Medical science has made remarkable progress in cancer treatment. We can now offer options that were unimaginable a decade ago. However, innovation comes with a cost. Quality cannot be compromised for affordability. The measure of success for any cancer treatment is, not only the cure rate, but also how many patients gain the benefit by actually receiving it.
India’s cancer burden is rising. People are living longer, lifestyle risks are changing, better access to diagnostic facilities helps identify the disease early, and newer drug developments have increased the chances of a cure. Research, clinical trials, specialised technology, and manufacturing involve substantial cost. As a result, technology-driven personalised medicines can be expensive, especially when needed to be consumed for months, years or even the lifetime. As a result, companion diagnostics and cutting-edge targeted therapy are taken into consideration only when the patient is likely to be able to afford them. Clearly, this is not how clinical decisions should be made.
The Government of India’s recent decision to rationalise trade margins on anti-cancer medicines is therefore an important step to make cancer drugs affordable. The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins at 30% of the maximum retail price, excluding GST, for 137 identified non-scheduled anti-cancer drugs. Revised prices are due to take effect on November 9, 2026.
This step also has the potential to increase the availability of several novel treatments under Ayushman Bharat and other government health care schemes, now coming within the cap of ₹5/10 lakhs (as applicable). This is not without precedence. In 2019, the government had also applied a similar trade-margin limitation measure to 42 anti-cancer drugs.
Thankfully more patients will now have access to quality-assured, affordable cancer medicine.
What if the patient does not qualify for government schemes like Ayushman Bharat? Or the patient’s full treatment is likely to go over the ceiling? Creating a reimbursement framework in India is therefore the next logical step to ensure patients can access critical potentially lifesaving treatment.
I visualise the development of a win-win situation in the near future. Increased patient access to affordable medicines could bring more footfalls in hospitals. Doctors can select the best treatments based on what patients actually need rather than what they can afford. Cure rates and response rates increase without the financial burden on families. And the manufacturers could benefit from more prescriptions. All the stakeholders come together as a multidisciplinary team with the sole objective of providing optimal care to all cancer patients.
A delicate balance will need to be followed so that quality is possible at affordable costs. A larger portion of profits will need to be ploughed back as Investment in research, innovation, and manufacturing. Only then will innovation continue to increase cure rates of cancers across socioeconomic differences.
Trade-margin rationalisation is a welcome step by the government, to set the ball rolling. It is now up to us, the remaining stake holders to our part of the bargain for the greater good.
(The views expressed are personal)
This article is authored by Dr Purvish Parikh, medical oncologist and haematologist, president, Integrated Academic Society of Clinical Oncology and former professor and head, medical oncology, Tata Memorial Hospital, Mumbai.
