Families paying for cancer treatment could soon see some relief at the chemist's counter. The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins on 137 anti-cancer drugs at 30%, a move the government says could bring down the maximum retail price of some medicines by as much as 70%. The revised prices take effect from November 9, 2026, according to the notification issued on Saturday, October 17.
What has the government decided?
Under an exercise called Trade Margin Rationalisation, the NPPA, which works under the Department of Pharmaceuticals in the Ministry of Chemicals and Fertilizers, has used its powers under Paragraph 19 of the Drugs (Prices Control) Order, 2013. These 137 medicines are "non-scheduled" drugs, meaning their prices were not directly controlled until now. Companies were free to set their MRP, and the gap between what distributors pay and what patients pay was often very large.
The new rule says the trade margin, the difference between the price to the stockist or distributor and the MRP, cannot be more than 30% of the MRP (excluding GST). In practical terms, that equals a markup of about 42.86% over the price at which the drug is sold to the trade. The official statement said "the present exercise extends this approach to a larger set of anti-cancer drugs", building on an earlier pilot.
| Key fact | Details |
|---|---|
| Number of drugs | 137 non-scheduled anti-cancer drugs |
| Trade margin cap | 30% of MRP (excluding GST) |
| Expected price drop | Up to 70%, depending on the drug |
| New prices from | November 9, 2026 |
| Legal basis | Paragraph 19, DPCO 2013 |
| Reference month for prices | March 2026 |
| Where to check prices | Pharma Sahi Daam app, NPPA website |
Which cancer drugs are covered?
The list was drawn up by an expert committee under the Directorate General of Health Services, which included oncologists and hospital specialists. It covers some of the most expensive medicines used in modern cancer care, including patented drugs, except those exempted under Paragraph 32 of the DPCO. Among the names reported are:
- Immunotherapy drugs: pembrolizumab, nivolumab, durvalumab, atezolizumab, avelumab and ipilimumab.
- Targeted therapies: osimertinib, bevacizumab, palbociclib, ribociclib, abemaciclib, olaparib, pertuzumab with trastuzumab, abiraterone, enzalutamide, lenvatinib, daratumumab, ibrutinib and venetoclax.
- Supportive care: denosumab and pegfilgrastim.
The government has said the list will be updated from time to time.
What manufacturers and hospitals must do
- Drug makers must report their revised MRPs to the NPPA and the state drug controller within seven days of the gazette notification, even if their prices do not change. The NPPA has made it clear that "non-submission shall be construed as non-reduction of MRP".
- Companies must publish updated price lists on their websites and share them with retailers and hospitals.
- Production and supply must continue at current levels. Cutting production needs NPPA permission, and stopping production or imports requires six months' notice.
- From November 9, retailers and hospitals must charge and display the new prices. Hospitals must also put them on their websites.
State drug controllers will enforce the order.
What it means for patients
Cancer treatment is among the biggest causes of out-of-pocket health spending in India, and a single course of immunotherapy or targeted therapy can cost lakhs of rupees. By squeezing the margins that pile up between the factory gate and the patient, the government hopes to make these drugs more affordable without hurting legitimate manufacturing revenue or causing shortages.
There is a track record here. In 2019, a similar pilot capped margins on 42 cancer drugs at 30%, and the MRPs of 526 brands fell by up to 90% afterwards. Earlier this month, reports on the government's approval of the latest cap had put the number of drugs at around 110; the final notified list covers 137.
How to check the new price of your medicine
- Download the Pharma Sahi Daam app or visit the NPPA website.
- Search by the brand name or the generic name of the drug.
- Compare the listed ceiling or revised MRP with the price on your bill after November 9.
- If a chemist or hospital overcharges, you can raise a complaint with the NPPA or your state drug controller.
What happens next
Over the next three weeks, companies will file revised prices and send new lists to the trade. Stock already in the market will need to be sold at the new MRP from November 9. Patients currently on treatment should ask their hospital pharmacy about the revised rates, and keep an eye on the NPPA's published lists as they are updated.
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