The National Pharmaceutical Pricing Authority (NPPA) released a revised Maximum Retail Price (MRP) list for anti‑cancer medicines on October 28, 2026, citing data submitted by manufacturers up to October 27. The new list, covering 543 brands, will take effect on November 9 and is intended to make cancer treatment more affordable for patients across the country.
NPPA’s revised price list and trade margin rationalisation
The NPPA operates under the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers. In a statement issued on the same day, the authority explained that the revised MRP reflects the information supplied by companies and will be updated whenever manufacturers submit new prices for non‑scheduled anti‑cancer drugs.
Earlier, on October 17, the agency announced a Trade Margin Rationalisation (TMR) policy targeting 137 non‑scheduled anti‑cancer drugs. The policy was framed as a public‑interest move to curb excessive trade margins, improve access and lower the overall cost of cancer care. Manufacturers were instructed to provide revised price lists to the NPPA under the TMR framework.
The 137 drugs identified for margin rationalisation include a range of immunotherapy agents used to treat more than 20 cancer types, Denosumab for breast and prostate cancers, Pegfilgrastim to prevent neutropenia, and Bevacizumab, which is approved for colon, ovarian and cervical cancers.
Among the most striking price adjustments reported by health activists, the MRP of one brand of palbociclib fell from roughly ₹40,421 to ₹2,720 per pack, while the price of thiotepa dropped from about ₹80,072 to ₹7,150 per vial. These steep reductions highlight the disparity that existed before the NPPA’s intervention and raise questions about the pricing strategies of pharmaceutical firms, including major Indian manufacturers of generic cancer medicines.
Critics call for deeper reforms
Jan Swasthya Abhiyan India (JSA India), a non‑governmental organisation that works on medicine accessibility, welcomed the price cuts but warned that controlling trade margins alone would not ensure genuine affordability. In a statement, JSA argued that life‑saving cancer treatment should be priced according to medical need rather than a patient’s ability to pay.
The group pointed out that several patented cancer medicines remain priced at levels that are unaffordable for many patients. Moreover, the TMR policy excludes medicines supplied free under Patient Assistance Programmes (PAPs) from its calculations, limiting its overall impact on out‑of‑pocket expenses.
JSA also criticised the formula used to set permissible margins. The policy allows a 42.8% markup over the Price to Stockist (PTS), a figure the organisation says legitimises excessive margins, especially in supply chains that involve only one or two intermediaries or direct sales to hospitals. By contrast, scheduled formulations under the Drug Price Control Order (DPCO) are subject to a 16% margin, a level JSA believes could have delivered greater benefits if applied to non‑scheduled anti‑cancer drugs.
According to JSA, a one‑time reduction in MRP is insufficient. The group called for permanent, enforceable caps on trade margins, regular monitoring, and independent verification of price data by the NPPA. It stressed that companies should not be left to self‑report revised MRPs without robust oversight.
Medical professionals echoed many of these concerns. Tanvi Singh, a medical oncologist at MOC Cancer Care, explained that high drug costs can force patients to delay starting treatment, skip doses, or discontinue therapy altogether, compromising clinical outcomes. Singh described lower drug prices as essential for improving treatment continuity, reducing financial toxicity, and enabling patients to complete prescribed regimens.
However, Singh cautioned that price caps by themselves are not a panacea. She advocated for a broader approach that includes expanded insurance coverage, greater reimbursement under government schemes, wider availability of quality generics and biosimilars, robust PAPs, and improved access to comprehensive cancer care nationwide.
Sandeep Nayak, chairman of oncology at MACS‑Renova Oncology Institute, KIMS Hospital in Bengaluru, welcomed the government’s price‑control move, describing it as a positive step. He added that low‑cost life‑saving drugs must remain viable for manufacturers and sellers, hinting at the need to balance affordability with sustainable production.
The NPPA’s actions come amid growing scrutiny of drug pricing across India. Health activists argue that while the revised MRP list and the TMR policy represent progress, the underlying pricing architecture still permits substantial mark‑ups. Without systematic data collection across supply chains and independent verification, the risk of price inflation re‑emerging remains, according to JSA.
As the revised prices take effect on November 9, stakeholders will be watching closely to see whether the reductions translate into tangible relief for patients and whether the NPPA adopts the deeper structural changes urged by activists and clinicians.
Be First to Comment