The Indian government’s priority is to make affordable and quality cancer treatment available to every family. On 17 October 2026, the National Pharmaceutical Pricing Authority (NPPA) capped the trade margin on 137 non‑scheduled cancer‑preventive drugs, including patented drugs, at 30% of the maximum retail price (MRP). The revised prices will take effect from 9 November 2026. By 4 November 2026, 70 companies had announced revised MRPs for 120 drugs, recording a maximum reduction of 96.45% and an estimated saving of ₹3,357.49 crore. The average MRP reduction ranges from 20% to 70%.
Average reduction in cancer drug prices ranges from 20% to 70%
The government has imposed a cap on the markup on drug supply, including retail and hospital pharmacies, to make cancer treatment more affordable across the country.
Companies have recorded an average MRP reduction of 20% to 70%. The maximum reduction of 96.45% was recorded by 4 November 2026.
The estimated saving of ₹3,357.49 crore is due to these MRP reductions (as of 4 November 2026). This estimate reflects the difference between the original and revised prices for quantities sold from April 2025 to March 2026.
This limit was set in response to concerns raised by state officials, patients and citizens about the gap between the maximum retail price (MRP) of cancer‑preventive drugs and their purchase price.
Consumers can verify prices using the NPPA website and the official Pharma Sahi Daam mobile app.
New prices are based on distributor prices as of March 2026.
What is trade margin?
Trade margin is the difference between the price taken by the manufacturer’s stock‑holding distributor and the maximum price (MRP) paid by a patient for a drug, excluding GST. When this margin is high, the supply chain accumulates large profits, driving up the final cost for patients and making expensive cancer drugs even more costly than the manufacturer’s price.
According to this order, the new maximum retail price for each drug is determined from the average distributor price of March 2026. The trade margin on that price cannot exceed 30%, and GST will be added on top.
How are drug prices controlled?
To make life‑saving essential drugs more affordable, the government regulates drug prices under the Drugs (Pricing Control) Order (DPCO), 2013.
This is under the Essential Commodities Act, whose aim is to control drug prices, curb profiteering and ensure that essential treatment remains affordable.
Under DPCO, 2013, drugs are divided into two groups:
Scheduled drugs: These are drugs listed in Schedule I of DPCO, 2013, which is the National List of Essential Medicines (NLEM), 2022. The government sets a maximum price for each of them. NLEM 2022 lists 388 drugs, of which 63 are cancer‑preventive.
Non‑scheduled drugs: These are drugs not included in Schedule I of DPCO, 2013. Unlike scheduled drugs, whose maximum price is fixed, their regulation is through price monitoring: under Article 20 of DPCO, 2013, a manufacturer cannot increase the MRP by more than 10% in twelve months, and if the increase exceeds 10%, the price must be brought back to the 10% level for the next twelve months.
In addition to these essential drugs, to monitor high prices of other drugs, the government ran a pilot intervention in 2019 covering 42 non‑scheduled cancer‑preventive drugs, which successfully reduced costs for patients.
On this basis, and using market data showing higher margins and gaps between retail and hospital prices, the government exercised its extraordinary public‑interest powers under Article 19 of DPCO, 2013. Following a recommendation by a specialist committee under the Directorate of Health Services, the authority brought 137 non‑scheduled cancer‑preventive drugs (including patented drugs) under trade‑margin rationalisation through its order dated 17 October 2026.
What is the National List of Essential Medicines?
The National List of Essential Medicines (NLEM) is an official list of essential, high‑priority medicines for India. Its latest revised version, NLEM 2022, was issued by the Health Minister Dr Mansukh Mandavya on 13 September 2022 under the government’s “Everyone’s Medicine, Affordable Medicine” vision.
History: It was first created in 1996, then updated in 2003, 2011, 2015 and 2022.
Who created it: A specialist panel named the Standing National Committee on Medicines (SNCM) consulted doctors, scientists, industry experts and reviewed WHO standards before drafting it.
Why is this list important?
Low cost: Helps reduce medical expenses for families.
Better health service: Ensures safety, efficacy and high quality of medicines.
Better planning: Guides government procurement, hospital budgets, health insurance and medical student training.
Legal basis behind the order: Paragraph 19 of DPCO, 2013
Special powers for the government: In exceptional circumstances, the government can act in the public interest beyond standard rules.
Pricing or changes: The government has the authority to set a maximum (ceiling) price or retail price for any medicine, as deemed necessary.
