NPPA list brings little relief: No price cut for 25% cancer drugs

Mumbai: Nearly one in four cancer drug packs in a revised price list issued by the National Pharmaceutical Pricing Authority (NPPA) has seen no reduction in maximum retail price (MRP), including some costing several lakh rupees, raising questions over how much relief the government's latest intervention will deliver to patients.An analysis of 643 listed packs found an average price cut of 38.22%, but 159 entries remained unchanged, according to advocate KC Jain, a petitioner in the Supreme Court proceedings on medicine pricing. The list reflects information received from companies up to Wednesday. The revised prices take effect on November 9.

The unchanged prices include those of several patented drugs like Keytruda (pembrolizumab; one 100 mg injection pack) at ₹2.16 lakh, Tagrisso (osimertinib; 80 mg; 30 tablets) at ₹4.16 lakhs, Alecensa (alectinib; 150 mg; 224 capsules) at ₹4.3 lakhs, Voranigo (vorasidenib; 30 tablets of 40 mg) at ₹6 lakhs, and Koselugo (selumetinib; 25 mg; 60 capsules) at over ₹10 lakh, among several others.

Industry experts and patient advocates have raised questions over how the intervention will translate into savings for patients. Under the revised formula, the aggregate trade margin is capped at 30% of the MRP. This translates into a 42.86% markup over manufacturers' sale prices. In comparison, the government has capped retailer margin at 16% of the price to retailer (PTR) under the existing pricing framework for scheduled drugs under the Drug Price Control Order, they noted.


"Our contention is that the margins allowed to retailers and stockists are higher than what is contemplated under the provisions of the DPCO," Jain said. In a notification on October 17, the NPPA announced it had undertaken Trade Margin Rationalisation of 137 identified 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.

The intervention is expected to bring down the MRP of the identified non-scheduled anti-cancer drugs by up to 70%, depending on their existing price structures, it had said. The 137 identified non-scheduled anti-cancer drugs include immunotherapy drugs used for treating over 20 type of cancers.