Up to 70% Price Drop: India Caps Margins on 137 Cancer Drugs

For years, patients in India paid up to ten times the wholesale cost for life-saving cancer treatments. The Supreme Court ended that practice in September, labeling the pricing structure as carnage and extortion. The government has now formalized the court's findings by extending a 30% trade margin cap to 137 additional cancer medicines. The new pricing rules take effect in November.

The National Pharmaceutical Pricing Authority analyzed the supply chain and found that trade mark-ups on certain cancer drugs averaged 170%. In extreme cases, the markup exceeded 700%. Justices Vikram Nath and Sandeep Mehta cited specific evidence during a hearing on September 29. They noted that one drug supplied to hospitals for 2,700 rupees was sold to patients for 27,000 rupees. The Department of Pharmaceuticals stated that the new cap is expected to reduce medicine prices by up to 70%.

Sarojam Radhakrishnan, a retired bank clerk from Kerala, initiated the legal challenge. Diagnosed with breast cancer in 2021, she faced monthly treatment costs exceeding 63,000 rupees. Her family could not afford the expense, so she petitioned the Kerala high court in 2022. Radhakrishnan died in September 2022 while her case was still pending in the lower court. The matter eventually reached the Supreme Court, where judges examined the financial burden on patients.

The financial strain affects millions of families. Krishan Kalra, a former council member of the Rajiv Gandhi Cancer Institute and Research Centre, said many people avoid free diagnosis camps in Gurgaon because they fear the cost of treatment. Cancer drugs currently range from 38,000 to 380,000 rupees. Dr. Ravi Kannan, director of Cachar Cancer Hospital and Research Centre in Assam, described the new decision as a welcome step. He noted that many families start treatment but cannot sustain it due to high out-of-pocket costs.

The government's Ayushman Bharat insurance scheme covers some cancers but provides only 500,000 rupees in annual coverage per family. That amount equals the cost of a single dose of Kadcyla, a breast cancer drug for which patients may require up to 14 doses. Jyotsna Singh, co-convener of the Working Group on Access to Medicines, warned that hospitals might raise other charges to offset lower drug prices. She called for a total overhaul of healthcare transparency.

India recorded approximately 1.56 million new cancer cases in the past year, an increase from 1.39 million in 2020. The Department of Pharmaceuticals estimated that the new measures will help patients save 2,500 crore rupees annually. The Supreme Court has also asked government lawyers to explain why the margin cap applies only to cancer drugs and not to all non-patented medicines. The government has until October 27 to respond to that query.