https://www.thehindubusinessline.com/opinion/ensuring-affordable-cancer-care/article71670886.ece
Cancer care is one of the steepest barriers to equitable healthcare in India. When a single diagnosis can push a household into catastrophic health spending, and sometimes into poverty that lasts a generation, leaving prices entirely to the market is no longer an option. Structured price controls become a necessity.
The National Pharmaceutical Pricing Authority’s (NPPA) recent decision to cap trade margins at 30 per cent on 137 non-scheduled anti-cancer medicines, potentially reducing maximum retail prices by up to 70 per cent, is an important step towards addressing excessive mark-ups. India already has a well-established pricing framework under the Drugs (Prices Control) Order, 2013, supported by market competition, regulation of essential medicines and limits on annual price increases for non-scheduled formulations. The challenge is to ensure that pricing interventions deliver meaningful savings to patients while preserving medicine quality, uninterrupted supply and the investment needed for future innovation.
Understanding medicine prices requires looking at the entire supply chain. The price charged by a manufacturer, the price paid by a hospital or distributor, and the final price paid by a patient can differ substantially. These differences may reflect legitimate costs of storage, distribution and specialised handling, and should not automatically be treated as manufacturers’ profits. However, patients, particularly those undergoing cancer treatment, often have limited information about medicine prices and alternatives. While competition helps maintain affordability, its benefits may not always reach patients. Targeted regulation is therefore necessary where excessive trade margins place an unreasonable financial burden on patients.
Impact of price cut
Reducing medicine prices is important, but the real measure of success is whether patients actually pay less and continue to have access to treatment. In cancer care, lower medicine prices may provide relief, but the benefits can be limited if savings are offset by other charges or medicine availability is affected. India’s 2019 trade-margin rationalisation for 42 non-scheduled anti-cancer medicines provides a useful precedent. The latest intervention should therefore be assessed not only through reductions in maximum retail prices, but also through actual patient savings, medicine availability and continuity of treatment.
Government purchasing agencies and health insurance programmes can also help reduce costs by negotiating better prices and purchasing medicines together in larger quantities. Hospitals should clearly disclose medicine prices and provide itemised bills so that patients understand what they are paying for. Regular checks on prices and medicine availability, along with action against overcharging, can help ensure that these measures deliver lasting benefits without affecting supply.
Role of innovation
India’s strength in providing affordable medicines must be preserved while creating the conditions for future innovation. This requires a clear distinction between excessive trade margins and the legitimate costs of research, quality manufacturing and developing new treatments. Reducing unjustified mark-ups across the distribution chain can make medicines more affordable, but the impact of pricing interventions on investment, availability and supply must also be assessed. A predictable regulatory environment is therefore essential, not simply to support the pharmaceutical industry, but to ensure that patients continue to have access to safe, effective and innovative medicines at reasonable prices.
Innovation also extends beyond developing new medicines. Better manufacturing processes, more affordable diagnostics, improved delivery systems and technologies that help clinicians use medicines appropriately can reduce the overall cost of treatment. Research that improves treatment outcomes, reduces complications or makes existing therapies more accessible is equally valuable. The objective should be to encourage innovation that addresses unmet medical needs while making its benefits available to a wider population.
India should therefore pursue two complementary goals: encourage investment in high-quality and innovative medicines while strengthening mechanisms that make them accessible. Targeted price interventions, competitive markets, transparent procurement, appropriate reimbursement and research incentives can reinforce one another. An effective pricing policy should distinguish between margins that add little value to patient care and investments that improve the safety, quality and effectiveness of treatment.
This also has implications for healthcare financing. Publicly funded programmes and insurers should increasingly assess value through patient outcomes rather than simply the number of treatments financed or the prices negotiated. A lower medicine price is beneficial, but the larger objective is to ensure that treatment remains accessible, effective and financially manageable throughout the patient’s care journey.
The latest trade-margin intervention offers an opportunity to strengthen this approach. The NPPA, working with state drug regulators, could establish a monitoring mechanism to track whether revised prices translate into actual patient savings. This could involve comparing medicine prices before and after implementation, reviewing hospital and pharmacy bills, and monitoring the availability of affected medicines. Hospitals should also be encouraged to disclose revised medicine prices and provide itemised bills, allowing patients to identify the actual cost of medicines. Existing platforms such as Pharma Sahi Daam could be used more effectively to improve price awareness and enable patients to report overcharging.
Such monitoring should also examine whether pricing interventions affect medicine availability, supply continuity or investment in newer treatments. The findings could inform periodic reviews, allowing regulators to address excessive margins without imposing unnecessary restrictions on products where competition is already effective. The objective should be clear: patients must benefit from lower prices today, while the regulatory environment continues to support the quality, reliable supply and innovation needed for better treatments tomorrow.
The writer is a healthcare policy expert and former founding CEO of the National Health Authority
Published on November 6, 2026
