The National Pharmaceutical Pricing Authority (NPPA), the regulator that sets and monitors drug prices, has capped the trade margin on 137 non-scheduled anti-cancer medicines at 30% of their maximum retail price (MRP), a move the government expects to cut their prices by up to 70%. The revised prices will apply from November 9.
The trade margin is the share of a drug’s price kept by the distributors, chemists and hospitals that sell it. This provision lets the government fix the price of any drug in extraordinary circumstances, in public interest. NPPA has approved a formula for working out each drug’s revised MRP. Sales to government buyers will be excluded. The medicines include abemaciclib, abiraterone acetate, afatinib, anastrozole, bevacizumab, cabazitaxel, cetuximab, crizotinib, nivolumab, pembrolizumab, palbociclib, sunitinib and venetoclax, among others. Nivolumab and pembrolizumab are immunotherapy drugs, which help the body’s immune system attack cancer cells. The policy covers branded and generic medicines, both imported and made in India.
The decision was approved at NPPA meetings on October 16 and 17, according to the minutes, seen by HT. At the meeting, chaired by Manoj Joshi, secretary of the Department of Pharmaceuticals and chairman, NPPA, the authority invoked Paragraph 19 of the Drugs (Prices Control) Order (DPCO), 2013. The 30% cap is calculated on the MRP excluding goods and services tax (GST). This is equivalent to a mark-up of 42.86% on the price to stockist or distributor (PTS/PTD), the price at which the manufacturer sells the drug to the first link in the supply chain, according to the minutes. A medicine sold to a distributor at ₹ 100, for instance, can carry an MRP of no more than about ₹ 143 before GST, since the ₹ 43 difference is 30% of ₹ 143. It takes as its reference the PTS/PTD for March 2026, calculated from the manufacturer’s net sales realisation, the revenue it actually received after discounts, and the total quantity it sold that month. If a medicine had no sales in March, the calculation will use sales data from April 2025 to March 2026. The list of 137 medicines was recommended by an expert committee of the Union health ministry. The reduction will vary with each product’s existing price and margin, and a drug whose margin is already below 30% will not get cheaper.
Non-scheduled medicines are those outside the National List of Essential Medicines, which means the government sets no ceiling price for them. The reference is therefore the average price per unit the manufacturer actually received.
The committee considered “all available information/data/viewpoints and all relevant options for ensuring affordability”, according to the minutes. The minutes say the list “could be updated periodically”, depending on market developments and public-health considerations.
