Cancer treatment can place a substantial financial burden on patients and their families, particularly when the cost of medicines rises significantly between the manufacturer and the retail counter. To address this concern, the Centre has introduced a 30% cap on trade margins for 137 non-scheduled anti-cancer medicines, aiming to reduce the prices patients pay for these drugs.
The National Pharmaceutical Pricing Authority (NPPA), through an order issued on October 17, 2026, brought the medicines under the Trade Margin Rationalisation (TMR) mechanism. The revised prices came into effect on November 9, 2026.
By November 9, 85 pharmaceutical companies had reported revised maximum retail prices (MRPs) for 121 of the 137 medicines, covering 1,366 stock-keeping units (SKUs). The highest reported price reduction was 96.45%, while more than 650 formulations recorded MRP reductions of over 50%. The largest number of reductions fell in the 50%–75% range.
The estimated savings for patients stand at ₹3,541 crore. These savings have been calculated by comparing the original and revised prices and applying the difference to the sales volumes recorded between April 2025 and March 2026.
What exactly has the Government changed?
The Government has capped the trade margin on 137 non-scheduled anti-cancer medicines at 30% of the maximum retail price (MRP).
The cap applies across the pharmaceutical supply chain, including retail and hospital pharmacies. It covers the listed medicines irrespective of their dosage or form, such as tablets and injections, and whether they are sold individually or in combinations.
The revised MRP for each medicine is determined using its average price to stockists or distributors in March 2026 as the reference. The trade margin included in the price cannot exceed 30% of the MRP, with Goods and Services Tax (GST) added separately.
Manufacturers are required to calculate and report revised MRPs in accordance with the order. Medicines already being sold below the newly determined price limit cannot be made more expensive on account of the revised cap.
What is a trade margin, and why does it matter?
Trade margin is the difference between the price at which a manufacturer supplies a medicine to a stockist or distributor and the maximum retail price paid by the patient. It is calculated excluding GST.
Medicines pass through different stages before reaching patients. When the margins added along this supply chain are high, the final retail price can be substantially higher than the manufacturer’s supply price.
This gap can be particularly burdensome for cancer patients, who may require expensive medicines over extended periods.
For example, if a medicine is supplied by a manufacturer at a particular price but carries a substantially higher MRP, the difference reflects the margin added through the distribution and retail chain. By restricting this margin to 30% of the MRP, the new order seeks to limit excessive mark-ups and bring the final price closer to the underlying supply cost.
The intervention is intended to address concerns raised by State authorities, patients and civil society about the difference between procurement prices and the MRPs of anti-cancer medicines.
How much can patients save?
The price reductions reported by pharmaceutical companies indicate the potential financial benefit of the new regulation.
* 137 medicines: Non-scheduled anti-cancer medicines brought under the margin cap.
* 121 medicines: Revised MRPs reported by November 9, 2026.
* 85 companies: Companies that had submitted revised prices.
* 1,366 SKUs: Individual product units covered by the reported revisions.
* More than 650 formulations: Reported MRP reductions exceeding 50%.
* 96.45%: Highest reported price reduction.
* ₹3,541 crore: Estimated savings based on sales volumes from April 2025 to March 2026.
The reductions are not uniform across all medicines. The highest number of reported MRP reductions falls in the 50%–75% range, while some formulations have recorded even larger cuts.
Patients can check the revised prices through the NPPA website and the official Pharma Sahi Daam mobile application and portal.
Which cancer medicines are covered?
The order covers 137 non-scheduled anti-cancer medicines, including several widely used drugs and newer therapies.
The list includes medicines such as:
* Targeted and precision cancer therapies: Abemaciclib, osimertinib, olaparib, palbociclib, ribociclib, lorlatinib and venetoclax.
* Immunotherapy medicines: Pembrolizumab, nivolumab, atezolizumab, durvalumab, avelumab and dostarlimab.
* Cancer treatment drugs: Pemetrexed, paclitaxel-related therapies, eribulin, mitomycin, topotecan and trabectedin.
* Other therapies: Abiraterone acetate, enzalutamide, lenvatinib, sunitinib, imatinib-related treatment alternatives and several medicines used in blood cancers.
