Patients buying cancer medicines should see lower prices on a large number of brands from Monday, November 9, when the National Pharmaceutical Pricing Authority's (NPPA) cap on trade margins for 137 non-scheduled anti-cancer drugs comes into force.

Under a Gazette notification issued on October 17, the margin that stockists, distributors and retailers can earn on these drugs has been capped at 30%. The order has been issued under Paragraph 19 of the Drugs (Prices Control) Order, 2013, which allows the government to intervene in extraordinary circumstances in the public interest.

Why the cap

The NPPA's analysis found that the average trade mark-up on non-scheduled anti-cancer medicines was nearly 170%, and in some cases as high as 700%. Because these drugs are outside the national list of essential medicines, their prices are not directly controlled, leaving patients exposed to steep markups between the factory gate and the pharmacy counter.

Some reports estimate that retail prices of certain brands could fall by up to 70%. The move builds on a 2019 pilot, when trade margins on 42 anti-cancer medicines were capped at 30%.

Activists: welcome, but inadequate

The All India Drug Action Network (AIDAN) welcomed the decision but called it inadequate, pointing out that the cap applies only to intermediaries in the supply chain and does not touch the prices set by manufacturers.

Dr Anant Phadke of AIDAN said dealers earn average margins of about 170%, sometimes up to 700%. According to the network's analysis, around 204 of the roughly 900 affected formulations will see no reduction or a cut of 10% or less, because their existing trade margins are already close to the new ceiling.

Doctors and analysts say the real test will be whether the lower prices actually reach patients at the pharmacy counter.

What patients can do

  • From November 9, check the MRP on packs of cancer medicines; revised packs should carry the new price.
  • Ask your pharmacist whether your brand is among the 137 drugs covered by the order.
  • Overcharging above the notified price can be reported to the NPPA through its Pharma Sahi Daam app or the state drug controller.