NPPA slashes cancer drug MRPs by up to 93%; Thiotepa cut by ₹72,921
New Delhi: Cancer medicines in India are about to carry much lower price tags. The government’s drug price regulator has cut retail prices by up to 93.3%, with the new rates taking effect on 9 November, according to two officials and a government document reviewed by Mint.
The National Pharmaceutical Pricing Authority (NPPA) has reset the maximum retail price (MRP), the most a shop can charge, on 543 versions of 137 cancer drugs that have no government-fixed price ceiling. The biggest drop in rupees is on thiotepa, a chemotherapy injection used before stem cell transplants and to treat bladder cancer. A 100 mg vial of Samtepa goes from ₹80,071.86 to ₹7,150.33, a cut of ₹72,921.53, or 91.1%.
In percentage terms, the sharpest fall is on palbociclib, a breast cancer drug. A pack of 21 Palbopro 125 mg capsules drops 93.3%, from ₹40,421.33 to ₹2,720.
NPPA estimates patients will save ₹2,500 crore to ₹3,500 crore a year in out-of-pocket spending. The order comes as the Supreme Court considers wider controls on medicine prices, and weeks after a Mint report on 16 September found private hospitals marking up medical supplies by as much as 2,841%.
Extensive markdowns were also notified for other biological and targeted therapies.
Queries sent to the department of pharmaceutical and NPPA were not answered immediately.
Pertuzumab, prescribed for HER2-positive breast cancer, saw the retail price of its Hertumab formulation fall by ₹64,358 per vial, dropping from ₹94,951 to ₹30,593. Another Pertuzumab brand, Lupiher 420 mg, saw a reduction of ₹46,161.65, taking its price from ₹83,520 to ₹37,358.35 per vial.
Pills and hospital concerns
Price cuts were also recorded in Bevacizumab, a biological therapy prescribed for metastatic colorectal cancer, non-small cell lung cancer, cervical cancer, and ovarian tumours. The Ivzumab 400 mg injection saw a price drop of ₹56,340.12, coming down from ₹69,852.12 to ₹13,512, while Bevacizab 400 mg fell by ₹56,248.34, taking its retail price from ₹65,205.09 down to ₹8,956.75. Cizumab 400 mg was reduced by ₹47,605, dropping from ₹57,816 to ₹10,211.
The regulator’s notification also led to price reductions for oral therapies. Olaparib tablets, used in BRCA-mutated ovarian, breast, and pancreatic cancers, saw the Brcaone 150 mg pack fall by ₹34,790.37, dropping from ₹46,364.05 to ₹11,573.68. Peg L-Aparagin, an injectable formulation of Pegasparginase used to treat acute lymphoblastic leukaemia, was reduced by ₹34,079.12, from ₹41,845.97 to ₹7,766.85. For metastatic prostate cancer, Abiraterone acetate tablets sold under the brand Abirat 250 mg fell by ₹32,024.33, reducing the price of a 120-tablet bottle from ₹36,088.81 down to ₹4,064.48.
Efforts to make cancer treatment more affordable are welcome, but medicine pricing must also account for the rising costs of technology, operations and advanced clinical care, said Dr Harit Chaturvedi, chief executive officer of Apollo Hospitals’ Oncology Department. “While improving affordability is crucial, regulations must sustainably balance patient access with viability across all stakeholders to foster long-term growth and high standards of care,” he added.
The regulatory move also comes against the backdrop of a 16 September report by Mint that revealed profit markups of up to 2,841% on medical consumables billed to patients by private hospitals, based on findings from a Maharashtra Food and Drug Administration inquiry led by commissioner Tukaram Mundhe. The inquiry found wide margins between procurement rates and printed retail prices across products such as infusion sets, syringes, nebulizers, and catheters, prompting representations to the pricing regulator for margin caps on medical devices.
Legal questions and the size of the market
The price reduction directive follows sustained scrutiny from the Supreme Court on markups of up to 1,000% across the supply chain, as well as the wide margin between the price charged to retailers and the maximum retail price billed to patients. On Tuesday, as reported by Live Law, a bench reserved its order on a petition seeking broader regulation of medicine prices. During the proceedings, the bench questioned why distributor margin caps should remain restricted to select oncology therapies rather than being extended across the domestic pharmaceutical market.
“Drug price caps should improve affordability without undermining hospitals’ rights or lacking legal backing,” said Ajay Verma, Senior Advocate, New Delhi. “To ensure these interventions survive inevitable judicial challenges, the executive must establish a legally sound, balanced mechanism that protects vulnerable patients without arbitrarily encroaching upon hospital operations.”
According to NPPA, the domestic anti-cancer drug market comprises approximately 225 drugs and 500 formulations, with a total annual market turnover of around ₹12,500 crore. Scheduled oncology medicines covering 63 drugs under the National List of Essential Medicines 2022 account for approximately ₹2,250 crore and are regulated under ceiling prices fixed by the government. This leaves a balance of over ₹10,250 crore consisting of non-scheduled drugs.
