India expands price cap on cancer drugs

India’s National Pharmaceutical Pricing Authority (NPPA) has expanded price regulation in oncology by capping trade margins at 30% of the maximum retail price (MRP) for 137 non-scheduled anti-cancer drugs. The change was formalised through a Gazette notification published on October 17, 2026 and marks a significant broadening of the number of cancer medicines subject to controlled trade margins.

The cap applies to a defined list of non-scheduled formulations, meaning these medicines were not previously under direct price control through the standard schedule-based mechanism. By fixing the allowable trade margin at 30% of MRP for these products, the regulator aims to compress the gap between ex-factory prices and what patients pay at the retail level.

The notified list of 137 anti-cancer drugs was prepared on the recommendation of an Expert Committee under the Directorate General of Health Services. It encompasses both patented and non-patented formulations, bringing a wide spectrum of oncology treatments under the same 30% trade-margin ceiling.

Included in the list are widely used immunotherapies and targeted therapies such as pembrolizumab, nivolumab, osimertinib, bevacizumab, palbociclib and olaparib, among others. These drugs are used across multiple cancer indications and are often high-cost therapies, making changes to their pricing structure particularly significant for patients and providers.

Manufacturers of the affected medicines must recalculate MRPs in line with the new 30% trade-margin cap and submit these revised prices to the NPPA within seven days of the Gazette notification. This creates a compressed window for companies to adjust their pricing structures and internal systems.

The revised MRPs will come into force on November 9, 2026. Companies are also required to widely disseminate the updated price lists, including to retailers and hospitals, and to publish them on company websites. This is intended to ensure transparency and facilitate adoption of the new prices across the supply chain.

The government and NPPA estimate that MRPs for some of the identified anti-cancer drugs could fall by as much as about 70% under the new trade-margin ceiling. On an aggregate basis, authorities project potential annual savings for patients of roughly ₹2,500 crore once the revised prices are fully in effect.

These projections underscore the regulator’s objective of reducing out-of-pocket expenditure on high-cost oncology therapies. The focus on both patented and off-patent medicines means the expected benefits are spread across a broad range of brands and treatment categories.

The October 2026 move is described as an extension of the Trade Margin Rationalisation pilot launched in 2019, which capped trade margins at 30% for 42 anti-cancer drugs. That earlier initiative was followed by large reductions in MRPs across hundreds of brands linked to the covered molecules.

By building on the 2019 experience and scaling the approach to 137 non-scheduled cancer medicines, regulators are applying a tested framework to a wider set of therapies. The latest action thus represents a broadening of an established pricing mechanism within India’s oncology market.