unless specific
devices by distributor to the hospital is a delivery note. permission is obtained to the contrary.47 This
becomes an issue for importers of medical devices
The Rules requires that any sale or distribution should
which have a short claimed shelf life.
be recorded by the distributor. A stock transfer is not
a sale or distribution, therefore it is not recorded by The 2017 Rules have addressed the issue by relaxing
the distributor. However, the presence of stock at the the residual shelf life requirement for medical
hospital may be interpreted as an act of distribution. devices with short shelf life.48 Any medical device,
This can lead to unnecessary investigation against the whose total shelf life claim is
distributors by the licensing authority.
a. less than ninety (90) days, will be allowed to be
In order to resolve this complication, the 2017 Rules imported if it has more than forty (40) per cent
have permitted supply of implantable medical devices residual shelf-life on the date of import
against a delivery note (challan).43
b. between ninety (90) days and one (1) year, will
be allowed to be imported if it has it has more
K. Mandatory recalls on than fifty (50) per cent residual shelf-life on the
knowledge of risk to safety date of import
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c. is more than one (1) year, will be allowed to be These changes should bring lot of comfort to
imported by the licensing authority if it has stakeholders in the clinical investigation of medical
more than sixty (60) per cent residual shelf-life devices.
on the date of import.
N. Debarment on account of
M. New regulatory framework supply of misleading infor-
for clinical investigation of mation
medical device
The 2017 Rules frown upon submission of mislead-
The 2017 Rules will introduce a new regulatory ing information along with an application for grant
framework for clinical investigation of medical of any license. It prescribes that any applicant found
devices. Some of the interesting provisions of this guilty of submitting misleading, or fake, or fabri-
framework are: cated documents, may be debarred by the appro-
priate licensing authority for such period as it may
a. A fixed timeline of ninety (90) days has been
deem fit.49 In other words, if any misleading or false
prescribed for the licensing authority to arrive
information is found to have been submitted to the
at a decision on application for permission to
licensing authority, then it can debar the applicant
conduct clinical trial;
from doing business in India.
and distributors change. The fact of the matter is that even after com-
mencement of the 2017 Rules, medical devices will
continue to be deemed to be drugs, since the defini-
After the commencement of 2017 Rules, all licenses
tion of medical devices is tied to the definition of drugs
and registrations for medical devices issued under the
under Act. This has repercussions under other laws,
Rules that are valid on the date of commencement,
most important of which is the price control legisla-
shall be valid at least until July 31, 2018 or until the
tion the Drugs (Price Control) Order, 2013 issued
expiry date of the license or registration, whichever is
under the Essential Commodities Act, 1955. The Essen-
later (Grace Period). Upon expiry of the Grace Period,
tial Commodity Act, 1955 has notified drugs as defined
all existing licensees will require a license issued under
under Act as essential commodity. Due to the reference
the 2017 Rules. Therefore, there is no need to rush to
to this definition, medical devices which are deemed
adopt to the 2017 Rules. However, it is important to
to be drugs, are also currently subject to limited price
start preparing for the new regulatory regime under
control. Had the government separated the definition
2017 Rules.
of medical devices form the definition of drug, the trag-
edy that inadvertent and unintended price control of
It is not clear whether existing licensees could
medical devices is today would have been avoided.
voluntarily surrender their licenses before the expiry
of the Grace Period in order to obtain a license under
Having said that, there is no doubt that the fact
the 2017 Rules. However, such a step by licensees
of notification of the 2017 Rules and the very real
is not advisable. This is because the license fees
possibility of it coming into effect in 2018 needs to be
paid to obtain the license under Rules is far cheaper
celebrated!
than the license fees prescribed in 2017 Rules. By
opting to surrender the license, the licensee would
effectively end up forfeiting the license fees already
paid and incur expense of higher license fees. In case
the decision to surrender is being contemplated
for taking benefit of the beneficial provisions of
2017 Rules (eg. change in constitution), then such
rationale needs to be re-evaluated because the 2017
Rules clarify that the existing license under the
Grace Period shall be deemed to be valid under the
corresponding provision of 2017 Rules. Therefore,
all existing licensees should be able to derive the
benefit of 2017 Rules during the Grace Period despite
transacting on a license issued under the Rules.
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6. Taxation Regime
Section 90(2) of the ITA is a beneficial provision which
I. Direct Taxes states that, where the taxpayer is situated in a country
with which India has a double tax avoidance agree-
ment (Indian Tax Treaty), the provisions of the ITA
A. General overview apply only to the extent that they are more beneficial
to the taxpayer. Rules under Indian Tax Treaties are
Taxation of income in India is governed by the provi- generally more beneficial to the taxpayer than those
sions of the Income Tax Act, 1961 (ITA) as amended under domestic law (ITA) and hence it is typically
annually by the Finance Acts. Under the ITA, residents advantageous for a non-resident taxpayer to structure
are subject to tax in India on their worldwide income, his investments or business through a jurisdiction
whereas non-residents are taxed only on Indian source which has signed an Indian Tax Treaty.
income i.e. income that accrues or arises in India, is
In recent times, the Indian income tax authorities have
deemed to accrue or arise in India or which is received
been adopting an aggressive approach to transactions
or is deemed to be received in India. A company is said
where any form of exemption from taxation is sought
to be resident in India if it is incorporated in India or
by the taxpayer. Their approach is even more hostile
its place of effective management (POEM) is located
when the transaction in question has an offshore
in India.50 In this regard, the Central Board of Direct
element to it. Hence, it is has become critical to ensure
Taxes (CBDT) recently released the final guidelines
that offshore transactions are structured in a manner
for determination of POEM. (Please click here to read
such that legitimatetax exemptions are not challenged
our hotline on the same).
by the tax department.
