India’s drug price regulator, the National Pharmaceutical Pricing Authority (NPPA), has revised the maximum retail prices (MRPs) of 543 trade margin-capped cancer drug brands and pack sizes, with reductions of up to 93 per cent in some cases.
Several generic and biosimilar brands have become dramatically cheaper. But some of the most expensive cancer medicines, such as the high-selling Bevacizumab and blockbuster immunotherapy Keytruda, remain unchanged. This exposes the limits of the latest price control intervention.
The sharpest reductions in the revised list are substantially higher than the government’s earlier projection of price reductions of up to 70 per cent.
The price of Palbopro, a brand of targeted cancer molecule palbociclib marketed by RPG Life Sciences, has fallen from ₹40,421.33 per unit to ₹2,720 per unit, a reduction of 93.3 per cent.
Another palbociclib brand ISOGEN has seen its MRP drop by 91.6 per cent for its 100 milligram (mg) pack.
For patients who need repeated doses, such changes could translate into substantial savings, although the actual benefit will depend on the prescribed brand, treatment regimen and whether hospitals pass on the revised prices.
On the other hand, innovator drugs and therapies sold by multinational corporations (MNCs) have seen zero changes in MRP, even if the biosimilar and generic versions of the same drugs saw a huge price drop.
The MRP for Avastin – a monoclonal antibody molecule Bevacizumab marketed by Swiss drugmaker Roche – remains unchanged at ₹1.23 lakh per 400 mg vial.
This comes even as similar dosage strength biosimilar versions such as Bevacimab (marketed by Abbott) and Bevakalp (Torrent Pharma) have seen price drops of 86 per cent and 69 per cent, respectively.
Similarly, all versions of cancer drug Nivolumab marketed by Bristol Myers Squibb (BMS) India and Dr Reddy’s have seen no change in their MRPs.
Bevacizumab and Nivolumab are the second and third highest-selling anti-neoplastic drugs in India via retail channels, according to market research firm Pharmarack.
Another important drug Keytruda, whose active ingredient is Pembrolizumab and is indicated for more than 21 cancer types, remains priced at ₹2.16 lakh.
Patient groups flag patient assistance programs (PAPs) exclusions, data gaps behind partial relief
Officials told Business Standard that the reason for this divergence could be price reduction only for those indications where the MRP was high due to huge trade margins.
The move to cap margins comes amid growing scrutiny of cancer drug pricing, with the Supreme Court questioning the government over high medicine costs and the margins charged in the cancer treatment supply chain.
The convener of a Mumbai-based patient support group said, “Many major Indian companies making generic versions of the cancer drugs have been providing huge margins and exploiting patients.”
Malioni Aisola, coconvener of patient advocacy group All India Drug Action Network (AIDAN), said that trade margin rationalisation (TMR) was never about ensuring the affordability of cancer treatments.
“Even marginal price reductions in the price of exorbitantly priced patented medicines have been scuttled by the conscious exclusion of volumes provided free under PAPs under the TMR,” she added.
PAPs are manufacturer-funded programmes offering free or discounted medicines to eligible patients.
