Major Cuts in Cancer Drug Prices, Yet Some Remain High
Recent price regulations have significantly lowered costs of some cancer drugs, but many patented treatments remain expensive.
Significant Reductions in Cancer Drug Prices
The Indian government's recent decision to cap trade margins on 137 anti-cancer medications is leading to notable price reductions for many cancer treatments. However, the reform highlights a pressing concern regarding the affordability of patented therapies that remain untouched by these changes.
Price Reductions Observed
Following the new measures, manufacturers announced adjusted maximum retail prices (MRPs) for various formulations of drugs. Among the 543 formulations considered, 146 saw no change in pricing, while 21 recorded reductions of less than Rs 100. Overall, the average drop was slightly above Rs 5,000 across the board.
One significant example is Thiotepa, known commercially as Samtepa, produced by Samarth Life Sciences. The price for a 100 mg vial plummeted from Rs 80,071 to just Rs 7,150, amounting to an impressive reduction of about 91%. Another drug, Pertuzumab, sold as Hertumab by Glenmark, decreased from Rs 94,951 to Rs 30,593—approximately a 68% cut.
Remaining High Prices of Patented Drugs
Despite these reductions, certain high-cost patented medications still bear their original price tags. For instance, pembrolizumab, commonly marketed as Keytruda by Merck, retains its price of Rs 2.16 lakh for a 100 mg vial. Similarly, ribociclib branded as Kryxana and Kisqali by Novartis remains at Rs 24,435 for a pack of 21 tablets at 200 mg each. This situation raises questions about the effectiveness of solely capping trade margins in addressing the affordability of patented treatments.
K. M. Gopakumar, co-convenor of the Working Group on Access to Medicines and Treatments, highlighted concerns that simply regulating trade margins may not lower prices for patented drugs, where competition from generic alternatives is minimal.
Government's Price Control Measures
Under the Drugs (Prices Control) Order of 2013, the Indian government has imposed a cap of 30% on trade margins for those anti-cancer drugs included in the new regulations. The hope is to lower the maximum retail prices by as much as 70% and save patients around Rs 2,500 crore annually. The new pricing is set to take effect on November 9, 2026, and manufacturers are required to resubmit their prices to the National Pharmaceutical Pricing Authority (NPPA). Retailers and hospitals will then be obligated to charge these revised rates from the implementation date.
Supreme Court's Concerns Over Pricing Gaps
In a related development, the Supreme Court of India has raised questions about the stark price disparities between what retailers pay for drugs and the MRPs charged to consumers. During a hearing, Justices Vikram Nath and Sandeep Mehta emphasized a troubling example where a medicine costing retailers Rs 15 was sold for Rs 250 to patients. Concerns about the NPPA’s efficacy and its apparent favoritism towards manufacturers were also expressed.
The court requested more uniformity in trade margins and scrutinized the delay in addressing excessive pricing practices. The Centre defended its stance by stating that India has among the lowest medicine prices globally, advocating a measured regulatory approach.
Future of Cancer Treatment Affordability
While the recent price adjustments signal a positive change for some cancer medications, the unchanged costs of certain patented treatments spotlight the limitations of regulating trade margins alone. Experts advocate for a multi-faceted approach, stressing the importance of enhancing market competition and utilizing legal mechanisms like compulsory licensing to improve access to these essential treatments.
Ultimately, patients confronting high costs for cancer therapy are left to ponder whether the regulatory changes will yield sustained reductions in treatment expenses, particularly concerning newer therapies and immunotherapy drugs.