Changing a pre‑determined price: If a price is already set, the government can increase or decrease it directly without waiting for the usual annual adjustment linked to the wholesale price index.
How the new system limits trade margin on cancer drugs
Trade margin capped at 30% of maximum retail price: The trade margin (difference between the amount taken by the manufacturer’s distributor and the amount paid by the patient) cannot exceed 30%.
Applies to all forms: This rule applies to all listed cancer‑preventive drugs, regardless of dosage or form (tablets, injections, etc.) and whether sold alone or together.
Based on March 2026 prices: For this calculation, the initial price must be the distributor price (price paid to the stock‑holding distributor) up to March 2026.
How the new maximum retail price (MRP) is calculated
The formula for the maximum retail price that can be charged to the patient is set in this order:
Cancer‑preventive drugs covered under this order
Serial No.
Drug name
Serial No.
Drug name
1
Abemaciclib
70
Lenvatinib
2
Abiraterone Acetate
71
Lomustine
3
Acalabrutinib
72
Lorlatinib
4
Afatinib
73
Lymphosec Kit
5
एलेक्टिनिब
74
मेस्ट्रोल
6
अल्पेलिसिब
75
मिडोस्ट्रुरिन
7
एमिवेंटामैब
76
मिरवेटक्सिमैब सोरवतंसाइन
8
एनास्ट्राज़ोल
77
मिटोमाइसिन
9
अपालुटामाइड
78
मिटोक्सेंट्रोन
10
एस्सीमिनिब
79
नेलाराबीन
11
एटेज़ोलिज़ुमैब
80
नेटुपिटेंट
12
एवेलुमैब
81
निलोटिनिब
13
एक्सिटिनिब
82
निमोटुज़ुमैब
14
एज़ासिटिडाइन
83
निन्तेदानिब
15
बेलेंटामैब मैफोडोटिन
84
निरापरिब
16
बेवाकिज़ुमैब
85
निवोलुमाब
17
बोसुटिनिब
86
ओबिनुटुज़ुमैब
18
ब्रेंटुक्सिमाब वेडोटिन
87
ओफातुमुमाब
19
ब्रिगाटिनिब
88
ओलापैरिब
20
Busulfan
89
Osimertinib
21
Cabazitaxel
90
Palbociclib
22
Cabozantinib (S)-Malate
91
Panitumumab (Vectibix)
23
Capmatinib
92
Pazopanib (as Hydrochloride)
24
Carfilzomib
93
Pegaspargase
25
Carmustine
94
Pegfilgrastim
26
Ceritinib
95
Pegylated Interferon Alpha 2B
27
Cetuximab
96
Pembrolizumab
28
Cladribine
97
Pemetrexed
29
Clofarabine
98
Pertuzumab
30
Crizotinib
99
Pertuzumab + Trastuzumab
31
Sitarabine
100
Plerixafor
32
Dabrafenib
101
Polatuzumab Vedotin
33
Dacomitinib
102
Pomalidomide
34
Daratumumab
103
Ramucirumab
35
डारोलुटामाइड
104
रेगोराफेनिब
36
डासैटिनिब
105
रेलुगोलिक्स
37
डाटोपोटामैब डेरक्सटेकन
106
रिबोसिक्लिब
38
डेसिटाबाइन
107
रुकापारिब
39
डेगारेलिक्स
108
रुक्सोलिटिनिब
40
डेनोसुमैब
109
सेल्परकेटिनिब
41
डोस्टारलिमैब
110
सेलुमेटिनिब
42
दुर्वालुमाब
111
सर्पलुलिमैब
43
एलरानाटामैब
112
सोटोरासिब
44
एनफोर्टुमैब वेडोटिन
113
सुनीटिनिब
45
एंट्रेक्टिनिब
114
टैल्केटामैब
46
एन्ज़ालुटामाइड
115
टेक्लिस्टामैब
47
एपिरुबिसिन
116
टेगाफुर + यूरासिल
48
एरडाफिटिनिब
117
टेगाफुर , गिमेरासिल और ओटेरासिल
49
एरिबुलिन मेसिलेट
118
टेमसीरोलिमस
50
Erlotinib
119
Tepotinib
51
Estramustine
120
ThioTEPA
52
Everolimus
121
Tislelizumab
53
Exemestane
122
Tosilizumab
54
Fluorouracil
123
Topotecan
55
Fulvestrant
124
Toripalimab
56
Gilteritinib
125
Trabectedin
57
Goserelin acetate
126
Trametinib
58
Ibrutinib
127
Tremelimumab
59
Ibrutinib
128
Treosulfan
60
Idelalisib
129
Trifluridine + Tipiracil
61
Ifosfamide and Mesna
130
Triptorelin
62
Nivolumab and Relatlimab
131
Tucatinib
63
Pegylated liposomal irinotecan
132
Vemurafenib
64
Inotuzumab ozogamicin
133
Venetoclax
65
Interferon alpha 2B
134
Vinorelbine tartrate
66
Ipilimumab
135
Vorasidenib
67
Ivosidenib
136
Zanubrutinib
68
Lapatinib
137
Zolbetuximab
69
Lazertinib
Source : Ministry of Chemicals and Fertilizers, NPPB Order S.O. 5690(E) dated 17 October 2026
What changes will come for patients and companies?
