India caps prices of 137 cancer drugs after Supreme Court calls mark-ups 'extortion'

Drugs regulator says price cuts of up to 70% will save patients 2,500 crore rupees a year

By LineZotpaper

Published23 October 2026

Updated23 October 2026

Read Time3 min

Sources2 outlets

India will cut the price of 137 cancer drugs from next month after the Supreme Court condemned hospital and pharmacy mark-ups on life-saving medicines as "carnage" and "extortion". The decision follows a legal campaign by Sarojam Radhakrishnan, a retired bank clerk from Kerala who was diagnosed with breast cancer in 2021 and died in September 2022 before her case concluded.

The Department of Pharmaceuticals said the new 30% cap on trade margins is expected to reduce medicine prices by up to 70% and help cancer patients save 2,500 crore rupees (£199m) annually. The cap applies to 137 drugs that were not covered by an earlier limit, which had applied to just 42 medicines for some years.

Analysis by the National Pharmaceutical Pricing Authority found trade mark-ups on some cancer drugs averaged 170%, with extreme examples above 700%. During a hearing on 29 September, justices Vikram Nath and Sandeep Mehta noted that a life-saving cancer drug supplied to hospitals at 2,700 rupees was sold at a markedly higher price of 27,000 rupees.

Radhakrishnan's monthly treatment cost more than 63,000 rupees (£500), far beyond her family's means. Realising that thousands of families were being ruined by the cost of such drugs, she filed a petition with the Kerala high court in 2022 demanding government intervention.

The decision was welcomed by clinicians. Dr Ravi Kannan, a surgical oncologist and director of Cachar Cancer Hospital in Assam, said doctors regularly see families who cannot sustain treatment. "Some families start the treatment, hoping against hope to manage the cost. They start but they don't come back for chemotherapy or radiation. They can't sustain the cost," he said. "The decision is a welcome step if the outcome is that more patients can access the drugs they need."

Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, a civil society network, said a "total overhaul" of the healthcare system was needed. "Right from the cost of manufacturing a drug to the point of sale, we need to make the system transparent and regulate the entire supply chain. Only then will these drugs become available to those who need them," she said. She warned that companies and hospitals were likely to look for legal loopholes, such as raising charges on other items to offset lower drug prices.

The broader context is stark. Studies by the Public Health Foundation of India show that healthcare spending pushes about 55 million Indians a year below the poverty line. Cancer drug prices range from 38,000 to 380,000 rupees, and the government's Ayushman Bharat insurance scheme provides only 500,000 rupees of annual cover per family, the cost of a single dose of the breast cancer drug Kadcyla, of which patients may need up to 14 doses. India records about 1.56m new cancer cases annually, up from 1.39m in 2020.

Krishan Kalra, a former member of the council of the Rajiv Gandhi Cancer Institute and Research Centre, said few people attend free diagnosis camps because they fear what they might learn. "When I ask why, they say they're too scared. If something serious like cancer is detected, they haven't got the money to pay for the treatment so they prefer to remain in the dark," he said.

The Supreme Court has also asked the government to explain why the cap should apply only to cancer drugs and not the entire range of non-patented drugs. It has given the government until 27 October to respond.

Analysis

Why This Matters

From next month, cancer patients in India will pay up to 70% less for 137 drugs, with projected annual savings of 2,500 crore rupees (£199m) in a country where most treatment costs come out of patients' own pockets.
The ruling exposes a pricing system in which mark-ups on some cancer drugs averaged 170%, and follows evidence that healthcare costs push about 55 million Indians below the poverty line each year.
The Supreme Court has widened the question to all non-patented drugs, which could lead to far broader price regulation if the government accepts the logic.

Background

India has long regulated medicine prices through the National Pharmaceutical Pricing Authority, but its 30% trade margin cap covered only 42 drugs, leaving many cancer medicines free to carry large mark-ups. The current case began when Sarojam Radhakrishnan, a retired bank clerk in Kerala diagnosed with breast cancer in 2021, found her monthly treatment cost of more than 63,000 rupees unaffordable and petitioned the Kerala high court in 2022. The case reached the Supreme Court, whose judges on 29 September called the situation "carnage" and "extortion" before the government moved to impose the cap. Radhakrishnan died in September 2022, before the case concluded.