Section 9 of the ITA deems certain income of non-
Before delving into specific tax issues concerning
residents to be Indian source income. Under section
contract research and manufacturing, set out below
9(1), capital gains are considered to have their
is a snap shot of the taxation regime in India. The tax
source in India and are taxable in India if they arise
rates mentioned in this section are exclusive of appli-
directly or indirectly, through the transfer of a capital
cable surcharge and education cess, unless otherwise
asset situated in India. Similarly, the business
specified. As per the Finance Act, 2016, the surcharge
income of a non-resident is taxable in India only if
applicable to income generated by resident compa-
it accrues or arises, directly or indirectly, through or
nies for the financial year 2016-2017 is 7% where the
from any business connection in India.
income exceeds INR 10 Million but does not exceed
The Indian tax rates applicable to non-residents INR 100 Million and 12% where the income exceeds
could be up to 40% (all tax rates provided herein are INR 100 Million. Additionally, as per Finance Act, 2016
exclusive of surcharge and cess discussed below) on surcharge applicable to income generated by compa-
taxable business income and capital gains. nies other than domestic companies, for the financial
year 2016-2017 is 2% where the income exceeds INR
10 Million but does not exceed INR 100 Million and 5%
where the income exceeds INR 100 Million.
50. India introduced the place of effective management (POEM)
test for determining the residential status of a company in 2016.
Under the POEM test, a company is said to be resident in India if
it is incorporated in India or; if its place of effective management
is in India. POEM has been defined to mean the place where key
management decisions that are necessary for the conduct of the
business of an entity as a whole are, in substance made. Until
the introduction of POEM, foreign companies were character-
ized as being tax resident of India only on the satisfaction of the
control and management test, which required that the foreign
companys control and management be wholly situated in India.
i. Taxes Applicable to companies iii. Interest, Royalties and Fees for Tech-
nical Services
Resident companies are taxed at the rate of 30%51,
while non-resident companies are taxed at the rate of
Interest payable to non-residents on loans taken/
40%. A minimum alternative tax is payable by resi-
debt securities issued in foreign currency are taxable
dent, and in certain circumstances, non-resident com-
at a beneficial rate of 5%.53 However this benefit
panies at the rate of around 18.5%. The Indian Finance
has a sunset clause stating that the benefits would
Minister in his budget speech in 2017 (Budget 2017)
only be available for loan agreements entered into/
has proposed to reduce the corporate tax rate to 25%
bonds issued on or after July 1, 2012 and before July
(as opposed to the current rate of 30%) for domestic
1, 2017. The Budget 2017 has proposed to extend this
companies whose total turnover or gross receipts does
benefit to Rupee Denominated Bonds (RDB) and
not exceed INR 500 million (approx. USD 7.4 million).
extend the sunset clause to July 1, 2020. Similarly,
For the remainder of the companies, the corporate tax
interest payable to foreign portfolio investors
rates continue to be 30%.
(FPI) on investments made by them in RDBs and
government securities is taxable at the rate of 5%.54
ii. Dividends Further, the Budget 2017 has proposed to amend
the sunset clause for this benefit as well to state
this it shall be applicable to bonds issued till July
Dividends distributed by Indian companies are
1, 2020 as opposed July 1, 2017. Interest payable on
subject to a dividend distribution tax (DDT) at
majority of other circumstances not covered under
the rate of around 15% (calculated on a gross-up
the abovementioned benefits are taxable at a rate
basis), payable by the company. However, except as
ranging from 20% to 40%.
stated immediately below, no further Indian taxes
are payable by the shareholders on such dividend
Also as regards interest payments made by an Indian
income once DDT is paid. Accordingly, there should
company to its associated enterprises/related party55,
be no withholding tax applicable on the payment of
the Budget 2017 has proposed to introduce Thin
dividends to a non-resident.
Capitalization Rules as per which, interest payments
exceeding 30% of the Earnings Before Interest, Taxes,
Further tax at the rate of 10% is levied on dividends
Depreciation and Amortization (EBITDA) of the
received from a domestic company, by a resident
payer of interest shall not be deductible as an expense.
individual, HUF or firm, where the amount of
dividend received exceeds INR 1 million.52 Budget
The withholding tax on royalties and fees for
2017 proposes to amend this provision by providing
technical services earned by a non-resident is 10%.
that this additional tax rate of 10% should be
These rates are subject to available relief under an
applicable to dividends received by all resident
applicable tax treaty. In this context, it is important
taxpayers except domestic companies, certain kinds
to note that the definition of royalties and fees for
of funds, institutions, trusts, educational institutions,
technical services under Indian domestic law is much
hospital and medical institution as specified in the
wider than the definition under most tax treaties
ITA. Dividends received from a domestic company
signed by India.
by a non-resident company should continue to
be Indian tax exempt in the hands of the foreign
company, provided that DDT has been paid by the
distributing domestic company.