The complete list contains 137 medicines, including combination products. The revised price applicable to a particular medicine or formulation can be checked through NPPA’s published price information.
Why were these medicines brought under price regulation?
The Drugs (Prices Control) Order (DPCO), 2013, provides the legal framework for regulating medicine prices in India. It operates under the Essential Commodities Act and aims to prevent excessive pricing while ensuring access to essential medicines.
Under the DPCO, medicines are broadly divided into two categories:
Scheduled medicines: These are included in the First Schedule of the DPCO, which corresponds to the National List of Essential Medicines (NLEM). The Government fixes a ceiling price for these medicines. The NLEM 2022 contains 388 medicines, including 63 anti-cancer medicines.
Non-scheduled medicines: These are not included in the First Schedule. Their prices are monitored under Paragraph 20 of the DPCO, 2013. Manufacturers are generally permitted to increase their MRP by no more than 10% over a 12-month period. If an increase exceeds this limit, the price must be brought back within the prescribed level for the subsequent period.
However, monitoring annual price increases does not necessarily address high trade margins between manufacturers and retailers. To tackle this issue, the Government introduced Trade Margin Rationalisation for 42 non-scheduled anti-cancer medicines in 2019, which helped reduce costs for patients.
Building on that intervention, the Government invoked its extraordinary powers under Paragraph 19 of the DPCO, 2013, in public interest. Acting on the recommendation of an Expert Committee constituted under the Directorate General of Health Services, NPPA brought 137 non-scheduled anti-cancer medicines, including patented drugs, under the new margin cap through its notification dated October 17, 2026.
Paragraph 19 empowers the Government to fix or revise the ceiling price or retail price of a drug in extraordinary circumstances in the public interest, including where a price has already been fixed.
What is the National List of Essential Medicines?
The National List of Essential Medicines (NLEM) identifies medicines considered necessary and important for India’s healthcare needs. It helps guide medicine pricing, public procurement, hospital budgets and healthcare planning.
First introduced in 1996, the list has been revised in 2003, 2011, 2015 and 2022. The latest version, NLEM 2022, was released on September 13, 2022, under the vision of “Sabko Dawai, Sasti Dawai” – medicines for everyone at affordable prices.
The list is prepared by an expert body, the Standing National Committee on Medicines, after consultations with medical professionals, scientists and industry experts and consideration of relevant international standards, including those of the World Health Organization.
Its inclusion of a medicine allows the Government to regulate its price through a ceiling price mechanism. The latest trade margin intervention extends affordability measures to selected non-scheduled anti-cancer medicines that are outside this list.
What responsibilities do pharmaceutical companies and pharmacies have?
The new order places specific responsibilities on manufacturers and other stakeholders to ensure that the revised prices reach patients.
Pharmaceutical companies must recalculate their MRPs using the prescribed March 2026 distributor-price reference and inform NPPA of the revised prices. They must also publish the price reductions in newspapers, display the revised prices on their websites and communicate them to retailers and hospitals.
Hospitals and chemists are required to display the revised prices clearly. Companies that fail to implement the prescribed reductions must deposit the amount overcharged, along with interest.
The order also seeks to prevent shortages arising from abrupt discontinuation or reduction of production. Companies cannot reduce production of the covered medicines without permission and must provide six months’ notice before completely discontinuing a medicine.
These provisions are intended to ensure that the price reductions are implemented throughout the supply chain and that patients continue to have access to the medicines they need.
How does the Government support cancer patients beyond medicine price regulation?
The 30% trade margin cap is part of a wider set of measures aimed at making cancer prevention, diagnosis and treatment more accessible. Government programmes cover different stages of cancer care, from screening and early detection to hospital treatment and affordable medicines.
Ayushman Bharat PM-JAY: Cashless hospital treatment
Under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), eligible families receive health cover of ₹5 lakh per year for cashless hospital treatment. The scheme also covers all senior citizens aged 70 years and above.
