Supreme Court Ruling Triggers 70 Percent Price Cut for 137 Cancer Medicines

The cost of cancer treatment in India is set to drop sharply for many patients beginning next month. The government has extended a 30 percent cap on trade margins to 137 cancer drugs, a move that follows a Supreme Court ruling that described previous price markups as "extortion." This change applies to medicines that were previously exempt from pricing controls.

The legal challenge originated with Sarojam Radhakrishnan, a former bank employee from Kerala. Diagnosed with breast cancer in 2021, she faced monthly treatment costs exceeding 63,000 rupees, a sum her family could not afford. In 2022, she petitioned the Kerala high court to intervene. The case eventually reached the Supreme Court, where judges scrutinized the profits earned by hospitals, distributors, and retailers.

Justices Vikram Nath and Sandeep Mehta cited specific examples of inflated pricing during a hearing on 29 September. They noted that a drug supplied to hospitals for 2,700 rupees was sold to patients for 27,000 rupees. The court labeled the industry practices "carnage." Data from the National Pharmaceutical Pricing Authority revealed that average trade markups on some cancer drugs reached 170 percent, with some cases exceeding 700 percent.

The Department of Pharmaceuticals stated that the new cap is expected to reduce medicine prices by up to 70 percent. The government estimates that cancer patients will save approximately 2,500 crore rupees, or 199 million pounds, annually. This reduction aims to lower the out-of-pocket expenses that force many families to sell assets or take on debt to pay for care.

Healthcare spending in India already pushes an estimated 55 million people below the poverty line each year, according to the Public Health Foundation of India. Krishan Kalra, a former council member of the Rajiv Gandhi Cancer Institute, noted that patients often avoid free diagnosis camps because they fear the cost of treatment. Cancer drugs currently range from 38,000 to 380,000 rupees, a price range that causes many families to leave consults without a treatment plan.

Insurance coverage provides limited protection. The Ayushman Bharat scheme offers families 500,000 rupees in annual cover, which equals the cost of one dose of Kadcyla, a breast cancer drug. Patients may require up to 14 doses of this specific medication. Dr. Ravi Kannan, a surgical oncologist in Assam, described the new cap as a "welcome step" that may help families sustain treatment they could not previously afford.

India records approximately 1.56 million new cancer cases annually, up from 1.39 million in 2020. Jyotsna Singh, co-convener of the Working Group on Access to Medicines, warned that hospitals might offset lower drug prices by increasing other charges. The Supreme Court has also asked the government to explain why the cap does not apply to all non-patented medicines, setting a deadline of 27 October for a response. Radhakrishnan died in September 2022 while her case remained pending.

The extension of the margin cap marks a formal adjustment to the pricing structure for a large portion of the oncology market. The 137 drugs now fall under the same regulatory framework that has governed 42 other cancer medicines for several years. The change takes effect in November, altering the financial obligations for patients and the revenue streams for distributors across the country.