Prices for Over 100 Cancer Medicines Remain Unchanged Despite NPPA Revision List

The National Pharmaceutical Pricing Authority (NPPA) has released its latest updated list of revised prices, revealing that the needle has not moved on the price of at least 115 of the 643 cancer medicines featured. The situation has prompted healthcare experts to question whether a trade margin cap is indeed the most effective method to make patent-protected drugs accessible to a larger population.

A significant share of these 100-odd medicines originates from multinational drug companies, including Pfizer, AstraZeneca, Roche, MSD, Takeda, Eisai, GlaxoSmithKline, AbbVie, and Johnson & Johnson. A few domestic drug companies, such as Dr Reddy’s, Sun Pharma, and Cipla, are also represented in this group.

Explaining the lack of change among several critical cancer drugs from innovator companies, Anil Matai of the Organisation of Pharmaceutical Producers of India (OPPI) noted that these companies were already capping their trade margins at 30 percent, as outlined by the Drugs Prices Control Order (DPCO-2013). OPPI is a platform comprising mostly multinational companies.

The Centre recently capped trade margins at 30 percent on 137 cancer drugs following observations from the Supreme Court regarding steep trade margins and drug prices that impact final patient treatment costs at hospitals. Drug companies were required to submit revised prices on these medicines—estimated to include about 1,000 formulations—by October 27 for implementation by November 9.

However, the NPPA’s second update on revised prices showed that over 100 of the 600-plus brands did not reflect a price drop. Public health voices, including KM Gopakumar, Co-Convener of the Working Group on Access to Medicines and Treatments, stated that this outcome demonstrates how merely addressing the trade margin does not necessarily bring down the price of medicine for patients. Gopakumar pointed to flexibilities in the Patents Act, such as compulsory licences, as alternative tools for the government to improve affordability for critical medicines.

Meanwhile, the Jan Swasthya Abhiyan India (JSA India) has called for a comprehensive, cost-based price regulation covering all essential medicines, including cancer drugs. The group also recommended permanent and enforceable caps on trade margins across distribution channels with monitoring by the NPPA, transparent pricing data, independent verification of maximum retail prices and supply-chain margins, and full scrutiny of patient assistance programmes, free supplies, and discounts. Additionally, JSA India emphasized the need to strengthen public cancer-care services, including affordable diagnostics and treatment.

"The findings from the NPPA's updated price list highlight a complex challenge in healthcare pricing and regulatory enforcement. When policy interventions like trade margin caps fail to reduce end-consumer prices for critical medications like cancer drugs, it signals a need to re-evaluate the direct mechanisms of price control. For businesses and pharmaceutical firms operating in this sector, regulatory compliance requires looking beyond surface-level adjustments and preparing for more comprehensive, transparent pricing frameworks and increased scrutiny from public health stakeholders." — Dr. Shishir Gupta, Founder & CEO, StartupLanes