India Extends 30% Margin Cap to 137 Cancer Drugs After Court Verdict

A retired bank clerk from Kerala sparked a national price cut on 137 cancer medicines after the Supreme Court of India ruled that trade markups amounted to extortion. The government will enforce a 30 percent cap on trade margins for these drugs starting next month. This action directly addresses the financial strain on patients who often sell assets or incur heavy debt to afford treatment.

Sarojam Radhakrishnan filed her original petition in 2022 after doctors prescribed targeted breast cancer therapy. The monthly cost exceeded 63,000 rupees, a sum her family could not meet. Although she passed away in September 2022 while her case remained in the Kerala high court, her legal challenge reached the apex court and triggered the review of drug pricing structures.

Justices Vikram Nath and Sandeep Mehta reviewed the supply chain during a hearing on 29 September. They identified one specific drug supplied to hospitals for 2,700 rupees but sold at 27,000 rupees. The judges described the widespread disparity between supply costs and retail prices as carnage. They noted that hospitals, distributors, and chemists were capturing large portions of the final price.

Data from the National Pharmaceutical Pricing Authority indicated that trade markups on certain cancer drugs averaged 170 percent, with some instances exceeding 700 percent. A 30 percent margin cap had previously applied to only 42 drugs. The government has now expanded this restriction to include 137 additional medicines, bringing the total number of capped drugs to 179.

The Department of Pharmaceuticals stated the new measure is expected to lower medicine prices by up to 70 percent. Officials projected that cancer patients would save 2,500 crore rupees annually. This reduction targets the out-of-pocket expenses that force many families to abandon treatment after receiving initial cost estimates from consulting rooms.

Healthcare costs push approximately 55 million Indians below the poverty line each year, according to the Public Health Foundation of India. Dr. Ravi Kannan, a surgical oncologist in Assam, called the ruling a welcome step for patient access. He noted that many families start treatment but struggle to sustain it when drug costs range from 38,000 to 380,000 rupees.

The Supreme Court has asked government lawyers to explain why the cap does not apply to all non-patented medicines. Officials have until 27 October to provide a response. Jyotsna Singh, a co-convener of the Working Group on Access to Medicines, warned that hospitals might raise other charges to offset lower drug prices. India records about 1.56 million new cancer cases annually, a figure that has risen from 1.39 million in 2020.