The Indian government has moved to reduce cancer drug prices after a retired bank clerk took her case to the supreme court, with 137 cancer drugs expected to become cheaper from next month. The government said the measure is expected to reduce medicine prices by up to 70% and help cancer patients save 2,500 crore rupees annually, significantly reducing the amount they pay from their own pockets, according to a statement from the Department of Pharmaceuticals.
Sarojam Radhakrishnan, a former bank employee in Kerala, was diagnosed with breast cancer in 2021. Doctors prescribed life-saving targeted treatments but the monthly cost of more than 63,000 rupees was far beyond her family's means. Radhakrishnan filed a petition to the Kerala high court in 2022 demanding government intervention to lower costs. When the case reached the supreme court, judges Vikram Nath and Sandeep Mehta examined hospitals' and retailers' mark-ups on cancer drugs and called the situation carnage and extortion. During a hearing on 29 September, the justices noted how a life-saving cancer drug supplied to hospitals at 2,700 rupees carried a marked-up price of 27,000 rupees. Analysis by the National Pharmaceutical Pricing Authority revealed a trade mark-up on some cancer drugs averaging 170%, with some examples stretching to more than 700%.
A 30% trade margin cap on the price of 42 drugs has been in place for some years but many others remained off this list. The government has now imposed the cap on 137 other drugs, prodded by the supreme court's findings. Studies by the Public Health Foundation of India show that spending on healthcare pushes about 55 million Indians a year below the poverty line. India records about 1.56 million new cancer cases annually, up from 1.39 million cases in 2020, making it a significant public health challenge.
The government's nationwide insurance scheme, Ayushman Bharat, covers treatment for some cancers but provides only 500,000 rupees' worth of annual cover for a family. The cost of just one dose of Kadcyla, a drug used to treat breast cancer, can exceed this amount, and patients may need up to 14 doses. Dr Ravi Kannan, a surgical oncologist and director of Cachar cancer hospital in Assam, said the decision is a welcome step if the outcome is that more patients can access the drugs they need. Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, said a total overhaul of the healthcare system was needed and that companies and hospitals were likely to try to find legal loopholes to avoid the 30% cap.
The supreme court has asked the government's lawyers why the cap should apply only to cancer drugs and not the entire range of non-patented drugs. The court has given the government until 27 October to respond. Radhakrishnan, who initiated the court action, died in September 2022 while her case was still pending in Kerala.