NPPA caps trade margins on 137 non-scheduled anti-cancer drugs at 30 per cent

The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins at 30 per cent of the maximum retail price (MRP) on 137 non-scheduled anti-cancer drugs, according to a notification reported by The Indian Express and The Tribune on Saturday, 17 October 2026. The revised prices will come into effect on 9 November 2026. The NPPA’s own notification could not be accessed for this report; the details below are as reported by those outlets.

What the order says

The cap applies to non-scheduled formulations containing any of the 137 specified drugs, whether sold singly or in combination, irrespective of strength, dosage form or route of administration, The Tribune reported. The list includes targeted therapies and immunotherapies such as pembrolizumab, nivolumab, osimertinib, palbociclib, ribociclib, abemaciclib, atezolizumab and bevacizumab.

Non-scheduled drugs are those outside the list of medicines whose prices the government fixes directly. Manufacturers have been asked to submit revised MRPs to the NPPA within seven days, and the notification says the revised prices “shall remain in force until further orders”, The Indian Express reported.

The revised MRP is calculated from the manufacturer’s net sales realisation for March 2026, excluding government sales, or, if there were no sales that month, from the period April 2025 to March 2026, according to The Tribune. The Indian Express, citing the minutes of NPPA meetings on 16 and 17 October, reported that a 30 per cent margin on MRP (excluding GST) corresponds to a mark-up of 42.86 per cent on the price to stockist or distributor: a drug sold to a stockist at ₹70 would have an MRP of ₹100 before GST, which is added on top.

Patented medicines are included unless an exemption has been granted, The Tribune reported. Where a drug is sold directly to a hospital, the institution is treated as the stockist for the calculation. Drugs that companies supply free of charge under patient assistance programmes can be excluded from the calculation only if the manufacturer submits an undertaking, keeps patient records and allows NPPA audits.

Where a drug’s current MRP is lower than the newly calculated figure, the manufacturer must keep the lower price, the notification states, as quoted by The Indian Express.

Supply conditions

To guard against shortages, manufacturers have been told to maintain present production levels. Any reduction in average monthly production needs the NPPA’s prior permission, and discontinuing a formulation requires six months’ advance notice, The Tribune reported.

Context

The NPPA said it had observed that mark-ups on non-scheduled anti-cancer medicines “warranted extraordinary action in the public interest, following the precedent set in 2019”, as quoted by The Tribune. In 2019 the authority capped trade margins at 30 per cent on 42 selected anti-cancer drugs under Paragraph 19 of the Drugs (Prices Control) Order, 2013. The government said that measure cut MRPs by up to 91 per cent, with reported annual savings of ₹984 crore, Outlook India reported.

The Indian Express reported that, according to an analysis presented at a recent NPPA meeting, non-scheduled anti-cancer drugs carry an average trade mark-up of about 170 per cent, rising to 700 per cent in some cases. Cancer drugs have an annual market turnover of about ₹12,500 crore, of which regulated scheduled drugs account for about ₹2,250 crore, it reported. Experts at the meeting expected MRPs to fall broadly by 20 to 70 per cent, saving about ₹2,500 crore a year. Outlook India noted on 9 October that the actual reduction would depend on the drugs covered and their existing margins, so not every cancer drug would become 70 per cent cheaper.

What happens next

Manufacturers are due to submit revised MRPs within seven days, and the new prices apply from 9 November 2026. No response from drug manufacturers or industry bodies had been published in the coverage reviewed.