The National Pharmaceutical Pricing Authority has capped trade margins at 30 percent of the maximum retail price on 137 non scheduled anti cancer medicines, including patented ones. A Press Information Bureau factsheet dated 6 November 2026 says the revised prices take effect on 9 November 2026, and that by 4 November seventy companies had already reported revised MRPs for 120 of those drugs.
The same factsheet puts the highest reported MRP cut at 96.45 percent and estimated savings at Rs 3,357.49 crore, measured against volumes sold from April 2025 to March 2026. Average MRP reductions reported by companies sit in the 20 percent to 70 percent band.
Table of Contents
What the 17 October NPPA order did
On 17 October 2026 the NPPA, under the Department of Pharmaceuticals in the Ministry of Chemicals and Fertilizers, notified Trade Margin Rationalisation for 137 identified non scheduled anti cancer drugs. The Press Information Bureau release (PRID 2324743) said the step was taken in public interest under Paragraph 19 of the Drugs (Prices Control) Order, 2013, to curb excessive trade margins and improve access.
The list, recommended by an Expert Committee under the Directorate General of Health Services, includes immunotherapy medicines used across more than 20 cancer types, Denosumab used by breast and prostate cancer patients, Pegfilgrastim used to prevent neutropenia, and Bevacizumab used for colon, ovary and cervical cancers. Widely used brands such as Pembrolizumab, Durvalumab and Osimertinib are also expected to become more accessible once revised MRPs apply, the October release said.
Mint reported that NPPA meeting minutes cited average trade markups of about 170 percent on non scheduled anti cancer drugs, with markups reaching 700 percent in some cases, and large gaps between retail, hospital and e pharmacy transaction prices.
How the 30 percent trade margin cap works
A trade margin, the PIB factsheet explains, is the gap between what a manufacturer charges a stockist or distributor and the MRP a patient pays, excluding GST. When that gap is very large, markups along the chain push the final price far above the manufacturer selling price.
Under the order, the new MRP is worked out from the average distributor price of March 2026. Within that price, the trade margin cannot exceed 30 percent, and GST is added on top. The rule applies to all listed anti cancer drugs in every dose and form, whether sold alone or in combination. Medicines already priced below the new limit cannot be made more expensive.
Mint said the 30 percent of MRP cap corresponds to a markup of 42.86 percent on the price to stockist or distributor, using March 2026 reference net sales realisations. For drugs launched after 31 March 2026, the current price to stockist is used instead.
What patients will see for cancer medicines from 9 November
Revised prices become effective on 9 November 2026. Manufacturers must inform NPPA of revised prices, publish the cuts in newspapers and on their websites, and share them with retailers and hospitals. Retailers and hospitals must charge and display the lower prices from that date. Hospitals must also show revised prices on their websites.
A follow up PIB release on 28 October 2026 (PRID 2329698) said NPPA had published revised MRPs for 543 brands based on filings up to 27 October, with the list updated as more companies submit. Examples in that release included steep cuts on brands of Anastrozole, Azacitidine, Bevacizumab, Dasatinib, Denosumab and Enzalutamide, among others.
By 4 November, the 6 November factsheet said, 70 companies had reported revised MRPs covering 1,136 stock keeping units of 120 drugs. Consumers can check prices on the NPPA website and the Pharma Sahi Daam app.
Why the timing matters on Cancer Awareness Day
7 November is National Cancer Awareness Day in India. Our earlier explainer on National Cancer Awareness Day on 7 November sets out why early detection and affordable treatment both matter. The margin cap does not change clinical protocols, but it is meant to shrink the out of pocket bill for many non scheduled oncology medicines that sit outside the National List of Essential Medicines ceiling price system.
The factsheet notes that NLEM 2022 lists 388 medicines, of which 63 are anti cancer medicines with fixed ceiling prices. The new order extends price protection to a large set of non scheduled cancer medicines by limiting distribution and retail markups rather than setting a single national ceiling for each.
Access themes also run through our coverage of Ayushman Bharat Diwas on 30 April and World Health Day on 7 April, which look at how public programmes and prevention messaging sit beside the cost of care.
What companies must still do
The October PIB release said manufacturers must maintain current production and supply levels for the notified formulations so the price cut does not create shortages. State Drug Controllers are to enforce compliance by manufacturers, dealers, retailers, hospitals and medical institutions. Because much of the supply goes straight to hospitals, those institutions are responsible for applying the revised prices from the implementation date.
Mint added that drug makers must get prior permission before cutting average monthly output and must give at least six months notice before discontinuing production or imports. Free medicines under patient assistance programmes and direct government sales are kept out of the March 2026 distributor price calculation, the factsheet says.
The 2019 NPPA pilot that capped trade margins on 42 anti cancer drugs cut MRPs of 526 brands by up to 90 percent, according to the October release. The present exercise extends that approach to 137 drugs on the Expert Committee list, which NPPA said will be updated periodically.
For patients and families facing oncology bills, the near term checkpoint is 9 November 2026, when the reported lower MRPs are supposed to appear at retail and hospital pharmacies. The verified public numbers so far are the 30 percent margin cap, 137 drugs, estimated savings of Rs 3,357.49 crore as of 4 November filings, and a highest cut of 96.45 percent.
Featured image photo: ParentingPatch, CC BY SA 3.0, via Wikimedia Commons. It shows a bowl of assorted tablets and capsules and is used here to illustrate medicine pricing. Attribution is required under the Creative Commons licence.
FAQ
When do the revised cancer medicine prices start?
On 9 November 2026. Manufacturers, retailers and hospitals must charge and display the revised MRPs from that date.
How many medicines are covered?
One hundred thirty seven non scheduled anti cancer medicines, including patented ones. By 4 November 2026, seventy companies had reported revised MRPs for 120 of those drugs.
Sources
- Press Information Bureau factsheet, 6 November 2026: 30 percent trade margin cap; effective 9 November 2026; 70 companies, 120 drugs, 1,136 SKUs by 4 November; highest cut 96.45 percent; estimated savings Rs 3,357.49 crore; trade margin definition; NLEM 63 anti cancer medicines.
- Press Information Bureau, Department of Pharmaceuticals, 17 October 2026 (PRID 2324743): NPPA TMR order on 137 drugs; Paragraph 19 DPCO 2013; drug examples; 2019 pilot; compliance duties; production continuity.
- Press Information Bureau, 28 October 2026 (PRID 2329698): revised MRPs for 543 brands; sample brand wise cuts; continual portal updates.
- Mint: average markup about 170 percent and up to 700 percent; 42.86 percent PTS markup maths; production notice rules.