Cancer drug prices slashed by over 90% in India, but Keytruda and other costly medicines get no relief

PTC Web Desk: India’s drug price regulator has lowered the maximum retail prices of 543 cancer drug brands and pack sizes and in some cases the fall is steeper than 90%. But the biggest and costliest names in cancer care, including the immunotherapy drug Keytruda, have not seen any change, which shows how far this price-control move can really go.

The list has been issued by the National Pharmaceutical Pricing Authority (NPPA). The new prices will come into force on November 9.

Where prices have fallen sharply

The breast cancer drug palbociclib has seen one of the biggest drops. A pack of the Palbopro brand (125 mg) now costs Rs 2,720, down from Rs 40,421, a cut of 93.3%. Another brand, ISOGEN, is down 91.6% for its 100 mg pack.

The chemotherapy drug thiotepa has fallen from about Rs 80,072 to Rs 7,150 per vial for the SAMTEPA brand, a saving of nearly Rs 72,922 on each vial. The anastrozole brand WOMAZOL has dropped from Rs 458.85 to Rs 39.52. Prices of dasatinib, lenvatinib, abiraterone and olaparib, used for different cancers, have also come down sharply.

These cuts are much deeper than the 70% reduction the government had earlier indicated.

The savings are not the same for every brand, though. The PALENO brand of palbociclib (100 mg) has moved only slightly, from Rs 5,717.81 to Rs 5,624.10. For a patient, the real benefit will depend on the brand prescribed, the treatment plan and whether hospitals actually pass on the new prices.

Who has been left out

Keytruda (pembrolizumab), which is used for more than 21 types of cancer, is still priced at Rs 2,16,500. Ribociclib, sold as Kryxana, remains at Rs 24,435. Other originator brands such as Tagrisso, Tecentriq, Darzalex and Imfinzi also show no change.

The reason lies in the way the NPPA has gone about it. It has capped trade margins at 30% of MRP for 137 non-scheduled anti-cancer drugs, rather than ordering a flat cut across all medicines. Where the supply chain has been adding huge margins, this brings prices down a lot. For very expensive patented drugs, the effect is much smaller.

The move comes as the Supreme Court has been questioning the government about high medicine costs and the margins in the cancer treatment chain. The court is considering whether to cap trade margins on all non-scheduled drugs in the country. It has reserved its order, so it is not yet clear what will happen next.

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