Hyderabad: Prices of 137 life-saving cancer medicines came down from Monday following a move by National Pharmaceutical Pricing Authority (NPPA) to cap trade margins at 30%. The decision follows a Supreme Court hearing in late Sept on the high cost of cancer treatment, during which an example was cited of a cancer drug bought by a shop for ₹2,700 being sold to patients for ₹27,000, a tenfold increase.NPPA issued an order on Oct 17, capping the margins that traders and retailers can add to the prices of these 137 cancer medicines at 30%. Prices are expected to fall by 20% to 70%, potentially saving patients around ₹2,500 crore annually. However, for poor families, public health experts say, the more important question is whether the overall treatment bill will actually comes down.
The answer, they say, is only partly. Chemotherapy alone typically costs between ₹8,000 and ₹2 lakh per cycle in India, depending on the hospital, while a full course of treatment can cost anywhere from ₹1 lakh to over ₹20 lakh. Calling the decision “encouraging and welcome,” experts cautioned that lower medicine prices alone will not make treatment affordable for the poorest households.Senior surgical oncologist Dr Ramu Damuluri of CARE Hospital said medicines account for only a part of the overall treatment bill. Surgery, radiotherapy, diagnostics, hospitalisation, supportive care and follow-up consultations all add to the cost. “A substantial reduction in medicine prices does not mean an equivalent reduction in the overall treatment bill,” he said.Coverage is another gap“Many of the 137 drugs, including immunotherapy medicines such as nivolumab, pembrolizumab and osimertinib, are not covered under Ayushman Bharat. They are likely to stay out of reach for much of the population even at lower prices. These drugs are also not on the National List of Essential Medicines, making it unlikely that govt hospitals will stock them. Meanwhile, private hospitals could offset the savings through other charges,” said Dr Parth Sharma, a community physician and public health researcher working in rural Assam.Experts also questioned why margin caps should apply only to cancer drugs instead of ensuring greater price transparency across the supply chain of non-patented medicines. Dr Sadasivulu G, superintendent of MNJ Cancer Hospital, advocated bringing all drugs and surgical items under price control. “Patients also need supportive medicines such as antiemetics, antibiotics and painkillers, besides IV sets and syringes,” he added.Basic drugs, experts said, are being neglected. Morphine tablets that once cost about 85 paise now cost Rs 5 to Rs 7, raising the cost of daily pain relief for a patient from around Rs 5 to Rs 30. Affordable chemotherapy drugs such as carboplatin have also faced shortages because manufacturers have little incentive to produce them. “Yet these basic drugs do most of the work in treatment, while newer immunotherapies may add only 5 to 10% to survival,” said Dr Ramu.Beyond the pharmacy counter, expenses on travel and accommodation, along with lost earnings for patients and caregivers, add to the “financial toxicity” of cancer treatment, often resulting in delayed or abandoned treatment. “Patients in southern Assam often travel three hours with no public transport, paying Rs 2,000 to Rs 3,000 each way for a cab. Some families mortgage land or borrow from moneylenders just to afford travel, even when treatment is almost free under Ayushman Bharat,” claimed Dr Parth.A 2023 study in Frontiers in Public Health, covering 12,148 patients at seven cancer centres, found that patients spent an average of ₹3.31 lakh a year out of pocket. The poorest patients were 7.4 times more likely than the richest to face high hospitalisation costs and nearly 11 times more likely to incur high outpatient costs. When lost income was included, 99.7% of families faced severe financial strain due to outpatient care. A 2018 PLOS study found that 79% of patients faced severe financial strain, and 43% had to borrow money or sell assets.Cancer in TelanganaTelangana records around 55,000 to 60,000 cases annually, up from about 40,177 in 2015, with breast cancer being the most common among women and oral cancer among men. In an effort to bring cancer care closer to home, the govt last year launched 34 district daycare cancer centres in Sept 2025, shifting routine chemotherapy and screenings to district hospitals so that rural patients would not have to travel to Hyderabad for every session. The initiative also aimed to ease overcrowding at institutions such as MNJ and NIMS. In April 2026, Telangana state declared cancer a notifiable disease, paving the way for a registry to map the disease burden, guide policymaking and expand early detection efforts.Late diagnosis a big hurdleMeanwhile, late diagnosis remains a bigger challenge, doctors said. “About 90% of patients arrive at stages three or four, as many cannot afford scans and tests costing ₹10,000 to ₹20,000. Screening rates are below 2%, cancer registries cover only 10% to 15% of the population, and public hospitals have long waiting periods for MRI and CT scans,” said a govt doctor.Health experts also called for wider access to quality generic medicines and biosimilars wherever suitable. “Health insurance and financial assistance schemes also need to cover a greater share of cancer-related expenses, including hospital care and essential investigations,” said Dr Raziuddin Khwaja, consultant medical oncologist at Head & Neck Cancer Institute of India.The larger solution, experts said, lies in prevention, early diagnosis, accessible treatment and social security for families. This would require measures such as higher taxes on tobacco and alcohol, as well as action against the health risks posed by ultra-processed food and mining pollution. “Price cuts are visible and easy to celebrate. Prevention and diagnosis are not. It is like a bucket that overflows and has holes, and we are buying mops instead of fixing the bucket,” said Dr Parth.
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