A new ResMed AirSense 11 AutoSet at a US street price of around USD 850 lands in India at an indicative retail of ₹95,000–₹1,15,000 — roughly 35–55% above the dollar-converted equivalent. A 5 LPM oxygen concentrator from Philips Respironics shows a similar gap. The math behind the gap is mostly tax and duty, with a smaller component of distribution markup and warranty-network amortisation. This guide walks through the structure: how GST is applied, what import-duty stack a manufacturer pays before the unit reaches an Indian retailer, why imported units cost what they cost, and what a domestic-Indian-brand alternative actually saves.
GST classification — HSN 9019 and the 12% rate
Most respiratory therapeutic equipment in India falls under HSN 9019, the customs and GST sub-heading covering “Mechano-therapy appliances; massage apparatus; psychological aptitude-testing apparatus; ozone therapy, oxygen therapy, aerosol therapy, artificial respiration or other therapeutic respiration apparatus.”
The applicable GST rate under the Indian regime is 12% (6% CGST + 6% SGST for intra-state, 12% IGST for inter-state) on most devices in this category. Specifically:
- Oxygen concentrators — HSN 9019, 12% GST.
- CPAP and BiPAP devices — HSN 9019, 12% GST.
- Ventilators (home NIV, ICU) — HSN 9019, 12% GST.
- Nebulizers — HSN 9019, 12% GST.
Some accessories and consumables fall under different HSN codes at higher rates:
- Pulse oximeters as standalone devices — HSN 9018, 12% GST.
- CPAP / BiPAP masks sold separately — HSN 9019, 12% GST.
- Tubing, filters, and replacement parts — sometimes 9019 (12%), sometimes general plastic / electronics codes (18%) depending on classification.
- Oxygen cylinders (the steel/aluminium cylinder itself, separate from the filling) — HSN 7311, generally 18% GST.
- Carry bags, accessories, batteries — typically 18% GST under general HSN.
The classification matters because reimbursement schemes — CGHS, ECHS, ESIC — recognise HSN 9019 as the primary medical-device classification. An invoice that shows the concentrator under a non-9019 code is often rejected on classification grounds.
Why GST-compliant invoicing matters even outside reimbursement
Three concrete consequences of invoice integrity:
- Reimbursement readiness. Without HSN 9019, GSTIN of seller, valid tax breakup, and matched buyer details, no central-government scheme will pay. (See the CGHS/ECHS/ESIC article for the full file.)
- Warranty registration. Most manufacturers tie India warranty activation to a verifiable GST invoice on the serial number. Cash transactions and unregistered-seller invoices break the warranty path even on legitimate units.
- Tax-deduction claims. Section 80DDB of the Income Tax Act allows deduction of expenses for specified diseases including chronic respiratory failure where prescribed by a specialist. The deduction requires a tax-invoice with proper GST treatment.
Import duty structure — what the importer pays before the unit reaches the patient
For a manufacturer or authorised importer landing a CPAP, BiPAP, or oxygen concentrator from outside India, the duty stack is:
- Basic Customs Duty (BCD) — typically 7.5% on most respiratory medical devices under the current tariff. Some categories see higher rates; some are at 5% under preferential agreements; the COVID-era exemption on oxygen concentrators (which dropped BCD to nil through 2021) has rolled back.
- Social Welfare Surcharge (SWS) — 10% of the BCD value.
- IGST on landed value — 12% on the assessable value plus BCD plus SWS.
- Health Cess — applied on certain medical devices at 5% on assessable value plus BCD; coverage is item-specific.
Working example for a CPAP machine with a USD 500 CIF (Cost-Insurance-Freight) landed value at an exchange rate of ₹83/USD:
- CIF value: ₹41,500.
- BCD at 7.5%: ₹3,113.
- SWS at 10% of BCD: ₹311.
- Health Cess at 5% (where applicable): ₹2,075.
- Subtotal: ₹46,999.
- IGST at 12% on subtotal: ₹5,640.
- Total landed cost: ₹52,639 — a duty + tax stack of about 27% on top of CIF.
For the manufacturer / importer, that ₹52,639 then carries distribution margin, marketing cost, warranty reserve, and dealer margin before it reaches the patient. A USD 500 CIF unit with a USD 850 US street price ends at an Indian retail of ₹95,000–₹1,15,000 by the time the chain is full. The “30–50% premium over US street” pattern is largely consistent across the imported respiratory category.
The COVID-era exemption and what changed in 2021–22
In April–May 2021, in response to the second-wave oxygen crisis, the Indian government issued temporary exemptions:
- BCD on oxygen concentrators dropped to nil.
- Health cess waived.
- IGST on imported oxygen concentrators dropped from 28% (which had briefly applied at the start of the crisis) to nil for personal-use imports.
These exemptions were time-bound and are no longer in force. A 2026 oxygen concentrator import lands under the standard duty stack at HSN 9019 with 12% GST. The COVID-era pricing — when a 5 LPM concentrator briefly sold at ₹35,000–₹45,000 in the import channel — does not return on the duty math, only on competitive pressure and currency movement.
Why imported units cost 30–50% more than US/EU street price
Stripping the math down:
- Duty + tax stack: ~27% on CIF value.
- Distribution margin: 10–20% over landed.
- Brand marketing and warranty reserve: 5–10% over distribution.
- Dealer margin: 10–25% over distribution-out.
The compounding of these multipliers, on top of duty, lands a USD 850 unit at ₹95,000–₹1,15,000 in India versus an unduty-tied USD-converted equivalent of ₹70,500. The 35–55% premium over US street is largely structural.
The structural conclusion: a Philips Respironics, ResMed, DeVilbiss, F&P, or Inogen unit costs more in India than in its home market because of duty, IGST, distribution stack, and the warranty-network amortisation cost of running an India service operation. The premium is not pure markup; some of it is the price of the service network the patient relies on after purchase.
