Cancer drug prices fall sharply, but can patients afford the full cost of treatment?

Cancer treatment in India has received a significant price intervention, with the government capping trade margins on 137 non-scheduled anti-cancer medicines. Revised prices came into effect on November 9, bringing down the maximum retail prices (MRPs) of more than 1,000 formulations across several brands. The government estimates that the measure will translate into annual savings of ₹3,502.31 crore for consumers.

According to the National Pharmaceutical Pricing Authority (NPPA), 76 pharmaceutical companies have reported revised MRPs for 1,225 formulations covering 121 drugs. Of these, 1,031 formulations have reported price reductions. Around 600 brands have seen reductions of more than 50%, with the highest reduction at 96.45%.

The intervention covers medicines used across different types of cancer, including breast, lung, prostate, ovarian and blood cancers. It brings down the prices of several widely used oncology drugs, including bevacizumab, denosumab, abiraterone, palbociclib, enzalutamide and pemetrexed.

For instance, the MRP of Zydus Lifesciences' bevacizumab brand Bryxta (100 mg injection), used in the treatment of lung, colon, ovarian and cervical cancers, has come down from ₹25,995 to ₹3,318. Glenmark Pharmaceuticals' abiraterone brand Abirapro, used for prostate cancer, has seen its MRP reduced from ₹28,744 to ₹5,768. The price of RPG Life Sciences' palbociclib brand Palbopro, used for breast cancer, has fallen from ₹40,421.33 to ₹2,720.

How does the price cap work?

The intervention is based on Trade Margin Rationalisation (TMR), a mechanism through which the government regulates the margins earned by intermediaries in the pharmaceutical distribution chain.

Unlike scheduled medicines, whose prices are directly regulated under the Drug Price Control Order (DPCO), non-scheduled medicines do not have the same direct ceiling-price mechanism. However, the government can intervene in their pricing through trade margin controls.

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Under the latest notification, the maximum permissible trade margin has been capped at 30%. This limits the margins that can be added across the distribution chain, bringing down the MRP paid by patients.

The measure follows recommendations made by an expert committee constituted by the Directorate General of Health Services on October 17, 2026. Of the 137 identified anti-cancer drugs, 10-15 have not yet been launched in India. The price control will apply to these medicines as well once they enter the market.

The notification will remain in force until further orders. Manufacturers can undertake annual price increases under the provisions of the DPCO, 2013, subject to continued compliance with the maximum permissible trade margin.

Medicines are only one part of cancer care

While the reductions are significant, the cost of cancer treatment extends well beyond medicines. Diagnostics, biopsies, imaging, surgery, radiation therapy, hospitalisation, and follow-up consultations add to the overall expenditure. Patients may also need to travel to larger cities for specialised treatment, incurring accommodation and other expenses over several months.

"A reduction in medicine prices is an important starting point, but the affordability of cancer care cannot be measured by the cost of medicines alone. For patients and families, the financial burden extends to diagnostics, hospitalisation, travel, accommodation and the ability to sustain treatment over several months," said Sheetal Arora, CEO and Promoter of Mankind Pharma.

"The long-term impact of the government's intervention will depend on effective implementation, transparent pricing across the distribution chain and uninterrupted availability of medicines. We also need a more comprehensive approach to financial protection, with insurance and public healthcare programmes addressing the wider costs of treatment," Arora added.

A lower MRP can reduce the cost of prescribed drugs, but it does not necessarily bring down the overall bill for a patient undergoing cancer treatment. The burden can be particularly high in cases requiring prolonged therapy, multiple treatment cycles or newer targeted medicines.

Access to treatment remains another challenge

Affordability is also linked to the availability of cancer care facilities. While major metropolitan centres have specialised oncology hospitals, access to quality treatment remains uneven across smaller cities and towns.

"Access to innovative medicines remains a critical part of this equation, particularly in oncology, where the cost of newer therapies can be a significant barrier for patients," said Mayur Sirdesai, Co-Founding Partner of Somerset Indus Capital Partners.

"Affordability must extend beyond medicines to the broader cancer-care pathway, including screening, diagnosis and treatment. Initiatives such as Ayushman Bharat PM-JAY play an important role in enabling eligible patients to access hospital-based oncology care. Equally important is expanding access to quality treatment across Tier 1 and Tier 2 markets," Sirdesai added.

This requires investment in hospitals, trained oncologists and diagnostic facilities, alongside wider insurance coverage and financial protection for patients.

Will the price reductions reach patients?

The next test will be implementation across the supply chain. The NPPA has directed retailers, dealers, hospitals and medical institutions to prominently display revised price lists on their websites and premises. State Drug Controllers will monitor compliance.

Patients can check revised medicine prices through the Pharma Sahi Daam mobile application and the NPPA website. The authority has also provided channels for consumers to report violations.

"OPPI welcomes the Government's notification extending Trade Margin Rationalisation to 137 non-scheduled anti-cancer medicines. With the revised prices set to take effect from November 9, the focus now is on smooth implementation across the supply chain so that the intended benefits reach patients while ensuring continued availability of these critical medicines," said Anil Matai, Director General of the Organisation of Pharmaceutical Producers of India (OPPI).

"It will be important to monitor the impact of the measure on patient access, availability and the broader cancer-care ecosystem as the revised pricing takes effect," Matai added.

The government's estimated annual savings of ₹3,502 crore indicate the potential financial benefit of the intervention. However, its actual impact will depend on compliance with revised prices and the continued availability of medicines, industry experts said