Over 1,300 anti-cancer drugs to get cheaper

Mumbai: India's National Pharmaceutical Pricing Authority (NPPA), has listed 1,366 anti-cancer drug brands that are scheduled to have their trade margins capped at 30% starting November 9, 2026. The NPPA had released its first list of 543 brands on October 27 and followed up with three additional revisions of primarily branded generic and patented drugs based on submissions by pharma companies.

These drug brands are based on 137 chemicals and biologic substances identified as non-scheduled formulations or those that are not already covered under the Drug Price Control Order (DPCO). On October 17, the NPPA said it would undertake an exercise for trade margin rationalisation on anti-cancer drugs and expected to save ₹2,500 crore annually for cancer patients.

The NPPA's efforts back a series of hearings on a petition in the Supreme Court that pleaded for effective curbs against exorbitant trade margins charged by private hospitals. As part of its scathing observations, the court called the pricing of drugs "loot and carnage." The government representatives said there needs to be a balancing of equities while regulating medicine prices. The bench of Justices Vikram Nath and Sandeep Mehta have reserved their judgment in the case.

While some generic brands like Samtepa (thiotepa) injection is expected to see a massive price drop of over 90% from ₹80,072 to ₹7,150, an extensively used breast cancer drug Hertumab (pertuzumab) will see a price of ₹30,593, revised from ₹94,951 for a 14 mg vial. Some other drugs like Palbopro (palbociclib) capsules will see prices drop by 93% to ₹2,700 from roughly ₹40,000.

Patient advocate Working Group on Access to Medicines and Treatments said prices of 201 out of 1366 brands have remained unchanged. In the initial analysis of 643 brands, the group found that prices of 159 patented drug brands were unchanged.

KM Gopakumar, co-convenor of the group, said the revised MRP based on the trade margin rationalisation clearly shows that the policy intervention has failed to reduce the price of patented medicines.

"Most of these medicines are clearly lifesaving, such as abemaciclib and ribociclib, as well as WHO-designated essential medicines such as pembrolizumab. The government needs to seriously consider using Section 93 or Section 100 of the Patents Act to issue a compulsory license for the government to use to bring generic production to facilitate affordable access," he noted, adding, nearly 56 molecules are enjoying monopoly due to patent protection.

He said 13 drugs out of 137 initially listed by NPPA are not part of the revised pricing list, which means the companies have not submitted their pricing data. A few of those include alpelisib, belantamab mafodotin, ceritinib, dabrafenib, datopotamab deruxtecan, ibritumomab, lazertinib and mirvetuximab soravtansine.

Gopakumar raised concerns about single-supplier drugs that can be both multinational companies and Indian generic drug makers that in-license the drugs. He pointed to prices of extensively used immunotherapy drug Keytruda (pembrolizumab) 100 mg which is still priced at ₹2,16,500 while Imjudo (tremelimumab) injections are sold at ₹4,17,522 for each 300 mg injection. Opdyta will continue to be sold at ₹1,09,450 for 100 mg infusion.

The NPPA has directed hospitals, medical institutions, retailers and dealers to comply with the applicable pricing and price-display requirements and prominently display revised prices on their websites. The agency said patients can check the new price details on the new medicine packs, displayed prices by retailers or hospitals and its own website.