Anti-Cancer Drug Prices Fall as New MRPs for 1,364 Formulations Kick In

Anti-cancer drug prices came down for hundreds of brands on Monday, 9 November, as revised MRPs for 1,364 formulations took effect, a move the government estimates will save consumers ₹3,540.38 crore a year.

The Department of Pharmaceuticals said 85 pharmaceutical companies had reported revised MRPs for formulations covering 121 drugs as of 8 November. Of these, 679 brands reported price cuts of more than 50%, and the steepest reduction was 96.45%.

The revision follows a decision by the National Pharmaceutical Pricing Authority (NPPA) to cap trade margins on 137 non-scheduled anti-cancer drugs. No chemist or hospital pharmacy can now charge more than the revised maximum retail price (MRP), the ministry said.

How the trade margin cap lowers anti-cancer drug prices

The NPPA has capped the trade margin at 30% of the MRP under Paragraph 19 of the Drugs (Prices Control) Order, 2013. Trade margin is the gap between the price at which a manufacturer sells to distributors and the price a patient finally pays.

The cap was notified on 17 October 2026 through notification S.O. 5690(E). It was based on recommendations of an expert committee constituted by the Directorate General of Health Services under the health ministry.

When the cap was announced in October, the NPPA said MRPs could fall by up to 70%, depending on existing prices. The 96.45% reduction reported for one brand is well above that estimate.

The 137 drugs include immunotherapy medicines used across more than 20 cancer types, as well as denosumab, pegfilgrastim and bevacizumab, according to Business Today. Widely prescribed drugs such as pembrolizumab, durvalumab and osimertinib are also covered.

The rollout has been gradual. In late October, the NPPA published its first list of revised MRPs for 543 brands, based on company submissions received up to 27 October, and said the list would be updated as more manufacturers reported prices.

Background: building on the 2019 pilot

The latest move expands a 2019 pilot under which the NPPA capped trade margins on 42 non-scheduled anti-cancer drugs at 30%. That exercise reduced the MRPs of 526 brands by up to 90%.

Many cancer medicines, including newer patented drugs, are non-scheduled, which means they sit outside the list of drugs with direct ceiling prices. Trade margin rationalisation allows the regulator to act on these products without fixing a ceiling price for each one.

The government has also directed manufacturers to maintain existing production levels for the notified formulations. The aim is to prevent artificial shortages as the new prices come into force.

What it means for pharma companies and healthcare businesses

For drug makers, the cap mainly squeezes the distribution chain rather than the manufacturer’s own selling price. When it announced the cap, the NPPA said the measure aims to control excessive trade margins in distribution and retail while safeguarding legitimate manufacturer revenues.

Distributors, retail chemists and hospital pharmacies are likely to feel the larger impact. Oncology drugs are high-value products, so a lower margin could reduce pharmacy income for hospitals that stock them.

Hospital groups may therefore need to revisit oncology package pricing and pharmacy margins, a further test for providers already rethinking how healthcare is delivered in India. Insurers and corporate health schemes could see some relief on claims involving long cancer treatment cycles.

The full effect on anti-cancer drug prices is still unclear. Reports on the earlier lists published in late October noted that the prices of some patented brands, including Keytruda (pembrolizumab) and Tagrisso (osimertinib), were unchanged. Public health groups have argued that trade margin caps alone may not make every cancer drug affordable.

What happens next

The NPPA list will keep changing as more companies file revised prices. Investors tracking listed drug makers, such as those covered in our report on Lupin’s Q2 results, will watch for any commentary on oncology revenue in coming earnings calls.

Patients and carers can check the revised MRP printed on the medicine pack, or verify prices through the Pharma Sahi Daam mobile app and the website of the National Pharmaceutical Pricing Authority. Complaints about overcharging can be filed on the Pharma Jan Samadhan portal or through the NPPA helpline at 1800-111-255.

The notification remains in force until further orders. More policy and corporate updates are available in our business news section.