Published Oct 09, 2026 | 12:53 PM ⚊ Updated Oct 09, 2026 | 12:53 PM
NPPA has, in principle, approved a proposed cap on trade margins on identified cancer medicines at 30% of their MRP.
Synopsis: The Union government has proposed capping trade margins on identified cancer medicines at 30%, following reports of markups reaching 700%. The National Pharmaceutical Pricing Authority estimates the move could reduce medicine prices by 20% to 70% and generate annual savings of ₹2,500 crore. The final list of medicines is awaited.
Cancer medicines can carry trade markups of up to 700% in some cases, according to the National Pharmaceutical Pricing Authority (NPPA).
The authority has in principle approved a proposed cap on trade margins on identified cancer medicines at 30% of their maximum retail price (MRP), estimating annual savings of approximately ₹2,500 crore.
The decision was taken at the NPPA’s 151st meeting under the Drugs (Prices Control) Order (DPCO), 2013, on Thursday, 8 October. The proposal aims to curb high markups on non-scheduled cancer medicines, which are not subject to the same ceiling-price mechanism as scheduled drugs.
According to the meeting minutes, “The proposed intervention is expected to reduce MRP broadly in the range of 20–70%, depending upon the existing trade structure and markup of individual medicines.”
The proposal has not yet been implemented and still needs to finalise the list of medicines to be covered.
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Trade margins refer to the difference between the price at which a medicine is purchased within the supply chain and the price at which it is sold, before accounting for other costs and applicable taxes.
A cap limits how much can be added at the relevant stage of the supply chain. It does not mean that every cancer medicine will become 70% cheaper. The actual reduction will depend on each medicine’s existing price structure.
An analysis of Pharmarack data cited in the NPPA meeting minutes found that non-scheduled anti-cancer medicines carried an average trade markup of approximately 170%, with markups reaching up to 700% in certain cases.
The authority also noted substantial variations in transaction prices across retail pharmacies, hospitals and e-pharmacies, including differences in discounts offered against MRP.
Highlighting the role of trade margins in medicine prices, the meeting minutes stated that “high trade margins, particularly in non-scheduled anti-cancer formulations, are a significant factor contributing to the high prices of such medicines.”
The NPPA said the proposed intervention intended to reduce patients’ out-of-pocket expenditure, improve affordability and accessibility, curb excessive trade markups and bring greater transparency to the prices charged to patients.
The authority also noted that information asymmetry in healthcare could make it hard for patients and their families to assess medicine prices and compare costs across providers.
Emphasising the need to protect consumers, the authority unanimously agreed that “consumer interest must remain paramount” given excessive profiteering in anti-cancer medicines and its impact on patients.
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The NPPA meeting minutes noted that India’s anti-cancer medicines market comprised approximately 225 drugs and 500 formulations, with an annual turnover of around ₹12,500 crore.
Scheduled cancer medicines accounted for approximately ₹2,250 crore of this market, while the remaining market comprised non-scheduled drugs.
Scheduled medicines are subject to government price controls through a ceiling-price mechanism. Prices of non-scheduled medicines are monitored to ensure that annual increases do not exceed 10%, but they are not subject to the same ceiling-price mechanism.
The Department of Pharmaceuticals has directed the NPPA to implement trade margin rationalisation for non-scheduled anti-cancer medicines under Paragraph 19 of the DPCO, 2013, in the public interest.
The authority noted that “extraordinary circumstances existed warranting urgent action under Paragraph 19 of the DPCO, 2013, to address market distortions, curb profiteering and ensure fair and affordable prices.”
The Department has requested the Ministry of Health and Family Welfare to constitute an expert committee under the Directorate General of Health Services (DGHS) to recommend cancer medicines for inclusion in the exercise.
The committee is requested to submit its report by 14 October 2026. The minutes stated that the list of medicines may be updated periodically in response to market developments and public health considerations.
The authority has not yet specified when the proposed margin cap will come into effect or which individual medicines and brands will be covered.
The latest proposal followed a similar intervention by the NPPA in 2019. Notified on February 27 that year, the exercise covered 42 non-scheduled anti-cancer drugs and imposed a 30% trade margin from the first point of sale.
The minutes of the latest meeting said the 2019 intervention resulted in substantial reductions in maximum retail prices, including cuts of up to 91% for 526 brands. The exercise generated estimated annual savings of approximately ₹984 crore.
The NPPA is now proposing another intervention to address excessive trade markups and reduce the financial burden on patients purchasing expensive cancer medicines.
The authority has approved, in principle, a 30% trade margin cap for identified non-scheduled anti-cancer medicines, projecting annual savings of approximately ₹2,500 crore.
If implemented as envisaged, the measure could provide financial relief to cancer patients and their families. However, the extent of savings for individual patients will depend on the medicines included in the final list and the price reductions ultimately implemented.
The NPPA is responsible for fixing and revising drug prices, monitoring implementation of the DPCO, 2013, and ensuring medicines are available at affordable prices. The proposed intervention would use its powers under Paragraph 19 of the order to regulate trade margins on identified medicines in the public interest.
(Edited by Majnu Babu).
