New Delhi: The revised Maximum Retail Price (MRP) list of anti-cancer medicines published by the National Pharmaceutical Pricing Authority (NPPA) raises serious concerns about excessive pricing and the exploitation of patients, medical health activists said on Wednesday (October 28, 2026).
The Revised List
The NPPA, under the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, has released a list of 543 brands of anti-cancer medicines with their revised MRP, effective from November 9.
“The revised price list reflects the information submitted by companies up to October 27, 2026, and it will be updated as and when manufacturers submit their revised prices of non-scheduled anti-cancer drugs,” said a release issued by the Union government.
Background: Trade Margin Rationalisation
On October 17, the NPPA had announced Trade Margin Rationalisation (TMR) of 137 non-scheduled anti-cancer drugs in public interest to address excessive trade margins, make cancer treatment more affordable and improve access.
The 137 drugs include immunotherapy medicines used in the treatment of over 20 types of cancer, Denosumab used by breast and prostate cancer patients, Pegfilgrastim used to prevent neutropenia in cancer patients, and Bevacizumab, approved for colon, ovarian and cervical cancers.
The Scale of the Cuts
Jan Swasthya Abhiyan India (JSA India), an organisation working for accessibility of medicines, said controlling trade margins alone is insufficient, and that life-saving cancer treatment must be affordable based on medical need, not a patient’s ability to pay.
In their statement, the group explained: “For example, the reported MRP of one brand of palbociclib fell from approximately ₹40,421 to ₹2,720 per pack, while thiotepa fell from approximately ₹80,072 to ₹7,150 per vial. Such drastic reductions raise serious questions about the pricing practices of pharmaceutical companies, including major Indian manufacturers of generic cancer medicines that have reportedly offered substantial trade margins while patients continued to face unaffordable prices.”
It added that several patented cancer medicines remain exorbitantly priced. The TMR policy has failed to ensure affordability, while excluding medicines supplied free under Patient Assistance Programmes from its calculations has further limited its potential impact, the group said.
‘The Formula Is Deeply Flawed’
“The policy’s formula is also deeply flawed. Allowing a 42.8% markup over the Price to Stockist [PTS] legitimises excessive margins, particularly in a supply chain often involving only one or two intermediaries or direct sales to hospitals,” JSA stated.
“A substantially lower markup, comparable to the 16% margin applicable to scheduled formulations under the DPCO framework, could have delivered greater benefits to patients. A one-time MRP reduction is not enough. Without permanent, enforceable margin caps, regular monitoring and verification by NPPA, excessive pricing can persist or re-emerge.”
The NPPA must also strengthen its collection and maintenance of price data across supply chains, the group said, adding that companies should not be left to calculate and self-report revised MRPs without adequate independent verification.
Doctors on Access and Continuity
Tanvi Singh, medical oncologist at MOC Cancer Care, said cancer is an ailment whose treatment demands are extensive, so when drug costs are high, patients may delay treatment initiation, skip doses or discontinue therapy prematurely — all of which compromise outcomes.
“Lowering drug costs is an imperative that can improve treatment continuity, reduce financial toxicity, and help patients complete the prescribed course of therapy. However, price caps are not enough on their own,” Dr. Singh said.
“Meaningful and sufficient improvement in affordability can be said to be achieved when price regulation is complemented by wider insurance coverage expansion of government reimbursement schemes, increased availability of quality generic and biosimilar medicines, robust Patient Assistance Programmes (PAPs), and greater access to comprehensive cancer care across the country.”
Sandeep Nayak, chairman of oncology at MACS-Renova Oncology Institute, KIMS Hospital, Bengaluru, said: “The price control introduced by the government is a positive move. But low cost life-saving drugs should remain viable to manufacture and sell.”