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Nishith Desai Associates 2017
Provided upon request only
Gains earned by a resident company from the Tax would have to be withheld at the applicable
transfer of capital assets situated anywhere in rate on all payments made to a non-resident, which
the world are taxable in India. In the case of non- are taxable in India. The obligation to withhold
residents, only those gains arising out of the transfer tax applies to both residents and non-residents.
of a capital asset in India should be taxable.56 The Withholding tax obligations may also arise with
tax treatment of capital gains depends mainly on respect to specific payments made to residents
whether the gains are short term or long term. Short and the failure to withhold tax could result in tax,
term capital gains (STCG) arise upon the transfer interest and penal consequences.
of assets held by a taxpayer for a period of 36 months
or less before the date of transfer (12 months or less
B. Incentives Under the ITA
in the case of securities listed on a recognized stock
exchange in India, and 24 months in the case of
The Government of India has taken various policy
unlisted shares of an Indian company). Long term
initiatives in order to strengthen scientific research
capital gains (LTCG) arise upon the transfer of
and development in the various sectors, including the
a capital asset held for a period of more than 36
medical device sector. The term scientific research
months (12 months in the case of listed securities
has been defined in the ITA to include activities for
and 24 months in the case of unlisted shares of an
the extension of knowledge in the fields of natural or
Indian company).
applied science. Scientific research can be carried out
either in-house or by contributing to outside agencies
Listed: STCGs arising from the transfer of a listed
engaged in scientific research. Typically, in the
equity share are taxable at the beneficial rate of
medical device industry, fiscal incentives are awarded
15%,57 while long term capital gains arising from
to research and development units towards the
the transfer of listed equity share are tax exempt
development of new technology that adds medical
under the ITA generally.58 This is applicable to both
benefits and for life-saving medical equipment.
residents and non-residents.
It should be borne in mind here that no company business connection in India. Similarly, under the
would be entitled to the aforementioned deduction Indian Tax Treaties, typically, the business income
unless it enters into an agreement with the Depart- of a non-resident is taxable only to the extent that it
ment of Scientific and Industrial Research for co-op- is attributable to a Permanent Establishment (PE)
eration in such research and development facility of such non-resident in India. The concept of PE
and for audit of the accounts maintained for that under typical Indian Tax Treaties is expressed as an
research and development facility. exhaustive list of factors, as opposed to the business
connection rule contained in the ITA, which has no
Currently, this deduction is available for expenses
exhaustive definition in the ITA and which has been
incurred prior to March 31, 2017.
afforded a wide interpretation by Indian courts in the
past. Therefore, there may be situations where
ii. Contributions made to other a non-resident is considered to have a business
Institutions for Scientific Research connection in India, but no PE. As mentioned ear-
lier, since it is open for the non-resident taxpayer
to choose to be treated under the more beneficial
The ITA provides for a deduction of 200 percent
regime, a non-resident may rely on the PE rule under
of sums paid to any scientific research association
the applicable Indian Tax Treaty rather than the
(having as its object the undertaking of scientific
business connection rule in the ITA.
research), or to any university, college or other insti-
tution, for the purpose of scientific research approved
The term PE has been succinctly defined by the
by the concerned authority. Similar to the position
Andhra Pradesh High Court in the case of CIT v.
in respect of an in-house research and development,
Visakhapatnam Port Trust60, as follows:
the Finance Bill 2016 proposes to restrict the rate of
deduction to 150 percent with effect from 01.04.2017 In our opinion, the words permanent establishment
to 31.03.2020. Further, the deduction shall be postulate the existence of a substantial element of an
restricted to 100 percent from 01.04.2020 onwards. enduring or permanent nature of a foreign enterprise
in another country which can be attributed to a fixed
place of business in that country. It should be of such
iii. Capital Expenditure
a nature that it would amount to a virtual projection
of the foreign enterprise of one country into the soil
Under Section 35(1)(iv) read with Section 35(2)
of another country.
of the ITA, the whole of any expenditure on
scientific research (other than expenditure on The Indian Tax Treaties typically lay down certain
acquisition of any land) being capital in nature, criteria to determine whether a foreign enterprise earn-
incurred after 31 March 1967 is allowed as a ing business income from India would be construed
deduction. Further, under Explanation 1 to to have a PE in India. Some of these tests are discussed
Section 35(2) of the ITA, the aggregate capital below, especially in the context of contract research
expenditure on scientific research incurred three and manufacturing.
years immediately prior to the commencement
of business is allowed as a deduction in the year
i. Fixed Place of Business PE
in which the business is commenced.
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Nishith Desai Associates 2017
Provided upon request only
(l) the furnishing of services, other than included Depending on the manner in which it is structured,
services as defined in article 12 (royalties and fees for a contract research and manufacturing arrangement
included services), within a Contracting State by an could run the risk of being taxed under the ITA as
enterprise through employees or other personnel, a separately taxable unit called an association of
but only if: person (AOP). This is a significant issue for the
foreign enterprise which outsources these functions,
i. activities of that nature continue within that
given that, if such arrangement is treated as an AOP,
State for a period or periods aggregating to more
the profits of the foreign enterprise attributable to
than 90 days within any twelve-month period; or
such AOP, which otherwise would not have been
subjected to tax in India (in the absence of a PE of the
ii. the services are performed within that State for
foreign enterprise in India), would be taxable at the
a related enterprise (within the meaning of para-
maximum marginal rate of 40%.
graph 1 of article 9 (associated enterprises).
E. Structuring Investment into to the arms length price (discussed below). The TP
Regulations define associated enterprise to include
India Use of Intermediate any enterprise that participates directly or indirectly
Jurisdictions or through one or more intermediaries in the man-
agement or control or capital of another enterprise.
