India has widened its cancer drug price caps to cover 137 non-scheduled anti-cancer drugs, a move the government expects to reduce the retail prices of several cancer medicines by up to 70 per cent. The National Pharmaceutical Pricing Authority (NPPA) has limited the trade margin on these medicines to 30 per cent of the maximum retail price (MRP), and the revised prices are due to take effect on November 9, 2026, according to a statement from the Union Ministry of Chemicals and Fertilisers.
How the Cancer Drug Price Caps Work
The NPPA proceeded under Paragraph 19 of the Drugs (Prices Control) Order, 2013, a provision that allows the regulator to intervene in extraordinary circumstances in the public interest. Non-scheduled medicines are those not listed in the National List of Essential Medicines, which means that no government-fixed ceiling price applies to them. Hence, a cap on the trade margin is the main instrument of control in this case.
According to a report in the Hindustan Times, the 30 per cent cap is calculated on the MRP excluding goods and services tax, which translates into a mark-up of 42.86 per cent on the price to stockist or distributor. The regulator approved the decision at meetings held on October 16 and 17, and the list of medicines was recommended by an expert committee of the Union Health Ministry.
Which Medicines Are Covered
The official statement said the 137 drugs include immunotherapy medicines used in more than 20 types of cancer, denosumab, which is used by breast and prostate cancer patients, pegfilgrastim, which helps prevent neutropenia in cancer patients, and bevacizumab, an approved treatment for colon, ovarian and cervical cancer. The South First reported that the list spans immunotherapy, targeted therapies, conventional chemotherapy and supportive medicines used during cancer treatment. The policy applies to branded and generic medicines alike, whether imported or manufactured domestically.
The NPPA has also directed manufacturers to maintain existing production levels of the 137 drugs, a safeguard intended to prevent supply disruptions once the new prices apply. An industry analysis of the order adds that manufacturers must calculate the revised MRP using their March 2026 price to stockist or distributor, and must submit updated pricing information to the regulator within seven days of the order’s publication.
Why the Government Intervened
The decision followed an in-principle approval granted by the NPPA at its meeting on October 8. In the weeks before, the Supreme Court had drawn attention to excessive mark-ups on essential medicines, questioning why the MRP of such drugs, including cancer medicines, could not be capped at 16 per cent above the price to retailer, as applies to scheduled medicines. The NPPA has said that cancer medicines can carry trade mark-ups of up to 700 per cent in some cases.
At the proposal stage, the Centre estimated that the measure could save patients about Rs 2,500 crore annually, and that it could reduce the MRP of several cancer medicines by 20 to 70 per cent. The NPPA’s own minutes put the annual turnover of India’s anti-cancer medicines market at around Rs 12,500 crore, which indicates the scale of the spending affected. The government has framed the step as a means of improving patient affordability in a country where most patients meet treatment costs out of pocket.
A Familiar Instrument, Applied More Widely
The latest cancer drug price caps follow a precedent set in 2019, when the NPPA invoked the same paragraph to cap trade margins at 30 per cent on 42 non-scheduled anti-cancer drugs. According to a reply given to the Lok Sabha in December 2023, that exercise led to the revision of the MRP of 526 brands. At the time, patients’ rights groups welcomed the principle but cautioned that the effect on treatment costs could be limited, partly because not every anti-cancer drug fell within the cap.
What Comes Next
The scale of the savings will become clear only after November 9, as the reduction will vary from one drug to another. Reports of the order indicate that the list of 137 drugs is not closed and will be updated periodically as market and public health conditions change. Pressure for a wider approach is also building: Karnataka has urged the Centre to extend similar controls to other high-cost life-saving medicines, including those used for cardiac and kidney ailments. For now, the expanded cancer drug price caps represent the most significant step in several years to bring down what patients pay for expensive oncology treatment.
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