NPPA orders strict checks to enforce price cuts on 137 cancer drugs

New Delhi: The National Pharmaceutical Pricing Authority (NPPA) has ordered strict nationwide monitoring to ensure patients benefit from recent price reductions on 137 non-scheduled anti-cancer drugs.

In an office memorandum issued on 11 November, the pricing regulator directed all state drug controllers (SDCs), state food and drug administrations (FDAs), and price monitoring and resource units (PMRUs) to enforce compliance with the trade margin rationalisation (TMR) framework. Notified via gazette notification on 17 October, the revised prices took effect from 9 November.

"SDCs shall submit an action taken report to NPPA by 16 November 2026,” the memorandum stated.

Citing the latest revised price list submitted by pharmaceutical companies on 11 November—and uploaded on the NPPA website and Pharma Sahi Daam portal—the authority warned stakeholders against non-compliance.

"All manufacturers, retailers, dealers, stockists, hospitals and medical institutions are to ensure compliance with the reduced/revised prices. Any violation of these directions will entail initiation of overcharging proceedings as per extant provisions of DPCO, 2013," the memorandum read.

To prevent arbitrary billing at retail and hospital pharmacies, the directive mandates transparent price disclosures. "Every retailer/dealer/hospital/medical institution is required to prominently display the revised price lists/supplementary price lists at respective business premises and websites,” it stated, adding that "hospitals and medical institutions are required to monitor the MRPs of formulations as per the said order and ensure compliance."

Furthermore, "in order to ensure that the benefits of revised MRPs are passed on to the patients, SDCs shall strictly monitor compliance of the said order by the manufacturers, dealers, hospitals and medical institutions who shall assist the SDCs for the same," it said.

Steep price cuts

The enforcement push follows NPPA's 17 October intervention under the drugs (prices control) order, 2013, which capped trade margins at 30% of the MRP—translating to a maximum 42.86% markup on the price to stockist—to curb exorbitant markups of up to 700% in the non-scheduled oncology market.

According to market analytics cited in NPPA proceedings, India’s domestic anti-cancer drug market is valued at roughly ₹12,500 crore annually, of which over ₹10,250 crore comprises non-scheduled formulations outside direct ceiling-price controls.

Subsequent company filings showed retail price reductions exceeding 90% on several high-cost therapies. Notable cuts included thiotepa (Samtepa 100 mg vial) dropping by ₹72,921.53, or 91.1%, from ₹80,071.86 to ₹7,150.33, and breast cancer drug palbociclib (Palbopro 125 mg) falling 93.3% from ₹40,421.33 to ₹2,720. Widely prescribed therapies such as pertuzumab, olaparib, and abiraterone acetate also saw major downward revisions, with overall annual patient savings estimated at ₹2,500 crore to ₹3,541 crore.

The regulatory crackdown also comes amid heightened Supreme Court scrutiny questioning why distributor margin caps should remain restricted to select cancer drugs rather than wider pharmaceutical segments.

To curb supply disruptions or hidden overcharging, the memorandum noted that "any violation or complaints of overcharging, shortage or non-availability may be reported to NPPA through the Pharma Sahi Daam app/portal; helpline No. 1800-111-255; email ID- monitoring-nppa@gov.in."

About the Author

Priyanka Sharma is a journalist at Mint, where she covers the Union Ministry of Health and the pharmaceutical industry. Her work focuses on explaining government policies and how they impact healthcare and the medicine market in India. With 12 years of experience in journalism, she has built a reputation for providing clear and honest news on important health topics that affect the entire country.<br><br>Her educational background includes a journalism degree from the prestigious Indian Institute of Mass Communication (IIMC) and specialized training in public health from the Public Health Foundation of India. Before her current role at Mint, Priyanka worked with India Today, The Pioneer, and ANI. She also served as a lead consultant for the National Health Authority, which gave her firsthand knowledge of how the government manages large-scale health programmes.<br><br>Priyanka is based in New Delhi and is an avid traveller who loves visiting the mountains. She has a great interest in regional flavours, particularly South Indian food.