The Supreme Court of India on Tuesday, 29 September 2026 sharply questioned the vast disparity between the maximum retail price (MRP) of medicines and the price at which they are supplied to retailers (PTR), asking the Centre why a uniform margin cap could not be mandated across pharmaceutical products. The bench raised the issue while hearing public interest litigations concerning medicine price regulation, generic drugs, medical devices, and prescription practices.

The MRP-PTR Chasm at the Centre of the Controversy

A bench comprising Justice Vikram Nath and Justice Sandeep Mehta spotlighted the case of cancer medicines carrying an MRP of ₹27,000 while their price to retailers stood at roughly ₹3,000 — a nearly ten-fold difference. The bench questioned the logic of permitting such a gap, asking where the 'huge chunk of money' in between ultimately goes.

The court also raised a pointed concern about patient trust: 'Suppose there is a medicine, the patient goes to the chemist; the chemist says MRP may be ₹27,000, I will give it for ₹3,000. Will the patient think it is genuine? He will think it will be a spurious one. Where does this huge chunk of money go?' the bench observed.

This follows an equally forceful remark during the previous hearing on 22 September, when the court had described the ten-fold MRP-PTR difference as 'broad daylight dacoity' — language that underscored the judiciary's frustration with the current regulatory framework.

Corporate Hospital Pharmacy Lock-In Under Scrutiny

The bench also flagged a separate but related concern: the practice of corporate hospitals directing patients to purchase medicines exclusively from their in-house pharmacies, with the implicit threat of withholding treatment assurance for medicines procured elsewhere.

'Corporate hospitals say you have to buy from our chemist. If you bring it from outside, we are not assuring treatment. If that patient is taking treatment under a government scheme, who reimburses? The taxpayer pays. Why not uniform criteria?' the bench asked, underlining the fiscal burden on the public exchequer when government scheme patients are forced into captive pharmacy arrangements.

Regulatory Gaps and the DPCO Question

The bench further pressed on the distinction between essential and non-essential medicines under the Drug Price Control Order (DPCO), asking why a uniform margin percentage could not be applied across all pharmaceutical products covered by the Essential Commodities Act. PIL litigant Kishan Chand Jain had submitted in earlier proceedings that there is no effective mechanism governing the initial price fixation of medicines outside the controlled-price list — meaning manufacturers can set the MRP at any level, with restrictions applying mainly to subsequent increases rather than the baseline price itself.

Senior advocate Kapil Sibal, appearing for the Indian Pharmaceutical Alliance, had previously argued that manufacturers were not responsible for the high prices ultimately borne by patients and that retailers were earning substantial margins — a contention the court has not appeared to accept without scrutiny.

Centre Seeks Time, Next Hearing Set for October 12

Solicitor General Tushar Mehta, representing the Centre, acknowledged the need for a solution while signalling that balancing all stakeholder interests would require internal deliberation. 'We will have to find a way out. Some way that balances equities. Let me sit with the officers and then respond,' he submitted, requesting an adjournment.

The Supreme Court has scheduled the next hearing for 12 October 2026. The outcome of that date could determine whether the court issues interim directions on margin caps or awaits a comprehensive policy response from the government — a question that has significant implications for India's ₹2.2 lakh crore pharmaceutical retail market and the millions of patients navigating its pricing opacity.