Foreign entities that are looking at incorporating sub- Enterprises may also be regarded as associated as
sidiaries in India for outsourcing research and manu- a result of circumstances such as interdependence
facturing functions can achieve tax efficiency by use by virtue of borrowings, guarantees, licensing of
of a tax neutral intermediate jurisdiction which has trademarks, purchase, sales or where enterprises have
signed an Indian Tax Treaty (Treaty Jurisdiction) mutual interest as may be prescribed by the reve-
rather than directly investing into the Indian com- nue authorities. Here, enterprise is defined broadly
pany. The foreign entity can achieve tax efficiency and covers any entity (including a permanent estab-
by incorporating a company (or any other entity lishment) which is or proposes to be engaged in any
which is eligible to benefits of the relevant Indian Tax activity relating to the provision of goods / services
Treaty) in the Treaty Jurisdiction which would, in of any kind, investment activity, dealing in securities
turn, invest into the underlying Indian company. and extending loans. The term international trans-
action has been defined as a transaction between
The choice of an appropriate Treaty Jurisdiction, apart
two or more associated enterprises, either or both of
from tax neutrality and a good treaty network, would
which are non- residents. As mentioned earlier, the
depend on factors such as political stability, ease of
basic principle is that any income arising from such
administration, availability of reliable administrators,
an international transaction shall be computed hav-
favourable exchange controls and legal system, cer-
ing regard to the arms length price.
tainty in tax and legal framework and ease of winding
up operations. The Budget 2017 has introduced the concept of
secondary adjustment under the transfer pricing
Indian Tax Treaties aim to prevent double taxation
regulations.
of income and capital gains for a person or entity
resident in another jurisdiction.
i. Arms Length Price
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Provided upon request only
other than associated enterprises, in uncontrolled tion, and to obtain and furnish to the revenue author-
conditions. The OECD Transfer Pricing Guidelines for ities an accountants report containing prescribed
Multinational Enterprises and Tax Administrations, details regarding the international transactions.
2010 (Guidelines) provide that the application of the Stringent penaltieshave been prescribed for non-com-
arms length principle is generally based on a compari- pliance with the procedural requirements and for
son of all the relevant conditions in a controlled trans- understatement of profits.
action with the conditions in an uncontrolled transac-
tion. Under the Guidelines, comparability is achieved
G. Disallowance of Deduction
when there are no differences in the conditions that
could materially affect the price or when reasonably
of Expenses Incurred in
accurate adjustments can be made to eliminate the Unethical Promotion
effects of any such differences. The analysis of the con-
trolled transactions with uncontrolled transactions is The Indian Medical Council (Professional Conduct,
the very basis of ascertaining whether the controlled Etiquette and Ethics) Regulations, 2002 prohibit the
transactions adhere to the arms length standard. medical practitioners and their professional associa-
tions from taking any Gift, Travel facility, Hospital-
The arms length price in relation to an international
ity, Cash or monetary grant from the medical device
transaction is to be determined by any of the
industry. The Central Board of Direct Taxes has issued
following methods depending on which is the most
instructions63 to the revenue department that the
appropriate given the business of the enterprises:
claim of any expense incurred in providing above
mentioned or similar freebees in violation of the pro-
Comparable uncontrolled price method; visions of Indian Medical Council (Professional Con-
duct, Etiquette and Ethics) Regulations, 2002 shall be
Resale price method;
inadmissible as expense because it is an expense pro-
Cost plus method; hibited by the law.
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Nishith Desai Associates 2017
Provided upon request only
An exemption has been provided to pre-packaged to avoid the cascading effect of taxes that was
goods where the sale price has been declared on the prevalent under the erstwhile sales tax regime.
package. The SAD paid is only available as a refund if it
is proved that state level VAT is paid on the subsequent
D. CENVAT
sales of the imported products. The issue often faced by
companies is that the process of obtaining refunds of
CENVAT is a duty of excise which is levied on all
SAD is tedious and time consuming and the time limit
goods that are produced or manufactured in India,
for filing the refund is stipulated as one year, which
marketable, movable and covered by the excise
often leads to a failure in obtaining rightful refunds.
legislation. The peak duty rate was reduced from 16 per
cent to 14 per cent by the Finance Act, 2008 and was
Under Section 9A of the Tariff Act, the Central
further reduced to 8 per cent, although there are other
Government can impose an Antidumping Duty on
rates ranging upwards, or based on an ad valorem/
imported articles, if it is exported to India at a value
quantity rate.
less than the normal value of that article in other
jurisdictions. Such duty is not to exceed the margin
of dumping with respect to that article. The law in E. Goods and Services Tax
India with respect to anti-dumping is based on the (GST)
Agreement on Anti-Dumping pursuant to Article VI
of the General Agreement on Tariffs and Trade, 1994.
The government is in the process of introducing the
GST, which will consolidate most indirect taxes.
