Cancer Medicines Get Cheaper: Trade Margin Cap Cuts MRPs of 1,364 Anti-Cancer Formulations
New, lower maximum retail prices (MRPs) for anti-cancer medicines came into force across India on 9 November 2026.
As of 8 November 2026, 85 pharmaceutical companies had reported revised MRPs for 1,364 anti-cancer formulations (ready-to-use medicine products) covering 121 drugs, according to the Ministry of Chemicals and Fertilizers.
The cuts follow a 30% cap on trade margins (the share of the price kept by wholesalers and retailers) for 137 non-scheduled anti-cancer medicines, notified through notification S.O. 5690(E) dated 17 October 2026, based on the advice of an expert committee set up by the Directorate General of Health Services.
679 brands saw their MRP fall by more than half, and the biggest cut was 96.45%. Patients are expected to save about ₹3,540 crore every year.
No chemist or hospital pharmacy may charge more than the revised MRP. Shops and hospitals must display the updated price list. Prices can be checked on the Pharma Sahi Daam app or the NPPA website, and overcharging can be reported on the Pharma Jan Samadhan portal or the toll-free helpline 1800-111-255.
Trade Margin Rationalisation (TMR): A New Pricing Tool
Trade Margin Rationalisation, or TMR, makes medicines cheaper by limiting how much the middlemen in the supply chain can add to the price. Instead of fixing the final price, the government fixes the largest allowed gap between the price at which the company first sells the medicine (to a stockist or distributor) and the MRP printed on the pack. For costly medicines like cancer drugs, this gap was often huge, so capping it brings the MRP down sharply.
The revised MRPs of 1,364 formulations are the direct result of applying the 30% trade margin cap to 137 cancer medicines. Brands that earlier had very high margins saw the steepest falls, up to 96.45%.
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), and the body that applies it is the National Pharmaceutical Pricing Authority (NPPA). Medicines on the National List of Essential Medicines are "scheduled" and get a ceiling price. All other medicines are "non-scheduled": companies set their own price but may raise it only within a limit.
The 137 anti-cancer medicines in this step are non-scheduled, so their prices were not under a ceiling. The NPPA's power to step in for non-scheduled drugs, and its role in checking that chemists follow the new MRPs, is what makes this price cut enforceable.
National List of Essential Medicines (NLEM)
The National List of Essential Medicines is the government's official list of the medicines India considers most important for public health: safe, proven and good value for money. The list is prepared by an expert committee of the Ministry of Health and Family Welfare. Any medicine on the NLEM becomes a "scheduled formulation" under the DPCO, and the NPPA fixes a ceiling price for it.
Many cancer medicines are not on the NLEM, so they had no ceiling price. Capping trade margins is a way to bring down the prices of these non-listed medicines without adding them to the NLEM.
- Revised MRPs effective: 9 November 2026
- Companies reporting: 85; formulations: 1,364; drugs covered: 121 (as of 8 November 2026)
- Trade margin cap: 30% on 137 non-scheduled anti-cancer medicines (notification S.O. 5690(E), 17 October 2026)
- Brands with more than 50% price cut: 679; highest MRP reduction: 96.45%
- Estimated annual savings for patients: about ₹3,540 crore (₹3,540.38 crore)
- First TMR pilot: 42 anti-cancer drugs, 30% cap, effective 8 March 2019, under Paragraph 19 of DPCO 2013
- NPPA: set up 29 August 1997, under the Department of Pharmaceuticals
- Complaints: Pharma Jan Samadhan portal, helpline 1800-111-255; price check on the Pharma Sahi Daam app
- NLEM 2022: 384 medicines in 27 categories