Key Perspectives

Doctors and patient advocates: Clinicians such as Dr Ravi Kannan of Cachar Cancer Hospital welcome the cap but point to the deeper problem of families who start treatment and cannot sustain it. They see the measure as meaningful only if more patients can actually complete their courses of treatment.

The government: The Department of Pharmaceuticals frames the cap as a major relief measure, projecting price cuts of up to 70% and annual savings of 2,500 crore rupees. The Supreme Court has asked it to justify why the cap should not extend beyond cancer drugs to all non-patented medicines.

Civil society groups: Jyotsna Singh of the Working Group on Access to Medicines and Treatments argues that a cap on individual drugs is not enough. She calls for transparency across the entire supply chain, from manufacturing to the point of sale, and warns that hospitals and companies may use loopholes, such as raising other charges, to preserve their margins.

What to Watch

The government's response to the Supreme Court by 27 October on why the cap should not apply to all non-patented drugs.
Whether the promised price reductions actually appear at pharmacies and hospitals from next month, and whether the 30% cap holds in practice.
Signs of offsetting behaviour, such as hospitals raising charges on other items, which civil society groups warn could blunt the policy's effect.

Sources

India slashes cost of cancer drugs after court rules mark-ups are ‘extortion’ · Business | The Guardian
India slashes cost of cancer drugs after court rules mark-ups are ‘extortion’ · World news | The Guardian

Checked

12 claims in this story checked against 1 source: 9 supported.

Show each claim

Partly supportedThe headline says India capped the prices of 137 cancer drugs.World news | The Guardian: “Now, prodded by the supreme court’s findings, the government has imposed the cap on 137 other drugs.”
SupportedThe Supreme Court called the mark-ups “extortion.”World news | The Guardian: “When the case reached the supreme court, the judges looked at hospitals’ and retailers’ mark-ups on cancer drugs and called the situation “carnage” and “extortion”.”
Partly supportedThe summary attributes the price-cut and savings estimate to a drugs regulator.World news | The Guardian: “a statement from the Department of Pharmaceuticals said.”
Partly supportedThe price reductions will save patients 2,500 crore rupees a year.World news | The Guardian: ““The measure is expected to reduce medicine prices by up to 70% and help cancer patients save 2,500 crore rupees [£199m] annually”
SupportedThe price cuts are expected to be up to 70%.World news | The Guardian: ““The measure is expected to reduce medicine prices by up to 70%”
SupportedThe cap will apply to 137 drugs from next month, after an earlier cap covered 42 drugs.World news | The Guardian: “A 30% trade margin cap on the price of 42 drugs has been in place for some years but many others remained off this list. Now, prodded by the supreme court’s findings, the government has imposed the cap on 137 other drugs.”
SupportedDr Ravi Kannan said some families start treatment but do not return for chemotherapy or radiation because they cannot sustain the cost.World news | The Guardian: ““Some families start the treatment, hoping against hope to manage the cost. They start but they don’t come back for chemotherapy or radiation. They can’t sustain the cost,” he said.”
SupportedJyotsna Singh called for a “total overhaul” and said the supply chain needed to be transparent and regulated.World news | The Guardian: ““Right from the cost of manufacturing a drug to the point of sale, we need to make the system transparent and regulate the entire supply chain. Only then will these drugs become available to those who need them,” she said.”
SupportedKrishan Kalra said people avoid free diagnosis camps because they fear they cannot afford treatment if cancer is detected.World news | The Guardian: ““When I ask why, they say they’re too scared – if something serious like cancer is detected, they haven’t got the money to pay for the treatment so they prefer to remain in the dark,” he said.”
SupportedTrade mark-ups on some cancer drugs averaged 170%, with extreme examples above 700%.World news | The Guardian: “Analysis by the National Pharmaceutical Pricing Authority revealed a trade mark-up on some cancer drugs averaging 170% , with some extreme examples stretching to more than 700%.”
SupportedHealthcare spending pushes about 55 million Indians a year below the poverty line, according to studies by the Public Health Foundation of India.World news | The Guardian: “Studies by the Public Health Foundation of India show that spending on healthcare pushes about 55 million Indians a year below the poverty line .”
SupportedThe Supreme Court gave the government until 27 October to respond.World news | The Guardian: “The court has given the government until 27 October to respond.”