C. Sales Tax and Value Added The constitutional amendment required for the
Tax introduction of GST has been ratified by the required
majority of the state legislatures and has also
received the assent of the President of India, thereby
Central Sales Tax (CST) is imposed on the sale of
making it a law. The government is currently deliber-
goods in the course of inter-state trade or commerce.
ating on the implementation aspects of the GST, and
Sales of goods are deemed to take place in the course
is hoping to roll it out by July 2017.
of inter-state trade if they result in the movement
of goods from one state to another, or if such sales
are effected by the transfer of documents of title to F. Research and Development
the goods during their movement from one state Cess
to another. No CST is levied on direct imports or
exports or the purchase or sale effected in the course
All payments made towards the import of technology
of imports or exports. The process of phasing out
are subject to a cess of 5% under the Research and
CST commenced with a reduction in the CST rate
Development Cess Act, 1986. Technology includes
from 4 per cent earlier to 2 percent on April 1, 2008.
any special or technical knowledge or any special
Value Added Tax (VAT) is levied on the sale of service required for any purpose whatsoever by an
goods within a particular state at the two main industrial concern under any foreign collaboration,
VAT rates of 4 per cent and 12.5 per cent. VAT is and includes designs, drawings, publications and
a state specific levy and most states in India have technical personnel.
introduced specific legislations for VAT based on the
Model VAT legislation circulated by the Empowered
Committee of State Finance Ministers. Further,
under the VAT regime, a system of tax credits on
input goods procured by the dealer is also available,
Conclusion
All medical devices, other than those mentioned in
The Indian medical device industry continues its Annexure D below, are completely outside the scope
upward march of growth and is strongly supported of price control. With respect to the singular event
by Indias robust legal framework. of price fixation of Coronary Stents, The government
had several interactions with the importers and
The Indian Government has identified the medical
manufacturers of Coronary Stent and took their
device industry as a focus industry for its flagship
feedback into account before fixing the price. Thus,
Make in India programme. Due to this, the govern-
it appears that the government sought to be restrained
ment is especially committed to easing the pro-
and transparent in its approach. Also, it is still possible
cesses and compliances for doing business of medi-
for importers and manufacturers of Coronary Stents
cal devices in India. This commitment was reflected
to increase their current margins by structuring their
in the governments decision to relax foreign direct
business model or by using the available relaxations as
investment restriction for companies engaged in
discussed in the body of this paper.
manufacturing of medical devices in 2015. In 2016
and 2017, the Indian Government hosted a three day Lastly, with the introduction of the Medical Device
medical device conference that saw participation of Rules, 2017, the medical device industry in India is
top government functionaries, regulators and indus- certain to receive a fillip.
try participants. There were several invite only events
Therefore, the medical devices industry in India
aptly titled CEOs roundtable where the leaders of
continues to offer unparalleled opportunities to
the industry enjoyed direct access to the relevant
present and potential stake holders, now more than
government functionaries and regulators and could
ever before.
share their concerns within closed doors. There is
also a proposal to launch new medical device parks
in which government will provide fiscal and mone-
tary incentives. This should give lot of confidence to
potential stakeholders to consider the Indian medical
device industry seriously.
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Nishith Desai Associates 2017
Provided upon request only
Annexure A
List of Notified Medical Devices It is noteworthy that in addition to the above
medical devices, the following substances are also
1. Disposable Hypodermic Syringes regulated as Drugs under Drugs & Cosmetics Act,
1940 & Rules, 1945 there under:-
2. Disposable Hypodermic Needles
5. Cardiac Stents
4. Condoms
7. Catheters
6. Surgical Dressings
9. I.V. Cannulae
8. Blood/ Blood Component Bags
Annexure B
Labeling Requirements for medical devices xiii. To overprint on the label of the device, the
words Physicians Sample--Not to be sold,
i. Proper name of the medical device; if a medical device is intended for distribution
to the medical professional as a free sample;
ii. The details necessary for the user to identify the
device and its use; xiv. To provide, except for imported devices, the
manufacturing licence number by preceding
iii. The name of the manufacturer and address of the
the words Manufacturing Licence Number or
manufacturing premises where the device has
Mfg. Lic. No. or M.L.;
been manufactured;
xv. In case of imported devices, the import licence
iv. The correct statement of the net quantity in
number, name and address of the importer and
terms of weight, measure, volume, number of
address of the actual manufacturing premises, date
units, as the case may be, and the number of
of manufacture, (if not already printed at the time
the devices contained in the package shall be
of import). The label may bear symbols recognised
expressed in metric system;
by the Bureau of Indian Standards or Interna-
tional Organisation for standardisation (ISO) may
v. Date of manufacture and date of expiry;
be used in lieu of text and the device safety is not
vi. Indication that the device contains medicinal compromised by a lack of understanding on the
or biological substances, where necessary; part of the user. Where the meaning of the symbol
is not obvious to the device user, for example, for a
vii. Batch number or lot number;
newly introduced symbol; an explanation shall be
provided in the instructions for use..
viii. Special storage and handling conditions, where
required;
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Nishith Desai Associates 2017
Provided upon request only
Annexure C
Labeling requirements for medical devices iv. name and address of the manufacturer and
intended for export address of actual premises where the device has
been manufactured
i. name of the Device;
v. manufacturing Licence No. preceded by the let-
ii. distinctive batch number or lot number ters M.L. No. or Manufacturing Licence No.;
preceded by the word Lot No. or Lot or Batch
vi. internationally recognised symbols in lieu of
No. or B. No.;
text, wherever required
iii. date of expiry, if any;
Annexure D
List of Notified Medical Devices 8. Intra Ocular Lenses
9. I.V. Cannulae
1. Disposable Hypodermic Syringes
5. Cardiac Stents
14. Internal Prosthetic replacements
7. Catheters
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Nishith Desai Associates 2017
Provided upon request only
Annexure E
mechanical barrier, for compression or for
First Schedule absorption of exudates only, for wounds which
have not breached the dermis and can heal by
primary intention;
[See rule 4]
if it is a blood bag that does not incorporate vi. Invasive (body orifice) medical devices for
a medicinal product. short term use.
iii. Non-invasive medical devices for modifying a. Subject to clause (b), an invasive (body orifice)
compositions of substances. medical device shall be assigned to Class B, if,-
a. Subject to clause (b), a non-invasive medical 1. it is intended for short term use; and
device shall be assigned to Class C, if it is
2. it is not intended to be connected to an active
intended for modifying the biological or the
medical device; or
chemical composition of blood or other body
liquids or other liquids intended for infusion
3. it is intended to be connected to a Class A
into the body.
medical device only.
