A government cap on trade margins has cut the maximum retail prices (MRPs) of nearly three-fourths of listed cancer drug brands, with more than 200 formulations seeing reductions of 50% or more. But several expensive patented treatments, including Keytruda, nivolumab and osimertinib, remain unchanged, limiting the relief for patients on newer therapies.
A revised price list published by the National Pharmaceutical Pricing Authority (NPPA), based on company filings up to October 27, shows that 397 of 543 listed brand, strength and pack-size entries have lower prices ahead of the November 9 deadline. The average reduction among these entries is about 50%.
The NPPA’s October 17 order capped trade margins at 30% on 137 non-scheduled anti-cancer drugs, invoking Paragraph 19 of the Drugs (Prices Control) Order, 2013, which allows the government to regulate prices in the public interest. These drugs are not on the National List of Essential Medicines and are not subject to direct price fixation under the usual provisions.
Under the order, companies must set MRPs based on the average price charged to distributors in March 2026, with the permitted trade margin capped at 30%, plus applicable GST.
Generic and biosimilar brands see steep cuts
Of the 110 drugs represented in the filings so far, 35 have price reductions across every listed brand, while 47 show no change. The remaining 28 have mixed outcomes, with generic and biosimilar versions becoming cheaper while some original brands retain their existing prices.
The steepest cuts include:
Palbociclib, used for breast cancer: one 125 mg pack falls from ₹40,421 to ₹2,720, a reduction of about 93%.
Anastrozole, used for breast cancer: a 10-tablet pack falls from ₹458.85 to ₹39.52, about 91%.
Thiotepa, a 100 mg vial, falls from ₹80,072 to ₹7,150, a reduction of nearly ₹73,000.
Bevacizumab, one 400 mg vial falls from ₹69,852 to ₹13,512.
Pertuzumab, one 420 mg vial falls from ₹94,951 to ₹30,593.
Abiraterone, used for prostate cancer: a pack of 120 tablets falls from ₹28,000 to ₹4,840.
Dasatinib, used for leukaemia: one 70 mg pack falls from ₹17,811 to ₹1,808.
Denosumab: a 60 mg prefilled syringe falls from ₹22,031 to ₹5,941.
The reductions are not uniform across brands of the same drug. Lynparza, the original brand of olaparib, remains at ₹40,620 for the 100 mg strength, while the generic brand Brcaone’s 150 mg pack falls from ₹46,364 to ₹11,574.
Patented cancer drugs largely unchanged
The filings show no price change for several expensive, newer therapies, including pembrolizumab (Keytruda), nivolumab, osimertinib, atezolizumab, daratumumab, ibrutinib, venetoclax, ruxolitinib and zanubrutinib. For instance, Keytruda remains priced at ₹2,16,500. The price of ribociclib remained completely unchanged to ₹24,435.00.
Other drugs show a split between original brands and lower-priced alternatives. Avastin (bevacizumab), Lynparza (olaparib), Tasigna (nilotinib), Sutent (sunitinib), Faslodex (fulvestrant), Lenvima (lenvatinib) and Perjeta (pertuzumab) are among the brands where some versions became cheaper while others remained unchanged.
The order also covers patented drugs, but the price list shows that the margin cap does not automatically translate into a price cut for every brand. The filings do not explain why individual prices remain unchanged. One possible explanation is that some brands were already priced within the new limit, leaving no excess margin to remove.
As a result, generic and biosimilar versions account for many of the reported reductions, while patients on some of the costliest patented treatments may see no immediate relief.
27 drugs yet to appear in filings
The revised list is not complete. Of the 137 drugs covered by the order, 110 appear in the filings so far. The remaining 27 include abemaciclib, alpelisib, cabozantinib, dabrafenib, darolutamide, trametinib, vemurafenib, sotorasib and selpercatinib.
The NPPA said the list reflects information received from manufacturers through October 27 and is not final.
Companies must submit revised price lists to the NPPA and State Drug Controllers within seven days of publication of the order, even where prices remain unchanged. They must also publish price-cut notices in newspapers, display revised prices on their websites and report production and stock details.
Manufacturers must maintain production at existing levels and seek prior NPPA approval before reducing output. They must also repay any overcharged amount with interest under the pricing order and the Essential Commodities Act, 1955.
Hospitals also covered
The order recognises that manufacturers supply many cancer drugs directly to hospitals. In such cases, hospitals are treated as distributors for pricing purposes and must monitor maximum retail prices, display revised prices on their websites and report violations.
State drug controllers enforce compliance across manufacturers, distributors, retailers, and hospitals. Companies that fail to submit revised price details will be treated as having made no price reduction.
The order allows manufacturers to continue taking annual price increases permitted under Paragraph 20(1) of the pricing order, provided they remain within the prescribed trade-margin cap. Distributor-price calculations may exclude free medicines supplied through patient-assistance programmes, subject to record-keeping and audit requirements.
Published on October 28, 2026
