NPPA caps trade margins on 137 anti-cancer drugs at 30% of MRP
Synopsis
India's drug pricing regulator has capped trade margins on 137 non-scheduled anti-cancer drugs — including blockbuster immunotherapies like Pembrolizumab — at 30% of MRP, effective 9 November 2026. Prices could fall by up to 70%, extending a 2019 pilot that cut costs on 526 cancer drug brands by up to 90%. For millions of Indian cancer patients facing catastrophic out-of-pocket costs, this is one of the most significant affordability interventions in years.
Key Takeaways
The NPPA has capped trade margins on 137 non-scheduled anti-cancer drugs at 30% of MRP , effective 9 November 2026 .
Prices of several cancer medicines are expected to fall by up to 70 per cent .
Covered drugs include immunotherapy agents treating over 20 cancer types , Denosumab , Bevacizumab , Pembrolizumab , Durvalumab , and Osimertinib .
Manufacturers must report revised prices to NPPA within 7 days of the Gazette notification.
The move builds on NPPA's 2019 TMR pilot , which reduced prices of 526 cancer drug brands by up to 90 per cent .
Consumers can check revised prices on the Pharma Sahi Daam app or the NPPA website .
The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins on 137 non-scheduled anti-cancer drugs at 30 per cent of the maximum retail price (MRP), a move the regulator says could reduce prices of several cancer medicines by up to 70 per cent and significantly improve affordability for patients across India. The notification was issued on 18 October 2026, with revised prices taking effect from 9 November 2026.
What the Order Covers
The 137 identified non-scheduled anti-cancer drugs span a wide therapeutic range. They include immunotherapy drugs used for treating over 20 types of cancers, Denosumab prescribed to breast and prostate cancer patients, Pegfilgrastim used to prevent neutropenia in cancer patients undergoing chemotherapy, and Bevacizumab, an approved treatment for colon, ovarian, and cervical cancers. Widely used drugs such as Pembrolizumab, Durvalumab, and Osimertinib are also expected to become more accessible under the revised pricing framework.
How the New Prices Will Be Enforced
All manufacturers are required to inform the NPPA of their revised prices within 7 days of publication of the Gazette notification. From 9 November 2026, all retailers and hospitals must charge only the reduced prices and display them prominently in their pharmacies. Hospitals are also mandated to display revised prices on their official websites. Manufacturers must similarly publish updated price lists on their websites and disseminate them widely to retailers and hospitals.
Consumers can verify revised prices through the Pharma Sahi Daam app and the NPPA website.
Background: Building on the 2019 Pilot
This intervention builds on NPPA's 2019 pilot Trade Margin Rationalisation (TMR) exercise, under which trade margins for 42 anti-cancer drugs were capped at 30 per cent. Following that pilot, the MRP of 526 brands of non-scheduled anti-cancer medicines was reduced by up to 90 per cent. The current exercise extends that framework to a significantly larger drug basket, based on a list recommended by the Expert Committee under the Directorate General of Health Services (DGHS).
According to the official statement, the intervention is carried out under the Department of Pharmaceuticals in the Ministry of Chemicals and Fertilizers as part of the regulator's broader Trade Margin Rationalisation (TMR) programme aimed at curbing excessive margins across the pharmaceutical distribution chain.
Impact on Patients and Public Health
Cancer treatment costs in India remain prohibitively high for a large share of households, with out-of-pocket expenditure on oncology medicines pushing many families into financial distress. By rationalising distributor and retailer margins — which can account for a disproportionate share of the final price of non-scheduled drugs — the NPPA aims to ensure that cost savings flow directly to patients rather than intermediaries in the supply chain. The move is also intended to support the broader public-health objective of equitable access to cancer treatment, particularly for patients in tier-2 and tier-3 cities and rural areas.
With this notification, the government signals a continued willingness to intervene on drug pricing in high-burden disease areas, and all eyes will now be on manufacturer compliance rates and retail-level enforcement when the 9 November 2026 deadline arrives.
Point of View
But the harder test has always been enforcement — the 2019 pilot showed that regulatory orders and actual retail prices can diverge sharply once drugs move through multi-tier distribution networks. Capping margins on paper is not the same as ensuring patients in district hospitals and rural pharmacies see the reduction. The government has mandated website disclosures and app-based price checks, but without a credible field-inspection mechanism, intermediaries have historically found ways to absorb or offset margin cuts. The real measure of success will be compliance data — not the size of the drug list.
NationPress
18 Oct 2026
Frequently Asked Questions
What has the NPPA ordered on anti-cancer drug prices?
The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins on 137 non-scheduled anti-cancer drugs at 30 per cent of the MRP, with revised prices taking effect from 9 November 2026. The move is expected to reduce prices of several cancer medicines by up to 70 per cent.
Which anti-cancer drugs are covered under this price cap?
The 137 drugs include immunotherapy agents used for over 20 types of cancer, Denosumab (for breast and prostate cancer), Pegfilgrastim (to prevent neutropenia), and Bevacizumab (for colon, ovarian, and cervical cancers). Widely used drugs such as Pembrolizumab, Durvalumab, and Osimertinib are also included.
When will the reduced cancer drug prices come into effect?
The revised prices will become effective from 9 November 2026. Manufacturers must inform NPPA of their revised prices within 7 days of the Gazette notification, and all retailers and hospitals must charge the reduced prices from that date.
How can patients check the revised prices of cancer drugs?
Patients and caregivers can verify revised drug prices through the Pharma Sahi Daam app or the NPPA's official website. Retailers, pharmacies, and hospitals are also required to prominently display the revised price lists.
How does this compare to NPPA's earlier anti-cancer drug interventions?
This exercise extends NPPA's 2019 Trade Margin Rationalisation pilot, which capped margins on 42 anti-cancer drugs at 30% and subsequently reduced the MRP of 526 brands by up to 90 per cent. The current notification covers a significantly larger set of 137 drugs, based on recommendations from an Expert Committee under the Directorate General of Health Services (DGHS).