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Nishith Desai Associates 2017
Provided upon request only
ix. Surgically invasive medical devices for b. Subject to clause (c), a short term use surgically
transient use. invasive medical device shall be assigned to
Class C, if it is intended to undergo a chemical
a. Subject to clauses (b) to (g), a surgically
change in the body.
invasive medical device intended for transient
use shall be assigned to Class B. c. A short term use surgically invasive medical
device referred to in clause (b) shall be assigned
b. Subject to clauses (c) to (g), a transient use
to Class B, if it is intended to be placed into any
surgically invasive medical device shall be
tooth.
assigned to Class A, if it is a reusable surgical
instrument. d. A short term use surgically invasive medical
device shall be assigned to Class C, if it is
c. A transient use surgically invasive medical
intended for the administration of any
device shall be assigned to the same class as the
medicinal product or the supply of energy in
active medical device to which it is intended to
the form of ionising radiation.
be connected.
e. A short term use surgically invasive medical
d. A transient use surgically invasive medical
device shall be assigned to Class D, if it is
device shall be assigned to Class C, if it is
intended to have a biological effect or to be
intended for the supply of energy in the form of
wholly or mainly absorbed by the human
ionising radiation.
body or to be used specifically in direct contact
with the central nervous system or for the
e. A transient use surgically invasive medical
diagnosis, monitoring or correction of a defect
device shall be assigned to Class C, if it is
of the heart or of the central circulatory system
intended to have a biological effect or to be
through direct contact with these parts of the
wholly or mainly absorbed by the human body.
body.
f. A transient use surgically invasive medical
xi. mplantable medical devices and surgically
device shall be assigned to Class C, if it is
invasive medical devices for long term use.
intended for the administration of any
medicinal product by means of a delivery
a. Subject to clauses (b), (c) and (d), an
system and such administration is done in
implantable medical device or a surgically
a manner that is potentially hazardous.
invasive medical device intended for long term
use shall be assigned to Class C.
g. A transient use surgically invasive medical
device shall be assigned to Class D, if it is
b. A long term use medical device shall be
intended to be used specifically in direct
assigned to Class B, if it is intended to be placed
contact with the central nervous system or for
into any tooth.
the diagnosis, monitoring or correction of a
defect of the heart or of the central circulatory c. A long term use medical device shall be
system through direct contact with these parts assigned to Class D, if it is intended,-
of the body.
1. to be used in direct contact with the heart,
x. Surgically invasive medical devices for short the central circulatory system or the central
term use. nervous system;
a. Subject to clause (b), (d) and (e), a surgically 2. to be life supporting or life sustaining;
invasive medical device intended for short
3. to be an active medical device;
term use shall be assigned to Class B.
6. to be a breast implant.
c. An active diagnostic medical device referred to
in clause (a) shall be assigned to Class C, if it is
d. Subject to clause (b), a long term use medical
intended specifically for,-
device shall be assigned to Class D, if it is
intended to undergo chemical change in the
1. the monitoring of vital physiological
body.
parameters, where the nature of any variation
is such that it could result in immediate
xii. Active therapeutic medical devices for
danger to the patient (such as any variation in
administering or exchanging energy.
cardiac performance, respiration or activity of
a. Subject to clause (b), an active therapeutic the central nervous system); or
medical device shall be assigned to Class B, if it
2. diagnosing in a clinical situation where the
is intended for the administration or exchange
patient is in immediate danger.
of energy to or with a human body.
2. to be used to capture any image of the in 1. the nature of the medicinal product, body
vivo distribution of radiopharmaceuticals; or liquid or substance;
3. for the direct diagnosis or monitoring of vital 2. the part of the body concerned; and
physiological processes.
3. the mode and route of the administration or
removal.
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Nishith Desai Associates 2017
Provided upon request only
xiv. Other active medical devices. xvii Medical devices for sterilization or
disinfection.
An active medical device to which provisions of
sub-paragraphs (xii) and (xiii) do not apply shall be a. Subject to clause (b), a medical device shall be
assigned to Class A. assigned to Class C, if it is intended to be used
specifically for,-
xv. Medical devices incorporating medicinal
products. 1. the sterilization of any other medical device;
a. Subject to clause (b), a medical device shall 2. the end-point disinfection of any other
be assigned to Class D, if it incorporates as an medical device; or
integral part a substance which,-
3. the disinfection, cleaning, rinsing or hydration
1. if used separately, may be considered to be of contact lenses.
a medicinal product; and
b. A medical device shall be assigned to Class B, if
2. is liable to act on a human body with an action it is intended for the disinfection of any other
ancillary to that of the medical device. medical device before the latter is sterilized or
undergoes end-point disinfection:
b. A medical device referred to in clause (a) shall
be assigned to Class B, if the incorporated Provided, that end-point disinfection means the
substance is a medicinal product exempted disinfection of a medical device immediately before its
from the licensing requirements of the Drugs use by or on a patient.
and Cosmetics Act, 1940 (23 of 1940) and the
xviii. Medical devices for contraceptive use.
