NPPA Caps Trade Margins on 137 Anti-Cancer Medicines at 30%: How Drug Price Control Works
The National Pharmaceutical Pricing Authority (NPPA), India's medicine price regulator, capped the trade margin on 137 non-scheduled anti-cancer medicines at 30%. (Trade margin means the extra money that distributors, wholesalers and chemists add on top of the company's selling price.)
"Non-scheduled" means these medicines are not on the government's list of essential medicines, so their prices were not directly controlled before this order.
The NPPA used its special power under Paragraph 19 of the Drugs (Prices Control) Order (DPCO), 2013, through a method called Trade Margin Rationalisation (TMR). A gazette notification was issued on 17 October 2026, and the new prices apply from 9 November 2026.
Retail prices of some of these medicines could fall by up to 70%, depending on how high their margins were. The government has projected patient savings of about ₹2,500 crore a year.
The list of 137 medicines was recommended by an expert committee set up under the Directorate General of Health Services (DGHS), with cancer doctors, hospital experts and officials. The list will be updated from time to time.
Companies must publish revised price lists and keep supplies at current levels. Chemists and hospitals must charge and display the new prices, and State Drug Controllers will enforce the order. People can check prices on the NPPA website and the Pharma Sahi Daam app.
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 is the Drugs (Prices Control) Order, 2013 (DPCO), issued by the central government under the Essential Commodities Act, 1955. The body that applies it is the National Pharmaceutical Pricing Authority (NPPA), set up in 1997 and attached to the Department of Pharmaceuticals in the Ministry of Chemicals and Fertilizers. For essential medicines the NPPA fixes a ceiling price; for other medicines it mostly watches price rises, except when it uses its special power under Paragraph 19.
The 137 anti-cancer medicines are non-scheduled, so the normal ceiling price system did not cover them. The NPPA therefore used the emergency power in Paragraph 19 of the DPCO, 2013 to bring them under control, and asked State Drug Controllers to enforce it.
Trade Margin Rationalisation (TMR): A New Pricing Tool
Trade Margin Rationalisation is a way of making medicines cheaper by limiting how much the middlemen can add to the price. Instead of fixing the final price, the government fixes the maximum gap between the price at which the company first sells the medicine to the trade (the distributor or stockist) and the MRP the patient pays. A company can still choose its own selling price, but the MRP cannot be inflated far above it. This works well for costly medicines like cancer drugs, where very high margins were used to push sales through hospitals and chemists.
The 30% cap on 137 medicines is the largest use of TMR so far, building on the 2019 pilot of 42 cancer medicines. It targets the gap between the company price and the MRP, which is where most of the extra cost for patients was found.
- Medicines covered: 137 non-scheduled anti-cancer formulations
- Trade margin cap: 30%; effective from 9 November 2026; gazette notification on 17 October 2026
- Expected retail price fall: up to 70%; projected savings about ₹2,500 crore a year
- Legal basis: Paragraph 19, Drugs (Prices Control) Order, 2013 (issued under the Essential Commodities Act, 1955)
- List recommended by an expert committee under the Directorate General of Health Services (DGHS)
- 2019 pilot: 42 anti-cancer medicines, 30% cap, 526 brands, price cuts up to about 90%
- NPPA: set up 1997; attached office of the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers
- NLEM 2022: 384 medicines; non-scheduled medicines may raise MRP by at most 10% a year
- Price check tools: NPPA website and the Pharma Sahi Daam app