NPPA caps trade margins on 137 cancer drugs at 30%, revised prices from Nov 9

India’s drug pricing authority-National Pharmaceutical Pricing Authority (NPPA) on Saturday capped trade margins on extensively used 137 anti-cancer drugs at 30 per cent of MRP, with the revised prices set to take effect from November 9.

The list of 137 drugs has been recommended by an expert committee of the Union health ministry and includes extensively used drugs like-Atezolizumab, Bevacizumab, Daratumumab, Enzalutamide, Erlotinib, Ipilimumab, Lapatanib, among others. However immunotherapy drug Keytruda has not been included in the list.

The 30% cap on trade margins, calculated on the maximum retail price (MRP) excluding GST, corresponds to a mark-up of 42.86% on the price to stockist or distributor.


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The cap will apply irrespective of the strength, dosage form or route of administration, including formulations containing the drugs in combination, the NPPA said.

Under the approved mechanism, the revised MRP will be calculated using the price to stockist or distributor for March 2026 as the reference. Where a formulation had no sales during that month, the price will be calculated using sales data for April 2025 to March 2026. Government sales will be excluded from the calculation.

Manufacturers selling medicines above the newly calculated MRP will have to reduce prices to the prescribed level. If an existing MRP is already lower, it must be maintained, the NPPA said. The order will remain in force until further directions, while manufacturers can continue to avail themselves of annual price increases permitted under the DPCO, subject to compliance with the trade-margin cap.

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The order also covers formulations launched after March 31, 2026, containing any of the listed drugs. Where manufacturers supply medicines directly to hospitals or medical institutions, these institutions will be treated as stockists or distributors for the purpose of calculating the MRP, using the manufacturers’ invoice data.

The authority has also directed manufacturers to maintain current production levels to ensure uninterrupted availability of the covered medicines. “Any manufacturer intending to reduce average monthly production levels shall obtain prior permission from NPPA, the minutes said.

Manufacturers intending to discontinue production or imports must provide the prescribed information at least six months in advance.

The NPPA has allowed a limited exclusion for quantities supplied free of cost to patients under manufacturers’ patient assistance programmes. However to qualify manufacturers will submit an undertaking and maintain detailed records of patients, prescriptions, drug supplies and consumption.

The authority can seek further information, conduct audits and inspections, and verify implementation. Non-compliance could lead to the exemption being withdrawn.

Manufacturers will have to submit revised MRP information to the NPPA and the concerned state drug controller within seven days of publication of the order in the Official Gazette, even if there is no change in the MRP. They must also issue the prescribed price lists through the Integrated Pharmaceutical Database Management System and provide copies to state drug controllers, dealers and other entities as required.

Failure to submit the required information will be treated as non-reduction of MRP and may trigger action to recover overcharged amounts under the DPCO.

Hospitals and medical institutions, which account for a substantial share of anti-cancer drug supplies have been asked to monitor MRPs and report violations to the NPPA. State drug controllers will oversee compliance by manufacturers, dealers, hospitals and medical institutions.