India caps prices on 137 cancer medicines following Supreme Court intervention

The Indian government is imposing price controls on 137 cancer medications starting next month, a move expected to lower treatment costs by as much as 70% following sharp criticism from the country's Supreme Court over excessive retail markups.

The policy shift stems from legal action initiated by Sarojam Radhakrishnan, a retired bank employee from Kerala diagnosed with breast cancer in 2021. Unable to manage monthly medicine bills exceeding 63,000 rupees, she petitioned the Kerala High Court in 2022 to demand government intervention. Radhakrishnan died later that year while the proceedings were underway, but the matter eventually reached the Supreme Court.

During a hearing on 29 September, Supreme Court justices Vikram Nath and Sandeep Mehta denounced the pricing practices of distributors and medical facilities as "carnage" and "extortion." The bench highlighted instances where oncology drugs procured by hospitals for 2,700 rupees were being sold to patients for 27,000 rupees.

Data from the National Pharmaceutical Pricing Authority indicated that markups across the supply chain averaged 170%, with specific treatments marked up by more than 700%. Authorities had previously restricted trade margins to 30% on 42 cancer treatments, but over a hundred others remained unregulated. The new regulation extends that 30% trade margin ceiling across an additional 137 drugs.

India's Department of Pharmaceuticals stated that the expanded limits will generate collective savings of 2,500 crore rupees annually for patients and substantially reduce out-of-pocket medical expenses.

Medical expenses place a severe financial strain on households across India, where roughly 1.56 million individuals receive a cancer diagnosis each year. Research conducted by the Public Health Foundation of India has estimated that healthcare costs push approximately 55 million citizens into poverty each year. Although the state-funded Ayushman Bharat insurance program offers 500,000 rupees in yearly family coverage for specific conditions, oncologists point out that the sum can be exhausted by a single dose of certain advanced therapies.

Medical professionals and healthcare advocates have welcomed the price reductions while noting potential implementation hurdles. Civil society advocates have cautioned that healthcare providers could seek alternative revenue streams, such as inflating other hospital fees, to make up for lost margins on pharmaceuticals.

The Supreme Court has asked government officials to explain why margin limits should be restricted to oncology therapies rather than covering all off-patent pharmaceuticals, ordering a response by 27 October.