Page 182 - GSTL_21st May 2020_Vol 36_Part 3

428 GST LAW TIMES [ Vol. 36
vive. Only about 30% of the patients in need of a stem cell transplant as life-
saving treatment, are able to find a sibling match. The rest 70% depend on find-
ing a matching unrelated donor. Currently, 7 out of 10 blood cancer patients in
India are unable to find a compatible donor within the family and are likely to
find an unrelated matching blood stem cell donor. The odds are even lower for
those with diverse ancestry. This can change by registering more potential blood
stem cell donor.
5.4.4 A successful blood stem cell transplant needs a perfect HLA tissue
match i.e. a 10/10 match which increases the chance that the patient’s body will
accept donated cells as its own and not fight them. Patients and donors of Indian
origin have unique HLA characteristics that are severely underrepresented in the
global database, which makes the probability of finding a suitable donor very
difficult.
5.4.5 DKMS-BMST works on finding an HLA matched donor for every
patient in need of a transplant. As Indian patients mainly require an Indian tis-
sue match, DKMS-BMST focusses on increasing the awareness and on encourag-
ing many more people in India to register as a potential blood stem cell donor. It
maintains a register or database of donors, including but not limited to HLA typ-
ing data required for donor and patient matching.
5.4.6 With the help of upsurge in the details of potential donors in the
database of donors, the chances of patients finding a suitable match increases to a
large extent, thereby, increasing the chances of blood cancer treatment. It is also
pertinent to note that the entire and the purpose of the said database is assisting
in treatment of patient’s blood cancer and other blood disorders.
5.4.7 Further, once the initial testing is done and upon finding a suita-
ble match for the patient, the said step of reconfirming the samples of the identi-
fied donor and matching the same with the samples of the patient is also execut-
ed by LSL DE, Germany. Therefore, it is evident that the very first step and
thereafter the reconfirmatory step, being one of the most important steps in the
entire treatment process is being carried out of LSL DE, Germany through testing
of the samples sent to DKMS-BMST.
5.4.8 Therefore, the testing of samples provided by DKMS-BMST and
creating a database upon classification of the HLA tests conducted is an inevita-
ble step in the entire cycle of treatment of blood cancer/other blood disorders
and without the said step, stem cell transplant required for treatment of blood
cancer/other blood disorders would not have been possible.
6. For the first question, regarding the legal provisions classifying the
said HLA testing service under the definition of Health Care Services provided
by Clinical Establishment and therefore exempt from the levy of tax, the appli-
cant states as under :
6.1 The Section 2(47) of the CGST Act, 2017, defines “exempt supply”
and as per Section 11(1) of the CGST Act, 2017 the Government may issue notifi-
cation exempting a goods or service from tax. As per Entry No. 74 of Notification
No. 12/2017-Central Tax (Rate), dated 28-6-2017 and as amended from time to
time, the services by way of health care services by clinical establishment, an au-
thorized medical practitioner or para-medics have been granted absolute exemp-
tion from the whole of taxes leviable thereon.
6.2 Paragraph 2 of the aforementioned notification also defines health
care and clinical establishment as follows :
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