India caps margins on 137 cancer drugs

India imposed a 30% trade-margin cap on 137 additional cancer drugs, The Guardian reported Oct. 23, citing a Department of Pharmaceuticals statement and Supreme Court proceedings.

Evidence grade: Claim (no study cited) for projected savings. The department said prices could fall by up to 70% and save patients 2,500 crore rupees, or £199 million, annually, compared with an earlier cap covering 42 drugs.

The case began after Sarojam Radhakrishnan, a retired bank employee in Kerala, was diagnosed with breast cancer in 2021. She was prescribed targeted treatments costing more than 63,000 rupees, or £500, a month, and filed a petition in the Kerala high court in 2022 seeking government action on prices.

When the matter reached India’s Supreme Court, justices Vikram Nath and Sandeep Mehta examined reported margins charged by hospitals and retailers. At a Sept. 29 hearing, they referred to the pricing practices as “carnage” and “extortion,” according to The Guardian.

The court cited an example of a cancer medicine supplied to hospitals at 2,700 rupees and billed at 27,000 rupees. The National Pharmaceutical Pricing Authority found average trade mark-ups of 170% on some cancer drugs, with some cases exceeding 700%, The Guardian reported.

India records about 1.56 million new cancer cases a year, up from 1.39 million in 2020, according to figures cited in the report. Healthcare spending pushes about 55 million Indians below the poverty line each year, according to studies by the Public Health Foundation of India cited by The Guardian.

The financial gap can remain large even with public insurance. The report said Ayushman Bharat, the national insurance scheme, covers some cancer care but provides 500,000 rupees of annual family cover, equal to the cost of one dose of Kadcyla, or ado-trastuzumab emtansine, while some patients may need up to 14 doses.

Ravi Kannan, a surgical oncologist and director of Cachar cancer hospital and research centre in Silchar, Assam, said affordability often interrupts care. “Some families start the treatment, hoping against hope to manage the cost. They start but they don’t come back for chemotherapy or radiation.

They can’t sustain the cost,” he said. “The decision is a welcome step if the outcome is that more patients can access the drugs they need.”

The policy’s effect is still uncertain. Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, told The Guardian that companies and hospitals may seek loopholes and that hospitals could raise other charges while lowering drug prices.

Singh called for broader oversight of the supply chain. “Right from the cost of manufacturing a drug to the point of sale, we need to make the system transparent and regulate the entire supply chain. Only then will these drugs become available to those who need them,” she said.

The Supreme Court has asked government lawyers why the 30% cap should not apply to all non-patented drugs rather than cancer drugs alone. The government has until Oct. 27 to respond.

The change applies to cancer patients in India who need the listed medicines. It does not apply to all cancer costs, all cancer medicines or the wider range of non-patented drugs, based on the reported order.

Oct. 27 court deadline

The next observable step is the Indian government’s response to the Supreme Court by Oct. 27 on whether the 30% trade-margin cap should remain limited to cancer drugs or be considered for all non-patented drugs.

Source: news report, The Guardian Health, Oct. 23, 2026.

Atlas360 reports health research and does not provide medical advice.