New Delhi, November 9, 2026: Cancer patients across India continue to face substantial treatment expenses despite the government’s decision to regulate trade margins on 137 anti-cancer medicines, according to an investigation published by The Indian Express on Monday.
The investigation found that although the new pricing rules have reduced the cost of several medicines, some of the most expensive patented cancer treatments have seen no reduction.
The revised prices take effect on November 9, 2026, following an October 17 order by the National Pharmaceutical Pricing Authority (NPPA).
Cancer Drug Price Caps Take Effect Today
The central government has introduced a 30% cap on trade margins for 137 non-scheduled anti-cancer medicines.
The policy aims to reduce excessive markups charged through pharmaceutical distribution and retail channels.
The covered medicines include treatments used for breast cancer, lung cancer and several other forms of the disease.
However, the regulation limits trade margins rather than imposing a uniform reduction in the underlying prices charged by manufacturers.
This distinction has become central to concerns about how much relief patients will actually receive.
Investigation Finds 159 Drug Formulations Unchanged
An analysis by the Working Group on Access to Medicines and Treatments, cited by The Indian Express, examined revised prices for 643 formulations covering different strengths, brands and doses of the identified medicines.
The findings showed that 159 formulations recorded no price reduction.
These accounted for approximately one-quarter of the formulations examined.
All the patented medicines included in that analysis were among those whose prices remained unchanged.
Additionally, 53 of the 159 unchanged formulations cost more than ₹1 lakh per pack.
The findings indicate that some of the most expensive medicines remain beyond the financial reach of many families.
Cancer Drug Price Cuts: Key Findings
| Finding | Reported figure |
|---|---|
| Medicines covered by the government order | 137 |
| Formulations examined in the investigation | 643 |
| Formulations with unchanged prices | 159 |
| Unchanged formulations costing above ₹1 lakh | 53 |
| Formulations with cuts above 90% | 5 |
| Formulations with ₹5,000–₹10,000 reductions | 83 |
| Formulations with ₹1,000–₹5,000 reductions | 173 |
The investigation found that the average reduction across the 643 formulations was less than 40%.
These findings relate to the formulations examined, not necessarily every product covered by the government’s broader reporting system.
Breast Cancer Patient Faces ₹20 Lakh Treatment Bill
The investigation highlighted the experience of a 45-year-old breast cancer patient from Noida whose family was given an estimated treatment bill of approximately ₹20 lakh.
Her prescribed treatment included pembrolizumab, an immunotherapy marketed as Keytruda.
The medicine’s listed price remained at approximately ₹2.17 lakh per vial, despite being included in the government’s trade-margin regulation.
The patient’s family reported difficulties obtaining coverage for immunotherapy under the hospital’s economically weaker sections arrangement.
The case illustrates how expensive medicines can remain a major financial burden even after pricing interventions.
Patients Continue Spending Lakhs on Immunotherapy
Another patient featured in the investigation was a 49-year-old lawyer from Kerala undergoing treatment for breast cancer.
She was prescribed ribociclib, marketed as Kyxana, which had a maximum retail price of nearly ₹1 lakh.
Despite available discounts, she reported spending approximately ₹65,000 to ₹80,000 every month on the medicine.
For patients requiring prolonged treatment, recurring monthly expenses can become financially overwhelming.
Treatment costs can increase further when medicines are combined with surgery, radiation, diagnostic tests and hospital care.
Why Patented Cancer Medicines Remain Expensive
Patented medicines may face limited competition because other manufacturers cannot freely produce equivalent products during the period of patent protection.
Without competing alternatives, their prices can remain relatively high.
The latest government intervention regulates the trade margin between the distributor price and the final retail price.
It does not necessarily reduce the price charged by the manufacturer.
Consequently, a costly patented medicine may remain expensive even when distribution margins comply with the new rules.
Government Estimates Savings of ₹3,357 Crore
The government has presented a more positive assessment of the pricing intervention.
According to a November 6 factsheet issued by the Press Information Bureau, 70 pharmaceutical companies had submitted revised maximum retail prices for 120 medicines by November 4.
The government estimated potential savings of approximately ₹3,357.49 crore.
The figure was calculated by applying the differences between previous and revised prices to medicine sales volumes from April 2025 to March 2026.
It is therefore an estimate based on historical sales volumes, not a measurement of actual patient savings already achieved after implementation.
The government also reported that some individual medicine prices had fallen substantially, with the largest reported reduction reaching 96.45%.
Why Lower Medicine Prices May Not Reduce Total Treatment Costs
Cancer treatment involves more than purchasing prescribed medicines.
Patients may also need diagnostic scans, laboratory tests, surgery, chemotherapy, radiation therapy, hospital admission and follow-up consultations.
Some must travel to specialised treatment centres located far from their homes.
These additional costs can create significant financial pressure even when medicine prices decrease.
Insurance coverage and manufacturer-funded patient assistance programmes may provide some support, but eligibility and reimbursement vary.
Insurance Coverage Remains a Major Challenge
The investigation described patients who relied on savings, family assistance or health insurance to continue treatment.
One patient with lung cancer reported that employer-provided insurance covered a substantial portion of his immunotherapy expenses.
Others faced significant out-of-pocket costs because their treatment was not fully covered.
These experiences highlight differences in financial protection depending on the patient’s insurance policy, hospital arrangements and treatment plan.
Experts Call for Broader Affordability Measures
Medical professionals and patient advocates have questioned whether limiting trade margins alone can make advanced cancer treatments affordable.
The Organisation of Pharmaceutical Producers of India has supported the initiative while emphasising the importance of implementation and access.
Experts have also highlighted the need for wider insurance coverage, effective reimbursement systems and access to lower-cost alternatives where clinically appropriate.
The challenge involves improving affordability without disrupting the availability of essential treatments.
Hospitals and Pharmacies Must Follow Revised Prices
Under the government’s order, revised prices for the covered medicines become effective on November 9.
Manufacturers must communicate the updated maximum retail prices to the pricing authority and relevant distribution channels.
Hospitals and pharmacies are required to follow the applicable revised prices and make price information available.
Patients and caregivers can check official medicine prices through the NPPA website and Pharma Sahi Daam application.
The government has also asked state drug regulators to monitor compliance.
Cancer Treatment Costs Remain a Public Health Concern
The latest investigation highlights the difference between reducing medicine prices and making complete cancer treatment affordable.
While the government’s intervention is expected to benefit patients purchasing certain medicines, the unchanged prices of several expensive formulations remain a concern.
The findings suggest that regulatory action on trade margins may need to be accompanied by broader measures addressing insurance coverage, treatment expenses and access to medicines.
As the revised prices take effect on November 9, their actual impact on patients will become clearer through implementation and continued monitoring.
Sources: The Indian Express investigation, November 9, 2026; Press Information Bureau, November 6, 2026; National Pharmaceutical Pricing Authority, October 17, 2026
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