It covers 1,961 treatment procedures across 27 medical specialties, including medical oncology, surgical oncology and radiation oncology. As of June 30, 2026, the scheme had authorised 12.69 crore hospital admissions worth ₹1.92 lakh crore. By November 4, 2026, it had also authorised 19.5 lakh medical oncology admissions worth approximately ₹2,926 crore.
National Programme for Prevention and Control of Non-Communicable Diseases
The National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), under the National Health Mission, supports cancer screening, early diagnosis, referral, treatment infrastructure and health promotion.
The country has 770 District NCD Clinics, 6,410 NCD Clinics at Community Health Centres and 524 Day Care Cancer Centres. The Government has also approved 19 State Cancer Institutes and 20 Tertiary Care Cancer Centres to strengthen specialised cancer treatment.
Tata Memorial Centre has established six hospitals in Varanasi, Visakhapatnam, New Chandigarh, Guwahati, Sangrur and Muzaffarpur. Cancer diagnostic, medical and surgical services have also been extended to all 22 new AIIMS. The National Cancer Institute at Jhajjar and the second campus of Chittaranjan National Cancer Institute in Kolkata provide additional specialised facilities.
Cancer screening at Ayushman Arogya Mandirs
More than 1.86 lakh Ayushman Arogya Mandirs were functional across the country as of August 12, 2026. These primary healthcare centres screen people aged 30 years and above for common cancers, including oral, breast and cervical cancer.
As of July 2026, the reported screenings included 36.11 crore for oral cancer, 16.94 crore for breast cancer and 9.31 crore for cervical cancer. Frontline workers, including Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs), support these screening and awareness activities.
Free HPV vaccination to prevent cervical cancer
The nationwide Human Papillomavirus (HPV) vaccination campaign was launched on February 28, 2026, for approximately 1.2 crore eligible girls aged 14 years across all 36 States and Union Territories.
More than 80 lakh doses had been administered free of cost under the campaign as of September 11, 2026. HPV vaccination is an important preventive measure against cervical cancer.
Jan Aushadhi Kendras and AMRIT pharmacies
The Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) makes quality generic medicines available at affordable prices through Jan Aushadhi Kendras. Its product range covers 2,110 medicines and 315 surgical items, medical consumables and devices, including medicines for cancer.
There were 20,149 Jan Aushadhi Kendras across the country as of June 30, 2026. Between 2021–22 and 2025–26, sales through the scheme amounted to ₹7,873.85 crore, generating estimated savings of around ₹37,200 crore for citizens.
The Affordable Medicines and Reliable Implants for Treatment (AMRIT) initiative provides medicines for cancer, cardiac diseases and other serious illnesses at reduced prices. It offers more than 6,500 medicines, implants, surgical products and healthcare items, with discounts of up to an average of 50% on MRP.
As of September 24, 2026, 285 AMRIT outlets were operational across 24 States and four Union Territories. The network had served more than 8.13 crore patients, distributing products worth approximately ₹22,323 crore at MRP and generating estimated savings of around ₹10,969 crore.
Teleconsultations through eSanjeevani
The Government’s eSanjeevani teleconsultation platform also helps patients access specialist medical advice, including oncology consultations, particularly in remote and underserved areas. More than 50 crore patient consultations had been recorded across medical specialities as of October 21, 2026.
How can patients check the revised prices?
Patients and caregivers can verify the latest MRPs of covered anti-cancer medicines through the official NPPA website and Pharma Sahi Daam mobile application and portal.
Since companies are submitting revised prices in phases, patients should check the latest available price for the specific medicine, strength and formulation before purchasing it. They can also ask pharmacies and hospitals to display the revised MRP.
What does the new cap mean for cancer patients?
The 30% trade margin cap addresses one important source of high medicine costs: excessive mark-ups between manufacturers and patients. With reported price reductions reaching 96.45% and estimated savings of ₹3,541 crore, the intervention has the potential to reduce out-of-pocket spending for families requiring cancer medicines.
The measure complements existing support through cashless hospital treatment, cancer screening, HPV vaccination and low-cost medicine outlets. Together, these initiatives aim to improve access to affordable cancer care, reduce the financial burden of treatment and make essential medicines more accessible to patients across the country.
Published: Wednesday, 11 November 2026 | 8:06 PM IST