Why patented cancer therapies may miss India's steep drug price cuts

The NPPA has capped trade margins on 137 non-scheduled anti-cancer drugs at 30%. The reductions promise major savings, though costly patented therapies may see limited relief.Cancer patients in India could see significant relief in their treatment bills from today, with prices of several anti-cancer medicines falling sharply, in some cases by as much as 96%. The government estimates that the latest price intervention will save consumers more than Rs 3,540 crore annually.The move comes following a strong push by the Supreme Court as cancer cases continue to rise and the cost of prolonged treatment puts increasing pressure on household finances.The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins on 137 non-scheduled anti-cancer drugs at 30%. According to updated government figures, 85 pharmaceutical companies have reported revised maximum retail prices for 1,364 formulations covering 121 drugs.As many as 679 brands have reported price reductions exceeding 50%, with the steepest cut at 96.45%. For patients, these reductions could translate into substantial savings on medicines used to treat several cancers, including lung, ovarian, cervical and colorectal cancers.But despite slashing of prices, patients using expensive patented therapies may not see similar reductions, as the exercise primarily targets trade margins rather than manufacturers' pricing.MEDICINES WITH STEEPEST PRICE CUTS The impact is visible in individual drug prices. Zydus Lifesciences' bevacizumab brand Bryxta 100 mg injection, used in multiple cancers, has seen its price fall from Rs 25,995 to Rs 3,318. Reliance Life Sciences' BevaciRel has dropped from Rs 24,079 to Rs 3,985.The intervention comes as India's cancer burden continues to climb.Estimates put the number of cancer cases at around 15.62 lakh in 2024, with nearly 9 lakh deaths. The growing use of targeted therapies, immunotherapy and prolonged drug treatment is also expanding the cancer medicines market.In the case of families paying out of pocket, lower medicine prices can make a meaningful difference. However, medicines are only one part of the cancer bill, which can also include diagnostic tests, hospitalisation, surgery, radiation and repeated consultations.THE BIGGER CHALLENGEA key limitation is that a trade margin cap does not amount to a cap on the manufacturer's price. The 30% ceiling regulates what distributors and retailers can earn, not what pharmaceutical companies charge. Consequently, patients dependent on expensive patented therapies may not see comparable price relief. Drugs such as pembrolizumab, sold under the brand Keytruda, illustrate this challenge.Patient rights group All India Drug Action Network (AIDAN) has been among the strongest critics of this approach. It has argued that the government is addressing distributor and retailer margins while leaving manufacturers' pricing power largely untouched.AIDAN has also questioned the treatment of free doses supplied through patient assistance programmes in margin calculations, arguing that this can understate actual trade margins.Its earlier analysis of 50 anti-cancer medicines found estimated trade mark-ups exceeding 100% for 41 drugs, with some reaching several hundred per cent. AIDAN cited mark-ups of 709% for a bevacizumab formulation and 628% for a pemetrexed formulation. It has called for stronger manufacturer-level price regulation and sustained monitoring.Patients can check revised MRPs through the NPPA website or the Pharma Sahi Daam app and question pharmacies or hospitals continuing to charge old prices.Experts say that the latest reductions are a significant step towards making several cancer medicines more affordable, but the larger challenge will be extending that affordability to newer cancer therapies.- Ends