India caps margins on 137 cancer drugs after court calls mark-ups "extortion"
A case started in 2022 by a Kerala breast cancer patient has led to a 30% trade margin cap on cancer medicines, starting next month.
India will cap trade margins on 137 more cancer drugs from next month. The move follows Supreme Court hearings in which judges described the mark-ups charged by hospitals and retailers as "carnage" and "extortion", The Guardian reported.
The government has extended a 30% trade margin cap, which has covered 42 cancer drugs for some years, to the additional medicines. The Department of Pharmaceuticals said the measure was "expected to reduce medicine prices by up to 70%" and would save patients 2,500 crore rupees (£199m) a year.
The case began with Sarojam Radhakrishnan, a former bank employee in Kerala who was diagnosed with breast cancer in 2021. The targeted treatments her doctors prescribed cost more than 63,000 rupees (£500) a month, which her family could not afford. In 2022 she petitioned the Kerala High Court to seek government action on prices. She died in September 2022 while that case was still pending.
At a hearing on 29 September, Justices Vikram Nath and Sandeep Mehta noted that one life-saving cancer drug supplied to hospitals for 2,700 rupees was being sold for 27,000 rupees. According to The Guardian, National Pharmaceutical Pricing Authority analysis found trade mark-ups on some cancer drugs averaged 170%, and in extreme cases were more than 700%.
The Guardian reported that cancer drugs in India cost between 38,000 and 380,000 rupees. The government's Ayushman Bharat insurance scheme gives a family 500,000 rupees of cover a year. That is the price of one dose of the breast cancer drug Kadcyla, and patients may need up to 14 doses. Public Health Foundation of India studies show healthcare spending pushes about 55 million Indians below the poverty line each year. India records about 1.56 million new cancer cases annually, up from 1.39 million in 2020.
Dr Ravi Kannan, director of the Cachar cancer hospital and research centre in Assam, said some families begin treatment but do not return because they cannot keep paying. "The decision is a welcome step if the outcome is that more patients can access the drugs they need," he said.
Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, said the whole supply chain needed regulation. She warned that hospitals might get around the cap by raising charges on other items.
The Economic Times also covered the price cuts, under a headline asking whether cheaper cancer therapy was good news.
The Supreme Court judges have asked government lawyers why the cap should apply only to cancer drugs and not to all non-patented drugs. The government has until 27 October to respond.
Sources: The Guardian, India slashes cost of cancer drugs after court rules mark-ups are ‘extortion’; The Economic Times, Cancer therapy gets cheaper, is it good news?.
