India caps trade margins on 137 cancer drugs
The move follows a Supreme Court ruling that described hospital mark-ups as extortion, aiming to cut patient costs by up to 70%.
By Adewale Fletcher ·
A 30% cap on trade margins for 137 cancer medicines takes effect next month, extending a price control previously applied to only 42 drugs. The Indian government implemented the measure after the Supreme Court ruled that excessive mark-ups by hospitals and retailers amounted to extortion. This action aims to reduce the financial strain on patients who often skip treatment or incur debt to pay for essential care.
The legal battle began with Sarojam Radhakrishnan, a retired bank clerk from Kerala diagnosed with breast cancer in 2021. Her doctors prescribed targeted treatments costing over 63,000 rupees per month, a sum her family could not afford. She petitioned the Kerala high court in 2022, and the case eventually reached the nation's highest court. Justices Vikram Nath and Sandeep Mehta heard arguments on September 29, citing a specific drug supplied to hospitals at 2,700 rupees but sold for 27,000 rupees.
The court described the pricing structure as carnage. Data from the National Pharmaceutical Pricing Authority indicated that average trade mark-ups on some cancer drugs reached 170%, with extreme cases exceeding 700%. In a statement, the Department of Pharmaceuticals said the new cap is expected to reduce medicine prices by up to 70%. The department estimated that cancer patients would save 2,500 crore rupees annually, a figure equivalent to 199 million pounds.
Healthcare spending in India pushes approximately 55 million people below the poverty line each year, according to the Public Health Foundation of India. Krishan Kalra, a former council member of the Rajiv Gandhi Cancer Institute and Research Centre, noted that many people avoid free diagnosis camps in Gurgaon. He explained that patients are too scared to be diagnosed because they lack the funds for subsequent treatment. Cancer drug prices range from 38,000 to 380,000 rupees, often leading families to abandon treatment plans after hearing the cost.
Insurance coverage remains limited. The government's Ayushman Bharat scheme provides 500,000 rupees in annual cover per family. This amount equals the cost of one dose of Kadcyla, a breast cancer drug that patients may require up to 14 doses of. Dr. Ravi Kannan, director of Cachar Cancer Hospital and Research Centre in Assam, called the decision a welcome step if it improves access to necessary drugs. He noted that some families begin treatment but cannot sustain the financial burden over time.
India records about 1.56 million new cancer cases annually, up from 1.39 million in 2020. Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, argued that a total overhaul of healthcare is needed. She warned that hospitals might offset lower drug prices by raising charges elsewhere. The Supreme Court has asked the government to explain why the cap applies only to cancer drugs and has set a deadline of October 27 for a response. Radhakrishnan died in September 2022 while her case was still pending in Kerala.
