Cancer Medicines to Get Cheaper: NPPA Approves a 30% Cap on Trade Margins
The National Pharmaceutical Pricing Authority (NPPA), India's drug price regulator, approved "in principle" a cap on trade margins for non-scheduled anti-cancer medicines at its 151st meeting on 8 October 2026. (Trade margin means the share of the final price that goes to the wholesalers and chemists who sell the medicine.)
Under the plan, the total trade margin on these medicines cannot be more than 30% of the MRP (Maximum Retail Price, the highest price printed on the pack).
The NPPA used its special powers under Paragraph 19 of the Drugs (Prices Control) Order (DPCO), 2013, after the Department of Pharmaceuticals asked it to act in the public interest.
An analysis placed before the NPPA found an average trade mark-up of about 170% on non-scheduled cancer medicines, going up to 700% in some cases.
The NPPA expects MRPs to fall by roughly 20% to 70%, depending on each medicine, with patient savings of about ₹2,500 crore a year. The exact list of medicines will come from an expert committee under the Directorate General of Health Services (DGHS), which was asked to report by 14 October 2026.
India's anti-cancer medicine market has about 225 drugs and 500 formulations, with yearly sales of about ₹12,500 crore. Only about ₹2,250 crore of this comes from scheduled (already price-controlled) cancer medicines.
Drug Price Regulation in India: DPCO and NPPA
India controls the prices of many medicines so that ordinary people can afford them. The main rulebook for this is the Drugs (Prices Control) Order, 2013, called the DPCO. The body that applies these rules and fixes the prices is the National Pharmaceutical Pricing Authority (NPPA). Together, they decide how much a company can charge for an essential medicine and how much it can raise prices every year.
Most cancer medicines are non-scheduled, so the normal ceiling price rules do not apply to them; only their yearly price rise is limited. That left room for very high mark-ups. The NPPA has now used its Paragraph 19 emergency power, in the public interest, to cap the trade margins on these medicines at 30% of MRP.
Trade Margin Rationalisation (TMR): A New Pricing Tool
Trade Margin Rationalisation, or TMR, is a way of making medicines cheaper by limiting how much money the middlemen in the supply chain can add to the price. Instead of fixing the final price of a medicine, the government fixes the maximum gap between the price at which the company first sells the medicine and the MRP paid by the patient. The company is still free to choose its own selling price.
The NPPA's new decision applies the same TMR tool to non-scheduled anti-cancer medicines more widely, with a 30% cap on MRP. It was taken after data showed an average mark-up of about 170%, much higher than the roughly 43% mark-up that a 30% margin allows. This is why prices could fall by up to 70% for some medicines.
- NPPA 151st meeting: 8 October 2026; in-principle approval of 30% trade margin cap on non-scheduled anti-cancer medicines
- Legal power used: Paragraph 19 of DPCO 2013 (extraordinary powers, public interest)
- Average trade mark-up on non-scheduled cancer medicines: about 170%; highest about 700%
- Expected MRP reduction: about 20% to 70%; expected savings: about ₹2,500 crore a year
- Anti-cancer market: about 225 drugs, 500 formulations, about ₹12,500 crore yearly sales; scheduled part about ₹2,250 crore
- Medicine list to be recommended by an expert committee under DGHS (deadline 14 October 2026)
- 2019 pilot: 42 cancer medicines, 30% cap, 526 brands' MRPs cut, about ₹984 crore yearly savings
- NPPA set up on 29 August 1997; NLEM 2022 lists 384 medicines