The Centre has capped trade margins at 30% for all non-scheduled anti-cancer medicines, a move that could bring down the maximum retail prices (MRPs) of several cancer drugs by up to 70% and save patients an estimated ₹2,500 crore annually.
The new measure will apply to branded and generic medicines, including domestic and imported, patented and non-patented anti-cancer drugs that are currently outside the scheduled price-control system.
The government said the decision is aimed at curbing excessive mark-ups across the medicine supply chain and making cancer treatment more affordable while ensuring continued availability of essential medicines.
The move comes amid growing concerns over the high cost of cancer treatment and follows a recent intervention by the Supreme Court questioning the wide gap between the prices at which some medicines are supplied to retailers and the MRPs charged to patients.
How the pricing system works
Under India’s drug price-control framework, medicines are broadly divided into scheduled and non-scheduled categories.
Drugs listed under the National List of Essential Medicines (NLEM) are classified as scheduled medicines. Their prices are regulated by the government through ceiling prices, which are revised periodically.
Non-scheduled medicines, on the other hand, do not have a government-fixed ceiling price when they enter the market. However, manufacturers cannot increase their prices by more than 10% annually.
A large majority of medicines consumed in India fall under the non-scheduled category, including several medicines used in cancer treatment. The high cost of these medicines has become a significant financial burden for patients and their families.
India records more than 15 lakh new cancer cases every year, making affordable access to treatment an increasingly important public health concern.
Supreme Court raises concerns over high mark-ups
The government’s decision follows concerns raised by the Supreme Court on September 29 regarding the pricing of cancer medicines.
A bench of Justices Vikram Nath and Sandeep Mehta questioned the Centre after it was informed about a cancer medicine supplied to retailers for around ₹2,700 but sold to patients at an MRP of nearly ₹27,000.
The court questioned whether a more uniform margin structure could be considered for medicines and asked the government to examine the issue.
The bench also raised concerns about hospitals requiring patients to purchase medicines from their in-house pharmacies, particularly in cases where treatment expenses are covered under government health schemes.
The court had discussed the possibility of a 16% margin framework, similar to the retailer margin applicable to certain scheduled medicines. However, it did not impose a nationwide 16% cap. The matter is scheduled to be considered again on October 12.
The government’s latest decision instead adopts a 30% trade-margin cap for the wider category of non-scheduled anti-cancer medicines.
Earlier price-control measures
The government has previously used the Trade Margin Rationalisation (TMR) approach to control prices of selected medicines.
In 2019, the National Pharmaceutical Pricing Authority (NPPA) imposed a 30% trade-margin cap on 42 non-scheduled anti-cancer medicines. According to the government, the measure resulted in price reductions across 526 brands, with MRPs falling by an average of about 50%.
The intervention was estimated to have saved cancer patients around ₹984 crore annually.
The Centre now expects the expanded measure to result in MRP reductions of up to 70% for some medicines, depending on their existing trade margins. The total annual savings for patients are estimated at around ₹2,500 crore.
However, patient-rights groups have pointed out that controlling trade margins alone may not address the entire problem, as manufacturers can still determine relatively high base prices.
Government takes multiple steps to reduce treatment costs
The latest decision is part of a broader effort by the government to make cancer treatment more affordable.
As of March 2026, the NPPA had effective ceiling prices for 131 anti-cancer medicines. The government has also introduced customs-duty concessions on selected high-value patented medicines and promoted the availability of lower-cost medicines through initiatives such as Jan Aushadhi.
The expanded trade-margin regulation is expected to provide additional relief to patients who depend on expensive cancer medicines outside the scheduled price-control framework.
Pharma industry voices concern
The pharmaceutical industry, however, has expressed reservations about the latest move.
Industry representatives argue that India’s existing pricing framework already combines price controls for essential medicines, restrictions on annual price increases, market monitoring and provisions for exceptional government intervention.
They said competition among manufacturers and brands also plays an important role in keeping medicine prices affordable.
An industry representative said that future policy should balance affordability with the need to maintain investment in medicine quality, advanced manufacturing, research and development.
According to industry sources, unusually high trade margins are concentrated in a relatively small number of products, particularly certain specialised and hospital-based therapies.
They suggested that targeted intervention against specific pricing distortions could protect patients without undermining competition or discouraging investment in the pharmaceutical sector.
With cancer cases continuing to rise and treatment costs remaining a major concern for families, the impact of the new 30% trade-margin cap is likely to be closely watched by patients, hospitals, pharmaceutical companies and policymakers.