NPPA caps trade margins on 137 cancer drugs to drop prices up to 70%

Retail prices for 137 non-scheduled anti-cancer medicines will drop by up to 70 per cent from 9 November following a major policy intervention by India's drug pricing regulator.

The National Pharmaceutical Pricing Authority (NPPA) notified a 30 per cent cap on trade margins across the supply chain, invoking Paragraph 19 of the Drugs (Prices Control) Order, 2013. The measure addresses high mark-ups between distributor costs and hospital bills, significantly boosting healthcare affordability for cancer patients across the country.

How the trade margin cap works

The 30 per cent trade margin cap on maximum retail price (MRP), excluding Goods and Services Tax, translates to a maximum mark-up of 42.9 per cent on the price to stockists or distributors. The regulator set March 2026 as the reference month for calculating baseline distributor prices, while excluding quantities distributed under free patient assistance programmes.

Crucially, the capped list includes advanced patented therapies alongside non-scheduled formulations. High-cost oncology medications that currently command prices of up to Rs 5 lakh per vial or pack — including pertuzumab with trastuzumab, atezolizumab, teclistamab, inotuzumab ozogamicin, and daratumumab — will see substantial reductions under the new pricing framework.

Expanding affordable cancer care

The policy builds upon recommendations from an expert committee established under the Directorate General of Health Services (DGHS), which included oncologists, hospital specialists, and health ministry officials. The government plans to update the list of capped formulations periodically as new treatments emerge.

Enforcement and supply safeguards

To ensure seamless benefit delivery to patients, pharmaceutical manufacturers must submit revised price lists to the NPPA within seven days of the notification. Companies are required to publish updated rates on their websites and distribute them to all stockists, retailers, and medical institutions.

Hospitals and medical centres, which handle a large share of cancer drug dispensations directly, must prominently display the revised prices on their websites and pharmacy counters. State drug controllers have been tasked with enforcing compliance across all healthcare facilities.

To safeguard against market disruptions or artificial shortages, the NPPA has instructed drugmakers to maintain existing production levels. Any manufacturer seeking to reduce monthly output of the listed formulations must secure prior government permission. Consumers can verify updated drug prices using the official NPPA portal or the Pharma Sahi Daam mobile application.