Radhakrishnan's Court Win Cuts Prices on 137 Indian Cancer Drugs

The Indian government will apply a 30% cap on trade margins to 137 additional cancer medicines starting next month. This expansion follows a Supreme Court decision that found hospital and retailer markups on specific drugs reached extreme levels. The Department of Pharmaceuticals stated that the measure is expected to lower medicine prices by up to 70%.

The regulatory action originated from a legal petition filed by Sarojam Radhakrishnan, a retired bank clerk from Kerala. Diagnosed with breast cancer in 2021, Radhakrishnan faced monthly treatment costs exceeding 63,000 rupees, a sum her family could not afford. She petitioned the Kerala high court in 2022, requesting government intervention to reduce these costs before the case reached the nation's highest court.

During a hearing on 29 September, justices Vikram Nath and Sandeep Mehta reviewed data on drug pricing. They noted that one specific cancer drug was supplied to hospitals at 2,700 rupees but sold for 27,000 rupees. The justices described the prevailing market conditions as carnage and extortion. The National Pharmaceutical Pricing Authority analysis cited in the case found that trade markups on some cancer drugs averaged 170%, with some instances exceeding 700%.

A 30% margin cap has previously applied to 42 cancer drugs, but the current government order extends that limit to 137 further items. In a statement, the Department of Pharmaceuticals said the new caps would help cancer patients save 2,500 crore rupees, approximately 199 million pounds, annually. This reduction targets the out-of-pocket expenses that often force lower-income families to defer treatment or sell assets.

Financial constraints remain a primary barrier to care in India. Krishan Kalra, a former council member of the Rajiv Gandhi Cancer Institute and Research Centre, noted that few patients attend free diagnosis camps in Gurgaon because of fear regarding treatment costs. Cancer drugs currently range in price from 38,000 to 380,000 rupees. The Public Health Foundation of India reports that healthcare spending pushes roughly 55 million people below the poverty line each year.

The government's Ayushman Bharat insurance scheme provides 500,000 rupees in annual coverage per family. This amount equals the cost of one dose of Kadcyla, a breast cancer drug for which patients may require up to 14 doses. Dr Ravi Kannan, a surgical oncologist at Cachar Cancer Hospital in Assam, called the new pricing rule a welcome step for patients who might otherwise abandon treatment due to unsustainable costs.

India records approximately 1.56 million new cancer cases annually, a figure that has risen from 1.39 million in 2020. Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, stated that the sector needs a total overhaul of transparency and regulation. The Supreme Court has asked government lawyers to explain why the cap applies only to cancer drugs rather than all non-patented medicines, with a response due by 27 October. Radhakrishnan died in September 2022 while her case was still pending.