India Expands Margin Caps to 137 Cancer Drugs Following Court Ruling

India is cutting prices on 137 cancer medicines starting in November.

The Department of Pharmaceuticals announced that the move is expected to lower medicine prices by up to 70%.

Key Takeaways: - The government extended a 30% trade margin cap to 137 additional cancer drugs. - This extension follows a Supreme Court order that labeled hospital and retail markups as "extortion." - Authorities estimate patients will save 2,500 crore rupees annually, with some drugs seeing price drops of up to 70%.

The policy change stems from a case filed by Sarojam Radhakrishnan, a former bank clerk in Kerala who was diagnosed with breast cancer in 2021. Her monthly treatment cost exceeded 63,000 rupees. She petitioned the Kerala high court in 2022 to force the government to reduce costs. The Supreme Court examined the supply chain during a hearing on 29 September. Justices Vikram Nath and Sandeep Mehta noted that one drug supplied to hospitals at 2,700 rupees was sold to patients for 27,000 rupees. The court described the high margins as "carnage."

Data from the National Pharmaceutical Pricing Authority showed average trade markups on some cancer drugs reached 170%, with extreme cases exceeding 700%. A 30% margin cap has applied to 42 drugs for several years. The government has now added 137 more drugs to this list. The Department of Pharmaceuticals stated that the new cap will reduce out-of-pocket expenses for patients.

Healthcare costs currently push approximately 55 million Indians below the poverty line each year. Cancer drug prices range from 38,000 to 380,000 rupees. Krishan Kalra, a former council member at the Rajiv Gandhi Cancer Institute and Research Centre, said many people avoid free diagnosis camps in Gurgaon because they fear the cost of treatment if cancer is found. Dr. Ravi Kannan, a surgical oncologist in Assam, called the decision a "welcome step" to help families sustain treatment.

India records about 1.56 million new cancer cases annually, up from 1.39 million in 2020. Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, warned that hospitals might raise other charges to offset lower drug prices. The Supreme Court has also asked the government to explain why the margin cap does not apply to all non-patented medicines. The government has until 27 October to respond to that question. Radhakrishnan died in September 2022 while her legal case remained pending.