30% in 2019, cancer drug margins at 700% now

In 2019, the National Pharmaceutical Pricing Authority (NPPA) implemented a trade margin cap of 30% on selling prices for certain drugs, but a recent analysis reveals that most of these drugs have since surpassed the 43% mark-up level. The All-India Drug Action Network (AIDAN) highlighted the ineffectiveness of one-time MRP reductions without a mandate to maintain permanent margin caps and consistent monitoring.

Out of the 137 anti-cancer drugs on the 2019 NPPA list, 34 are included in the 2026 list, but the latest mark-ups show most of these drugs have breached the 43% mark-up threshold. Prior to the latest order, the mark-up was higher than before the 2019 order, resulting in more significant price reductions now compared to seven years ago.

However, drugs that experienced steep MRP reductions in 2019 have seen lower percentage decreases in 2026. Only five brands from the 2019 list had a mark-up of 43% before the latest order, while four others had mark-ups ranging from 43% to 100%. The remaining 39 had mark-ups between 100% and over 700%. NPPA refers to this as trade margin capping, but Malini Aisola of AIDAN emphasized that it is merely a one-time reduction of MRP through mark-up restrictions, which may not be sufficient to prevent mark-ups from rising again, as occurred after the 2019 measure.