A revised drug price list published by the National Pharmaceutical Pricing Authority (NPPA) shows how the government’s 30 per cent cap on trade margins for cancer drugs is playing out. Prices of many commonly used generic and biosimilar medicines fall by half or more from November 9. Most newer patented drugs show no change.
The move comes after the NPPA, on October 17, issued an order capping trade margins at 30 per cent on 137 non-scheduled anti-cancer drugs. These are cancer drugs not on the government’s essential medicines list, whose prices are therefore not fixed directly. The order uses Paragraph 19 of the Drugs (Prices Control) Order, 2013, a provision for stepping in on prices in the public interest.
“Trade margin” is the gap between the price a manufacturer charges a stockist or distributor and the maximum retail price (MRP) printed on the pack. Companies must now set the MRP at the distributor price divided by 0.7, plus GST. The distributor price is the average for March 2026.
The cap applies to all strengths, dosage forms and combinations of the listed drugs. It applies even if a drug is also used for something other than cancer. Patented drugs are covered too. The order notes that patented drugs have no price restriction under the pricing order unless an exemption has been approved. The filings run up to October 27 and are not final. The NPPA says the table is based on data received from companies so far.
Of the 137 drugs in the order, 110 appear in the filings so far. They fall into three groups:
35 drugs get cheaper on every listed brand. They include abiraterone, dasatinib, erlotinib, azacitidine, pomalidomide, thiotepa, pegfilgrastim, degarelix, pazopanib, vinorelbine and plerixafor.
47 drugs show no change on any listed brand. They include pembrolizumab (Keytruda), nivolumab, osimertinib, atezolizumab, daratumumab, ibrutinib, venetoclax, ruxolitinib and zanubrutinib. Most are newer, patented products sold under one brand.
28 drugs are mixed. Generic and biosimilar versions get cheaper while the original brand stays the same. Examples are Avastin (bevacizumab), Lynparza (olaparib), Tasigna (nilotinib), Sutent (sunitinib), Faslodex (fulvestrant), Lenvima (lenvatinib) and Perjeta (pertuzumab).
The list has 543 entries, one for each brand, strength and pack size. Of these, 397 (about 73%) show a lower MRP and 146 are unchanged. Among the reduced entries, the average cut is about 50%, and more than 200 entries fall by half or more.
Palbociclib (breast cancer): one brand’s 125 mg pack falls from ₹40,421 to ₹2,720, about 93 per cent.
Thiotepa: a 100 mg vial falls from ₹80,072 to ₹7,150, a drop of about ₹72,900.
Pertuzumab: a 420 mg vial from one brand falls from ₹94,951 to ₹30,593.
Bevacizumab: a 400 mg vial falls from ₹69,852 to ₹13,512 for one brand, with similar cuts across several others.
Abiraterone (prostate cancer): a pack of 120 tablets falls from ₹28,000 to ₹4,840.
Dasatinib (leukaemia): one brand’s 70 mg pack falls from ₹17,811 to ₹1,808.
Denosumab: a 60 mg prefilled syringe falls from ₹22,031 to ₹5,941.
Anastrozole (breast cancer): a pack of ten tablets falls from ₹458.85 to ₹39.52, about 91%.
Some brands show one cut and others none for the same drug. Olaparib is a case in point. Lynparza stays at ₹40,620 for 100 mg, while Brcaone’s 150 mg pack falls from ₹46,364 to ₹11,574.
The rule only lowers prices that sit above the new limit. Many original brands already sell at prices close to the distributor’s price, so there is nothing to cut. This is likely the reason, but the filings do not say so. The result is that the cuts land mainly on generics and biosimilars, where the gap was widest. Patients on the newest and costliest treatments may see little relief. Keytruda, for example, stays at ₹2,16,500.
Another 27 drugs in the order do not yet appear: abemaciclib, alpelisib, belantamab mafodotin, cabozantinib, ceritinib, cladribine, clofarabine, dabrafenib, darolutamide, datopotamab deruxtecan, ibritumomab, idelalisib, ifosfamide and mesna, interferon alpha 2B, lazertinib, lomustine, Lymphoseek kit, mirvetuximab soravtansine, nelarabine, nimotuzumab, ofatumumab, selpercatinib, serplulimab, sotorasib, temsirolimus, trametinib and vemurafenib.
Manufacturers have been asked to submit revised price details to the National Pharmaceutical Pricing Authority (NPPA) and the State Drug Controller within seven days of the publication of the order,even if there is no change in the maximum retail price (MRP). They must issue new price lists through the NPPA’sIntegrated Pharmaceutical Database Management System (IPDMS) portal and distribute them to dealers and retailers. Additionally, manufacturers must publish newspaper advertisements announcing price cuts and create a dedicated page on their websites to display pricing orders.They are also required to report batch-wise production and stock details, maintain production at current levels,and obtain prior permission from the NPPA before reducing output.
Companies may exclude free drugs supplied under their patient assistance programmes from the distributor-price calculation. They must keep patient records, submit an undertaking and allow audits.
The order notes that a large share of cancer drugs goes directly from manufacturers to hospitals. Where this happens, the hospital is treated as the distributor for pricing purposes. Hospitals must monitor MRPs, display the revised prices on their websites and report violations. State drug controllers are responsible for ensuring compliance by manufacturers, distributors, retailers and hospitals.
A company that does not file revised prices is treated as not having cut its MRP. A company that overcharges must repay the extra amount with interest under the pricing order and the Essential Commodities Act, 1955. Companies may still take the yearly price increase allowed under Paragraph 20(1) of the pricing order, as long as they stay within the margin cap.
Published on October 28, 2026