rules made thereunder.
each of the devices. Accessories are classified 2. causes a life-threatening disease with
in their own right separately from the device a high risk of propagation.
with which they are used.
b. An in vitro diagnostic medical device shall be
c. Software, which drives a device or influences assigned to Class C, if it is intended for use in,-
the use of a device, falls automatically in the 1. detecting the presence of, or exposure to,
same class. a sexually transmitted agent;
d. Standalone software, which are not 2. detecting the presence in cerebrospinal fluid
incorporated into the medical device itself or blood of an infectious agent with a risk of
and provide an analysis based on the results limited propagation (for example, Cryptococcus
from the analyser, shall be classified in to the neoformans or Neisseria meningitidis);
same category that of the in vitro diagnostic
3. detecting the presence of an infectious agent,
medical device where it controls or influences
where there is a significant risk that an erro-
the intended output of a separate in vitro
neous result will cause death or severe disa-
diagnostic medical device.
bility to the individual or foetus being tested
e. Subject to the clause (c) and (d), software that (for example, a diagnostic assay for Chlamydia
is not incorporated in an in vitro diagnostic pneumoniae, Cytomegalovirus or Methicillin-re-
medical device, shall be classified using sistant Staphylococcus aureus);
the classification provisions as specified in
4. pre-natal screening of women in order to
paragraph 2.
determine their immune status towards
f. Calibrators intended to be used with a reagent transmissible agents such as immune status
should be treated in the same class as the in tests for Rubella or Toxoplasmosis;
vitro diagnostic medical device reagent.
5. determining infective disease status or
g. If several rules apply to the same device, based immune status, where there is a risk that an
on the performance specified for the device by erroneous result will lead to a patient man-
the manufacturer, the stringent rules resulting agement decision resulting in an imminent
in the higher classification shall apply. life-threatening situation for the patient being
tested (for example, Cytomegalovirus, Enter-
2. The parameters for classification of in vitro
ovirus or Herpes simplex virus in transplant
diagnostic medical devices as follows:-
patients);
45
Nishith Desai Associates 2017
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1. test results that are not for the determination 1. human genetic testing, such as the testing for
of a medically-critical status; or cystic fibrosis or Huntingtons disease;
About NDA
Nishith Desai Associates (NDA) is a research based international law firm with offices in Mumbai, Bangalore,
Palo Alto (Silicon Valley), Singapore, New Delhi, Munich and New York. We provide strategic legal, regulatory,
and tax advice coupled with industry expertise in an integrated manner.
As a firm of specialists, we work with select clients in select verticals on very complex and innovative
transactions and disputes.
Our forte includes innovation and strategic advice in futuristic areas of law such as those relating to Bitcoins
(block chain), Internet of Things (IOT), Autonomous Vehicles, Artificial Intelligence, Privatization of Outer
Space, Drones, Robotics, Virtual Reality, Med-Tech, Ed-Tech and Medical Devices and Nanotechnology.
We specialize in Globalization, International Tax, Fund Formation, Corporate & M&A, Private Equity &
Venture Capital, Intellectual Property, International Litigation and Dispute Resolution; Employment and
HR, Intellectual Property, International Commercial Law and Private Client. Our industry expertise spans
Automobile, Funds, Financial Services, IT and Telecom, Pharma and Healthcare, Media and Entertainment, Real
Estate, Infrastructure and Education. Our key clientele comprise marquee Fortune 500 corporations.
According to the recent report by India Brand Equity Foundation (IBEF), Indias Civil Aviation Industry is on a
high-growth trajectory expected to grow from being the 9th largest aviation market in the world with a size of
around US$ 16 billion to being the 3rd biggest by 2020 and the largest by 2030.
The Government of India (GOI) also envisions airport infrastructure investment of US$ 11.4 billion under
the Twelfth Five Year Plan (2012-17). It has opened up the airport sector to private participation. The Airports
Authority of India (AAI) also aims to bring around 250 airports under operation across the country by 2020.We
at NDA accordingly prepare ahead, envisaging the coming 10 to 15 years, in order to provide clients appropriate
insights based on our understanding of current as well as future legal and regulatory issues.
Our ability to innovate is endorsed through the numerous accolades gained over the years and we are also
commended by industry peers for our inventive excellence that inspires others.
Most recently, NDA was ranked the Most Innovative Asia Pacific Law Firm in 2016 by the Financial Times - RSG
Consulting Group in its prestigious FT Innovative Lawyers Asia-Pacific 2016 Awards. While this recognition
marks NDAs ingress as an innovator among the globes best law firms, NDA has previously won the award for
the Most Innovative Indian Law Firm for two consecutive years in 2014 and 2015.
As a research-centric firm, we strongly believe in constant knowledge expansion enabled through our dynamic
Knowledge Management (KM) and Continuing Education (CE) programs. Our constant output through
Webinars, Nishith.TV and Hotlines also serves as effective platforms for cross pollination of ideas and latest
trends.
Our trust-based, non-hierarchical, democratically managed organization that leverages research and knowledge
to deliver premium services, high value, and a unique employer proposition has been developed into a global
case study and published by John Wiley & Sons, USA in a feature titled Management by Trust in a Democratic
Enterprise: A Law Firm Shapes Organizational Behavior to Create Competitive Advantage in the September
2009 issue of Global Business and Organizational Excellence (GBOE).
47
Nishith Desai Associates 2017
Provided upon request only
A brief below chronicles our firms global acclaim for its achievements and prowess through the years.
