Sharp cuts in price of cancer drugs expose excessive pricing, say health experts

Image used for representational purposes only.

The revised Maximum Retail Price (MRP) list of anti-cancer medicines published by the National Pharmaceutical Pricing Authority (NPPA) raises serious concerns about excessive pricing and the exploitation of patients, noted medical health activists on Wednesday (October 28, 2026).

Editorial | Bitter pills: on Court’s intervention, drug pricing

The NPPA, under the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, has released a list of 543 brands of anti-cancer medicines with their revised MRP that will be effective from November 9.

“The revised price list reflects the information submitted by companies up to October 27, 2026, and it will be updated as and when manufacturers submit their revised prices of non-scheduled anti-cancer drugs,” said a release issued by the Union government on Wednesday (October 28, 2026).

On October 17, the NPPA had announced Trade Margin Rationalisation (TMR) of 137 non-scheduled anti-cancer drugs in public interest to address excessive trade margins, make cancer treatment more affordable, and improve access to anti-cancer medicines. Manufacturers were instructed to submit their revised list to NPPA.

The 137 non-scheduled anti-cancer drugs include immunotherapy medicines used in the treatment of over 20 types of cancer, Denosumab used by breast and prostate cancer patients, Pegfilgrastim used to prevent neutropenia in cancer patients, and Bevacizumab, which is approved for the treatment of colon, ovarian and cervical cancers.

Stating that cost-based price control can further reduce medicine prices and curb excessive profiteering, Jan Swasthya Abhiyan India (JSA India), an organisation working for accessibility of medicines, said that controlling trade margins alone is insufficient. Life-saving cancer treatment must be affordable based on medical need, not a patient’s ability to pay.

In their statement, the group explained: “For example, the reported MRP of one brand of palbociclib fell from approximately ₹40,421 to ₹2,720 per pack, while thiotepa fell from approximately ₹80,072 to ₹7,150 per vial. Such drastic reductions raise serious questions about the pricing practices of pharmaceutical companies, including major Indian manufacturers of generic cancer medicines that have reportedly offered substantial trade margins while patients continued to face unaffordable prices.’’

It added that, several patented cancer medicines remain exorbitantly priced. The Trade Margin Rationalisation (TMR) policy has failed to ensure affordability, while excluding medicines supplied free under Patient Assistance Programmes from its calculations has further limited its potential impact on patients, said the group.

“The policy’s formula is also deeply flawed. Allowing a 42.8% markup over the Price to Stockist [PTS] legitimises excessive margins, particularly in a supply chain often involving only one or two intermediaries or direct sales to hospitals. A substantially lower markup, comparable to the 16% margin applicable to scheduled formulations under the DPCO framework, could have delivered greater benefits to patients. A one-time MRP reduction is not enough. Without permanent, enforceable margin caps, regular monitoring and verification by NPPA, excessive pricing can persist or re-emerge,” JSA stated in the release.

The NPPA must also strengthen its collection and maintenance of price data across supply chains and distribution channels, the group said, adding that companies should not be left to calculate and self-report revised MRPs without adequate independent verification.

Tanvi Singh, medical oncologist, MOC Cancer Care, said that cancer is an ailment whose treatment demands are extensive so when drug costs are high, patients may end up delaying treatment initiation, or skipping doses, or even discontinue therapy prematurely. All of these will in turn affect and compromise outcomes.

“Lowering drug costs is an imperative that can improve treatment continuity, reduce financial toxicity, and help patients complete the prescribed course of therapy. However, price caps are not enough on their own. Meaningful and sufficient improvement in affordability can be said to be achieved when price regulation is complemented by wider insurance coverage expansion of government reimbursement schemes, increased availability of quality generic and biosimilar medicines, robust Patient Assistance Programmes (PAPs), and greater access to comprehensive cancer care across the country,” said Dr. Singh.

Sandeep Nayak, chairman of oncology, MACS-Renova Oncology Institute, KIMS Hospital, Bengaluru, said: “The price control introduced by the government is a positive move. But low cost life-saving drugs should remain viable to manufacture and seller.”