Manufacturers must recalculate their maximum retail prices using average distributor prices from March 2026. Free drugs under patient assistance programmes and drugs sold directly by the government will not be included in this calculation.
New lower prices will take effect from 9 November 2026. Drugs already cheaper under the new price ceiling cannot be made more expensive.
Companies must notify NPPB of their revised prices. They must publish price reductions in newspapers, display them on their websites, and share them with all retailers and hospitals.
NPPB has made the revised prices of these drugs available on its website and updates the list when companies submit revised prices.
By 4 November 2026, 70 companies had reported revised MRPs for 1,136 stock‑keeping units (SKUs) of 120 drugs.
Companies are not allowed to reduce drug production without permission, and must give a six‑month notice before completely stopping production of any drug.
Hospitals and drug stores must display new prices clearly. Companies that do not reduce prices must refund the excess amount, including interest.
Detailed government help for cancer care
The government runs several health programmes to provide affordable cancer treatment, screening and drugs to the public.
AB-PMJAY: Cash‑less hospital services, including cancer treatment
The Indian government, through Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB‑PMJAY), provides 5 lakh rupees per family per year to the poorest 40% of families and all senior citizens aged 70 and above.
Under this scheme, up to 12.69 crore hospital admissions were allowed at a cost of 1.92 lakh crore rupees by 30 June 2026.
Cash‑less treatment is available for 1,961 procedures across 27 medical specialties, including medical oncology, surgical oncology and radiation oncology, in listed government and private hospitals under this scheme.
Under this scheme, 1.95 lakh admissions for medical oncology were approved, costing about 2,926 crore rupees (as of 4 November 2026).
NPI‑NCD: Care from cancer screening to treatment
The government, through the National Health Mission’s National Programme for Prevention and Control of Non‑Communicable Diseases (NPI‑NCD), strengthens infrastructure, human resource development, screening, early diagnosis, referral, treatment and health promotion for non‑communicable diseases, including cancer.
Under NPI‑NCD:
770 district NCD clinics for cancer patients, 6,410 NCD clinics in community health centres and 524 day‑care cancer centres have been established.
To strengthen cancer treatment infrastructure, the government supports the establishment of state cancer institutions (SCI), tertiary cancer centres (TCCC) and DCCCs under NPI‑NCD, ensuring equitable access to quality cancer care across the country.
Nineteen state cancer institutions (SCI) and twenty tertiary cancer centres (TCCC) have been approved nationwide to strengthen tertiary cancer care.
Additionally, Tata Memorial Centre (TMC) has established six hospitals in Varanasi, Visakhapatnam, New Chandigarh, Guwahati, Sangrur and Muzaffarpur to provide cancer care.
All 22 new MSs now offer cancer treatment services, including diagnosis, medicine and surgery.
Furthermore, National Cancer Institute (NCI), Jajjar and Chittaranjan National Cancer Institute (CNCI), Kolkata’s second campus provides advanced diagnostic and treatment facilities.
This programme, through the Indian Council of Medical Research (ICMR) National Cancer Registry Programme (NCRP), also helps population‑based screening, raises awareness of risk factors and strengthens cancer surveillance.
General health centres screen for common cancers
Ayushman Arogya Mandir, which are primary health care centres across the country, also provide cancer screening in their communities.
As of 12 August 2026, more than 1.86 lakh Ayushman Arogya Mandir (AAM) are operational. These mandirs screen for common cancers (mouth, breast and cervical) in people over 30 years, along with other primary health services.