IDEX Legal Awards: In 2015, NDA won the M&A Deal of the year, Best Dispute Management lawyer,
Best Use of Innovation and Technology in a law firm and Best Dispute Management Firm. Nishith Desai
was also recognized as the Managing Partner of the Year in 2014.
Merger Market: has recognized NDA as the fastest growing M&A law firm in India for the year 2015.
Legal 500 has ranked us in tier 1 for Investment Funds, Tax and Technology-Media-Telecom (TMT) practices
(2011, 2012, 2013, 2014)
International Financial Law Review (a Euromoney publication) in its IFLR1000 has placed Nishith Desai
Associates in Tier 1 for Private Equity (2014). For three consecutive years, IFLR recognized us as the Indian
Firm of the Year (2010-2013) for our Technology - Media - Telecom (TMT) practice.
Chambers and Partners has ranked us # 1 for Tax and Technology-Media-Telecom (2015 & 2014); #1 in
Employment Law (2015); # 1 in Tax, TMT and Private Equity (2013); and # 1 for Tax, TMT and Real Estate
FDI (2011).
India Business Law Journal (IBLJ) has awarded Nishith Desai Associates for Private Equity, Structured
Finance & Securitization, TMT, and Taxation in 2015 & 2014; for Employment Law in 2015
Legal Era recognized Nishith Desai Associates as the Best Tax Law Firm of the Year (2013).
Please see the last page of this paper for the most recent research papers by our experts.
Disclaimer
This report is a copyright of Nishith Desai Associates. No reader should act on the basis of any statement
contained herein without seeking professional advice. The authors and the firm expressly disclaim all and any
liability to any person who has read this report, or otherwise, in respect of anything, and of consequences of
anything done, or omitted to be done by any such person in reliance upon the contents of this report.
Contact
For any help or assistance please email us on [email protected] or
visit us at www.nishithdesai.com
49
Nishith Desai Associates 2017
Provided upon request only
The following research papers and much more are available on our Knowledge Site: www.nishithdesai.com
NDA Insights
TITLE TYPE DATE
ING Vysya - Kotak Bank : Rising M&As in Banking Sector M&A Lab January 2016
Cairn Vedanta : Fair or Socializing Vedantas Debt? M&A Lab January 2016
Reliance Pipavav : Anil Ambani scoops Pipavav Defence M&A Lab January 2016
Sun Pharma Ranbaxy: A Panacea for Ranbaxys ills? M&A Lab January 2015
Reliance Network18: Reliance tunes into Network18! M&A Lab January 2015
Thomas Cook Sterling Holiday: Lets Holiday Together! M&A Lab January 2015
Jet Etihad Jet Gets a Co-Pilot M&A Lab May 2014
Apollos Bumpy Ride in Pursuit of Cooper M&A Lab May 2014
Diageo-USL- King of Good Times; Hands over Crown Jewel to Diageo M&A Lab May 2014
Copyright Amendment Bill 2012 receives Indian Parliaments assent IP Lab September 2013
Public M&As in India: Takeover Code Dissected M&A Lab August 2013
File Foreign Application Prosecution History With Indian Patent
IP Lab April 2013
Office
Warburg - Future Capital - Deal Dissected M&A Lab January 2013
Real Financing - Onshore and Offshore Debt Funding Realty in India Realty Check May 2012
Pharma Patent Case Study IP Lab March 2012
Patni plays to iGates tunes M&A Lab January 2012
Vedanta Acquires Control Over Cairn India M&A Lab January 2012
Research@NDA
Research is the DNA of NDA. In early 1980s, our firm emerged from an extensive, and then pioneering,
research by Nishith M. Desai on the taxation of cross-border transactions. The research book written by him
provided the foundation for our international tax practice. Since then, we have relied upon research to be the
cornerstone of our practice development. Today, research is fully ingrained
in the firms culture.
Research has offered us the way to create thought leadership in various areas of law and public policy. Through
research, we discover new thinking, approaches, skills, reflections on jurisprudence,
and ultimately deliver superior value to our clients.
Over the years, we have produced some outstanding research papers, reports and articles. Almost on
a daily basis, we analyze and offer our perspective on latest legal developments through our Hotlines. These
Hotlines provide immediate awareness and quick reference, and have been eagerly received.
We also provide expanded commentary on issues through detailed articles for publication in newspapers and peri-
odicals for dissemination to wider audience. Our NDA Insights dissect and analyze a published, distinctive legal
transaction using multiple lenses and offer various perspectives, including some even overlooked by the execu-
tors of the transaction.
We regularly write extensive research papers and disseminate them through our website. Although we invest
heavily in terms of associates time and expenses in our research activities, we are happy
to provide unlimited access to our research to our clients and the community for greater good.
Our research has also contributed to public policy discourse, helped state and central governments
in drafting statutes, and provided regulators with a much needed comparative base for rule making.
Our ThinkTank discourses on Taxation of eCommerce, Arbitration, and Direct Tax Code have been widely
acknowledged.
As we continue to grow through our research-based approach, we are now in the second phase
of establishing a four-acre, state-of-the-art research center, just a 45-minute ferry ride from Mumbai
but in the middle of verdant hills of reclusive Alibaug-Raigadh district. The center will become the hub for
research activities involving our own associates as well as legal and tax researchers from world over.
It will also provide the platform to internationally renowned professionals to share their expertise
and experience with our associates and select clients.
We would love to hear from you about any suggestions you may have on our research reports.
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Nishith Desai Associates 2017
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