Nearly 1 in 4 cancer drug prices unchanged: Data

New Delhi: The Centre’s decision to cap trade margins on 137 non-scheduled anti-cancer drugs has reduced the maximum retail prices (MRPs) of 484 of 643 listed medicine packs, but left nearly one in four packs unchanged, raising questions about how much relief the measure will bring to cancer patients, an analysis of National Pharmaceutical Pricing Authority (NPPA) data has found.India NewsThe NPPA, which released its list of “Revised MRP of Non-Scheduled Anti-Cancer Drugs” on Tuesday, showed that prices of 159 packs remained unchanged.“The updated list records reductions for 484 of 643 entries. Selected medicines receive cuts exceeding 90%, while 159 entries show no reduction. Several unchanged packs retain prices of multiple lakh rupees,” said an analysis by Access to Medicines and Treatment India, which highlighted the limitations of the measure and called for broader policy interventions to make cancer treatment affordable and accessible.On October 17, the NPPA announced Trade Margin Rationalisation (TMR) for 137 non-scheduled anti-cancer drugs in the public interest, with the stated aim of addressing excessive trade margins, making cancer treatment more affordable and improving access to medicines. Manufacturers were asked to submit revised price lists to NPPA.KC Jain, an Agra-based advocate, had earlier petitioned the Supreme Court seeking changes to drug price controls.The analysis found that 204 packs had either no price reduction or a cut of up to 10%, while 275 packs recorded reductions of more than 50%. Prices of only 124 packs were reduced by 70% or more, and just five packs saw cuts of 90% or above.“Big pharma” products that actually burnt a hole in the pocket, have largely seen no cuts, said experts.Of the 56 entries priced above ₹1 lakh, 53 remained unchanged, the data showed.RPG Life Sciences’ Anarzole, a 1 mg anastrozole tablet used in hormone-sensitive breast cancer, has been reduced from ₹695.76 to ₹73 for a pack of 10 tablets. Dr Reddy’s Laboratories’ Azacytin, a 100 mg azacitidine injection, now has an MRP of ₹1,495.04, down from ₹6,337.Abbott Healthcare’s Bevacizab injection (100 mg/4 ml) has been reduced from ₹21,767.70 to ₹5,930.13 per vial. Natco Pharma’s Dasanat 20, a pack of 60 tablets of dasatinib, now costs ₹1,085.93, compared with ₹2,812.50 earlier. RPG Life Sciences’ Debrumab 60 mg, a denosumab injection, has been revised from ₹22,031.25 to ₹5,941 per pre-filled syringe.“The price drop is a clear example of how hospitals were actually exploiting the patients in collaboration with pharmaceutical companies. However, we can see these cuts have by and large been on generics and biosimilars. There are same molecules but different prices as the originator has not been slashed. In effect, it creates a situation where hospitals can still keep these high-valued brands and keep away the low-valued ones and make more money,” said KM Gopakumar, senior researcher and legal advisor at Delhi-based Third World Network.He said generic and biosimilar medicines had seen substantial price corrections, often exceeding 70-90%, but regulating trade margins alone would not ensure affordability or bridge the price gap between original drugs and their generic or biosimilar alternatives. The difference in prices of medicines containing the same molecules, he said, required an urgent review.“The hospital formularies can be manipulated in such a way to keep the high brands, and deny access to affordable brands. Even though law says people are free to buy from outside the hospital, once you are in hospital you have that pressure to buy from hospital. And they can easily continue with their business model,” Gopakumar said.He added that the measure could also undermine the existing generic medicine model, which allows manufacturers to produce medicines at lower costs and sell them at affordable prices while earning a reasonable profit. This model could come under pressure if hospitals do not stock generic alternatives.Experts cautioned that the revised prices represent reductions in the maximum retail prices and do not necessarily translate into equivalent savings for every patient. The actual relief will depend on the prices patients were previously paying, discounts or assistance schemes available to them, the quantities of medicines required and compliance by hospitals and pharmacies.Chetali Rao, an expert on patents, said the formula used to revise prices addressed distribution margins rather than the prices charged by manufacturers.“The formula (on basis of which prices have been slashed) addresses the distribution spread not whether the manufacturers’ starting price is low enough. The excessive distribution spread that we have requires a cut under this formula. Some biosimilars may not have received a cut because they could always say they were already below the 30% margin,” she said.Rao said greater clarity was needed on the formula used, along with broader government intervention.“True price rationalisation requires transparency and regulation of manufacturer-level reference prices, not just distribution mark-ups. Trade margin alone will not lead to a reduction in overall cancer care as new and efficacious treatments are still out of reach. Single-source medicines need different policy interventions, such as public health safeguards in the Patents Act such as compulsory licence, and capping of cancer treatment charges,” Gopakumar said.“What is actually required is capping the overall treatment cost,” he added.The revised maximum retail prices will come into effect from November 9, 2026.