The Ministry of Chemicals and Fertilizers said Saturday it is widening regulation in India's $2.6 billion oncology market to cover 137 additional non-scheduled anti-cancer drugs. This builds on 2019 controls for 42 cancer medicines that cut prices by as much as 90%.
For the newly covered set, prices will drop by as much as 70%, with the new rates effective Nov. 9. The basket includes immunotherapies used across 20 diseases and treatments addressing cancers of the breast, prostate, colon, ovary, and cervix.
Trade margins on these medicines are capped at 30% of the maximum retail price. An earlier government estimate pegged annual savings for patients at up to 25 billion rupees, or $263 million, at that level.
The cap applies the same to branded and generic versions, to products made in India or brought in from abroad, and to patented as well as non-patented drugs. As Indian Pharmaceutical Alliance secretary general Sudarshan Jain put it, "With the increasing incidence of cancer in the country, access to affordable, quality-assured medicines is critical." He added that the steps would help align oncology drug pricing while still leaving sufficient margin for distribution partners.
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Officials framed the step as part of a broader effort to rein in steep markups and lower patient costs, especially at hospitals. Out of pocket spending makes up about 44% of India's total health expenditure, among the highest shares in major economies.
According to the Press Trust of India, India's Supreme Court directed the federal government to investigate allegations that hospitals compel patients to purchase drugs from in-house or designated pharmacies when margins are high. The court called markups of up to 10 times on cancer medicines "carnage" and asked whether a uniform 16% margin should apply across all medicines.
In an Oct. 9 note, Nomura projected that average drug prices in India would decline by roughly 50%, with the near term impact likely heavier for companies with greater oncology exposure. Investor nerves are already visible, with Indian healthcare stocks sliding last month on worries that high margin pharmacy revenue could be at risk after the top court's questions on pricing.
Hospitals with larger oncology footprints face clearer revenue sensitivity. HealthCare Global Enterprises gets 72% of revenue from oncology, Max Healthcare Institute about 24%, and Apollo Hospitals Enterprise and Fortis Healthcare about 16% each.
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