India expands cancer drug price cap after court scrutiny of mark-ups

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India expands cancer drug price cap

Highlights

India's government extended a 30% trade margin cap to 137 additional cancer drugs after supreme court criticism of extreme mark-ups by hospitals and distributors.
The expanded cap is expected to save patients 2,500 crore rupees annually, addressing cancer drug costs ranging from 38,000 to 380,000 rupees per treatment.
The supreme court questioned why price caps cover only cancer drugs and has instructed the government to respond regarding broader application by 27 October.

Court pressure drives wider drug cap

As reported by The Guardian, citing the Department of Pharmaceuticals, the government is extending a 30% trade margin cap to 137 additional cancer drugs after the supreme court examined pricing practices and sharply criticised mark-ups by hospitals, distributors and chemists.

The policy shift follows a case brought by Sarojam Radhakrishnan, a retired bank employee from Kerala who was diagnosed with breast cancer in 2021 and challenged the affordability of prescribed treatment. After she petitioned the Kerala high court in 2022, the matter reached the supreme court, where justices Vikram Nath and Sandeep Mehta described the pricing situation as "carnage" and "extortion" during a 29 September hearing.

The court highlighted examples of large mark-ups, including a life-saving cancer drug supplied to hospitals at 2,700 rupees and sold at 27,000 rupees. Analysis by the National Pharmaceutical Pricing Authority found average trade mark-ups of about 170% on some cancer drugs, with some cases exceeding 700%, while only 42 drugs had previously been covered by the cap.

Patient costs and healthcare pressure

The Department of Pharmaceuticals says the expanded cap is expected to help patients save 2,500 crore rupees annually, easing a major burden in a country where serious illness often pushes families into debt, distress sales of land, or abandoned treatment.

With cancer drug costs ranging from 38,000 to 380,000 rupees, many households are unable to sustain care. Public Health Foundation of India studies show healthcare spending pushes about 55 million Indians below the poverty line each year, while the Ayushman Bharat insurance scheme covers only 500,000 rupees a year for a family, an amount the article says matches the cost of a single dose of Kadcyla used in breast cancer treatment.

Doctors and patient advocates say the price cut is welcome but does not resolve broader structural problems. Dr Ravi Kannan, a surgical oncologist and director of Cachar cancer hospital and research centre in Assam, says patients often begin treatment and then stop because they cannot keep paying, while Jyotsna Singh of the Working Group on Access to Medicines and Treatments says a wider overhaul of manufacturing, pricing transparency and supply-chain regulation is still needed.

India records about 1.56 million new cancer cases annually, up from 1.39 million in 2020, underscoring the scale of the public health challenge. The supreme court has also asked why the cap should apply only to cancer drugs rather than the full range of non-patented medicines, and has given the government until 27 October to respond.

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