Cancer Medicine Price Hike: Supreme Court Questions 10-Fold Markup on Cancer Drug

The Supreme Court has raised serious questions over the steep prices of cancer medicines and the wide gap between the price at which drugs are supplied to retailers and their maximum retail price (MRP).
A bench comprising Justices Vikram Nath and Sandeep Mehta questioned the Centre during a hearing on Tuesday, September 29, over how a cancer medicine supplied to a retailer for around ₹2,700 could carry an MRP of ₹27,000. The court described the 10-fold difference as a deeply serious issue and sought an explanation for the pricing mechanism.
The bench was hearing petitions concerning medicine pricing, generic prescriptions and price controls under the Drugs (Prices Control) Order, 2013. Solicitor General Tushar Mehta appeared for the Centre during the proceedings.
The court also questioned the financial burden placed on patients when expensive medicines are covered under government healthcare schemes. It observed that when such treatment is reimbursed through government schemes, the eventual burden can fall on taxpayers.
The Supreme Court further raised concerns about the practice of some corporate hospitals requiring patients to purchase medicines from their own pharmacies. The court asked the Centre to examine the issue, particularly where patients may not be permitted to buy the same medicines from outside pharmacies.
During the hearing, the court also asked why a uniform pricing framework could not be considered for medicines. The bench raised the possibility of limiting the MRP to 16 per cent above the price to retailer (PTR), rather than maintaining different approaches based on whether medicines fall under price-control categories.
Cancer Medicine Sales Rise 56 Per Cent in Three Years
According to the Department of Pharmaceuticals' 2025-26 annual report, annual sales of anti-cancer medicines in India stood at ₹5,281 crore in 2024-25, compared with ₹3,382 crore in 2021-22. This represents an increase of around 56 per cent over three years.
The pricing issue has also brought attention to the difference between medicines covered by government price controls and those outside the controlled framework. Petitioners argued that medicines whose prices are directly regulated by the government account for a relatively small share of the market, while medicines outside direct price regulation account for more than 80 per cent of the market.
The petitioners said that such pricing differences can increase the overall cost of treatment and place a significant financial burden on patients. They also pointed to instances in which families facing expensive cancer treatment may be forced to sell assets or jewellery to meet medical expenses.
What Does DPCO Say About Medicine Prices?
Under the Drugs (Prices Control) Order, or DPCO, essential medicines included in the National List of Essential Medicines (NLEM) are subject to government price regulation. Under the 2013 DPCO framework, the government determines the ceiling prices of medicines covered by the list.
The pricing process for essential medicines takes into account the prices of medicines already available in the market. Selling a scheduled medicine above the government-prescribed ceiling price is not permitted.
The Ministry of Health prepares and periodically reviews the National List of Essential Medicines, taking into account factors including the prevalence of diseases, public health needs, safety and efficacy of medicines. New medicines can be added to the list when required.
Medicines outside the essential-medicine price-control framework have comparatively less direct government control over their prices. The Supreme Court's latest observations have brought renewed attention to this distinction and the wider question of how medicine pricing affects patients and public healthcare expenditure.