Pre‑qualified social health workers (Asha) and auxiliary nurse midwives (ANM) provide prevention, control and screening services through trained frontline workers.
Screening up to July 2026:
Mouth cancer: 36.11 crore
Breast cancer: 16.94 crore
Cervical cancer: 9.31 crore
Free HPV vaccination for cervical cancer prevention
The nationwide Human Papillomavirus (HPV) vaccination campaign began on 28 February 2026 across all 36 states and union territories, vaccinating about 1.2 crore eligible girls aged 14.
Since the campaign started (as of 11 September 2026), over 80 lakh doses of HPV vaccine have been given free of cost in India.
Low‑cost drug stores: Jan Aushadhi and Amrit
The government also runs several schemes to make essential drugs, including cancer drugs, more affordable for the public.
These schemes improve access to affordable cancer drugs, stents and implants, reduce out‑of‑pocket expenses and encourage long‑term treatment commitment.
Prime Minister Indian Jan Aushadhi Project (PMBJP)
Under PMBJP, 2,110 drugs and 315 surgical products, medical consumables and equipment are included, covering all major medical groups, including cancer.
There are 20,149 public medicine centres across the country (as of 30 June, 2026).
From FY 2021-22 to 2025-26, PMBJP sold ₹7,873.85 crore through public medicine centres nationwide, saving citizens about ₹37,200 crore (as of 31 March, 2026).
Affordable drugs and reliable transplants for treatment pharmacies
Amrit (Reliable transplants for treatment and affordable drugs) aims to make drugs for cancer, heart disease and other serious illnesses available at affordable prices.
Under this initiative, over 6,500 drugs, transplants, surgical products and other health items are available at an average discount of up to 50% off the maximum retail price (MRP).
There are 285 Amrit outlets operating in 24 states and four union territories.
Since its establishment, Amrit has served more than 81.3 million patients.
Through the network, drugs and health products worth approximately ₹22,323 crore have been distributed at MRP, resulting in patients saving about ₹10,969 crore and helping reduce their healthcare expenses (as of 24 September, 2026).
Phone help for cancer treatment
To improve access to specialist medical services, especially in remote and underserved areas, teleconsultation services are provided via the e‑Sanjeevani platform, including cancer treatment.
By 21 October, 2026, over 50 crore patients have used this service for all types of treatment, including cancer.
Making cancer treatment affordable and accessible
By applying the trade margin limit, the government’s support at every stage of cancer care—screening at Ayushman Aarogy Mandirs, free HPV vaccination for girls, cashless hospital treatment under AB‑PMJAY, and low‑cost drugs at public medicine centres and Amrit pharmacies—has been strengthened. These measures bring quality cancer care closer to more families.
References
Ministry of Chemicals and Fertilizers
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2321092®=48&lang=2
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2324743
https://nppa.gov.in/storage/uploads/tender/277271-17-10-2026.pdf
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2297568®=3&lang=1
https://nppa.gov.in/storage/uploads/pdf/DPCO-inclusive-of-all-ammendmentscompressedpdf-6f9edc1bf7c000eb02b7eee6c180b527.pdf
https://nppa.gov.in/en/search_medicine_price
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2329698
https://nppa.gov.in/storage/uploads/tender/revised-mrp-report-04112026-04-11-2026.pdf
https://x.com/nppa_india/status/2117986916121628974
https://x.com/Pharmadept/status/2117305360692466164
Ministry of Health and Family Welfare
https://www.pib.gov.in/PressReleasePage.aspx?PRID=1858931®=48&lang=2
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2286948®=48&lang=2
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2294278
https://dashboard.nha.gov.in/public/
https://sansad.in/getFile/lsapps/loksabhaquestions/annex/188/AU931_DhFQWt.pdf
https://elibrary.sansad.in/server/api/core/bitstreams/b3b40e24-2357-43ce-b2ec-89a9d548f521/view
https://www.pib.gov.in/PressReleaseDetail.aspx?PRID=2309109®=3&lang=1
https://esanjeevani.mohfw.gov.in/
https://www.pib.gov.in/PressReleasePage.aspx?PRID=2314433®=48&lang=2
PIB Backgrouncers
https://www.pib.gov.in/FactsheetDetails.aspx?Id=150834®=5&lang=1
Click to see pdf
PIB Research