Domestic-Indian-brand price advantage
A handful of domestic Indian manufacturers — BPL, Niscomed, Home Medix, Oxymed, Genrich, Allied Medical, and several smaller players — produce CPAPs, BiPAPs, and concentrators on Indian soil:
- No import duty stack. The savings of ~27% at landed-cost stage flow into the retail price, partly.
- GST still applies at 12% — the domestic brands pay output GST on sale exactly like importers.
- Lower brand-marketing and distribution overhead in many cases.
The result: a comparable-spec 5 LPM domestic concentrator typically retails at 30–40% below an imported equivalent. A domestic CPAP at ₹25,000–₹40,000 fills the slot where a Philips DreamStation or ResMed AirSense sits at ₹50,000–₹80,000.
What the patient gives up in the trade:
- Service-network depth. Philips and ResMed have urban service centres in 25+ Indian cities and an authorised-dealer network that reaches Tier-2/3 cities through partnership. Domestic brands vary — BPL has broad coverage, Oxymed and Niscomed have decent metropolitan coverage, smaller brands often have only the manufacturer’s primary city.
- Software ecosystem. ResMed AirView, Philips DreamMapper, and Inogen Connect provide cloud-based therapy data with integration into sleep-clinic platforms. Domestic-brand equivalents are catching up but typically more limited.
- International portability. A Philips or ResMed unit is recognised by airline POC-approval lists and by service centres in any country the patient travels to. A domestic Indian brand is rarely on those lists.
For a patient on home oxygen in a Tier-2 Indian city with no plans to travel internationally and no need for cloud therapy data, the domestic-brand value proposition is genuinely strong. For a patient who travels internationally, needs cloud-data integration, or lives in a region where the imported brand has stronger service coverage, the import premium is often worth paying.
Grey-market import — the warning that the price tag obscures
A parallel to the legitimate import channel: parallel-imported, friend-brought, or marketplace-listed “international stock” CPAPs and concentrators that arrive in India outside the authorised-dealer chain. The visible price advantage is real (sometimes 25–40% below authorised-import retail). The hidden costs are larger:
- No India warranty. The serial number is registered in the country of origin or unregistered. Manufacturer service centres in India will refuse warranty claims.
- No India service. Even paid (out-of-warranty) service is sometimes refused on grey-market units; the brand cannot stock parts for SKUs they did not import.
- No GST-compliant invoice. The unit cannot be reimbursed through CGHS/ECHS/ESIC and cannot be claimed under Section 80DDB.
- Voltage compatibility. Some grey-market units are 110V US-spec and require a step-down transformer for use on Indian 220V mains — a fragile setup for a medical device.
- Customs liability. Personal import above the de minimis threshold without proper duty payment is technically a customs violation. The patient is at risk of duty assessment, penalty, and seizure on subsequent travel.
The economic case for grey market evaporates at the first service event. For long-term respiratory therapy, where service is part of the cost-of-ownership, the right answer is to buy through an authorised channel — domestic or imported — and accept the duty-driven premium.
Refurbished-import market
A separate sub-segment: manufacturer-certified refurbished imports. Philips and ResMed both run renewed-unit programmes in some markets; some of this stock makes it to India through authorised-dealer channels with documented refurbishment, abbreviated warranty (6–12 months), and full GST invoicing.
Refurbished-import economics:
- 25–40% below new-import retail.
- Full duty + GST applies at refurb landed cost.
- Warranty shorter than new but recognised by Indian service centres.
- Reimbursement-eligible if the invoice is in order; some schemes require sanction at the new-unit ceiling rather than refurb price.
For cost-constrained patients with stable prescriptions and pulmonologist sign-off, certified refurbished imports are a legitimate middle path. Uncertified “used” or “open-box” listings are not — they fall back into the grey-market warning.
A simple decision recipe
For a 5 LPM concentrator purchase in 2026:
- Cost-constrained, urban metro, no international travel: domestic Indian brand (Oxymed, Niscomed, BPL, Home Medix), authorised dealer, ₹35,000–₹55,000.
- Cost-flexible, international travel possible, Tier-1 metro: imported (Philips EverFlo, DeVilbiss, Inogen for portable), authorised dealer, ₹55,000–₹95,000.
- Cost-constrained but specific clinical fit on imported brand: certified-refurbished imported, authorised dealer with documented refurbishment, ₹40,000–₹65,000.
- Tier-3 city with weak imported-brand service: strongest-coverage domestic brand in the local service map, ahead of any imported unit with no service van within 100 km.
For CPAP/BiPAP, the same logic applies, with extra weight on the software ecosystem question — patients who need cloud-data sleep-physician follow-up benefit more from imported than from most domestic equivalents in 2026.
The takeaway
The price gap between Indian and US/EU street prices for imported respiratory equipment is largely structural — duty, IGST, distribution stack, and warranty-network amortisation. Domestic Indian brands save 30–40% by eliminating the import-duty stack but trade some service-network depth, software ecosystem, and international portability. Grey-market imports save more on purchase but cost more on service, reimbursement, and customs risk. For long-term respiratory therapy, the right answer is almost always authorised-channel — domestic or imported — with the duty-driven premium accepted in exchange for service and warranty integrity.
Cross-links
- Hospital channel vs online channel for respiratory equipment
- CGHS, ECHS, ESIC reimbursement for home oxygen
- Oxygen concentrators buyer’s guide (India 2026)
- Compare
- Oxygen concentrator catalogue
This guide is editorial opinion and general information. It is not tax, legal, or customs advice. Verify duty rates, GST treatment, and tax-deduction eligibility with a qualified tax professional and the current CBIC tariff schedule.