Cancer Drug Price Caps Announced: Which Cancer Treatments Could Get Cheaper?

India’s latest cancer drug price caps have resulted in significant price reductions for some medicines, offering potential relief to patients facing high treatment costs. The steepest cuts were reported for Thiotepa, a chemotherapy medicine, and Pertuzumab, a targeted therapy used in certain breast cancer treatment settings. However, several expensive patented cancer medicines have seen no change in their listed prices.

The price revisions followed the government’s decision to cap trade margins on 137 cancer medicines. Pharmaceutical companies subsequently announced revised maximum retail prices (MRPs) for different brands, strengths and formulations of the selected drugs.

According to the reported data, the exercise covered 543 formulations. Prices remained unchanged for 146 formulations, while another 21 recorded reductions of less than ₹100. Despite substantial cuts for a handful of medicines, the average price change across all formulations was just over ₹5,000.

The figures reveal a mixed outcome. While some medicines have become considerably cheaper, the intervention has not reduced the prices of every cancer treatment, particularly several high-cost patented drugs.

Which Cancer Medicines Have Seen the Biggest Price Cuts?

The largest reductions were recorded for Thiotepa and Pertuzumab. Both medicines experienced substantial decreases in their listed prices, although the actual savings for patients will depend on their prescribed treatment and the formulations they require.

1. Thiotepa: Price reduced by 91%

Thiotepa, sold under the brand name Samtepa by Samarth Life Sciences, recorded the largest price reduction among the medicines highlighted in the reported data.

The price of a 100 mg vial fell from ₹80,071 to ₹7,150, representing a reduction of approximately 91%.

The revised price marks a substantial change from the previous MRP. For patients who require this specific formulation, the reduction could lower the medicine component of treatment expenses.

However, the actual financial benefit will depend on the prescribed dose, the number of vials required and the price charged when the medicine is purchased. Patients should confirm the applicable MRP with their hospital or pharmacy.

2. Pertuzumab: Price reduced by 68%

Pertuzumab, marketed as Hertumab by Glenmark, recorded the second-largest reduction among the highlighted medicines.

The price of a 30 mg vial fell from ₹94,951 to ₹30,593, a reduction of approximately 68%.

Pertuzumab is a targeted therapy used for certain types of breast cancer. Its use depends on the cancer’s characteristics and the patient’s individual treatment plan.

The revised price could make the listed formulation more affordable than before. Nevertheless, patients should consult their oncologists about treatment requirements and verify the price of the exact brand and strength prescribed.

3. Bevacizumab and other cancer medicines

The reported price data also mentions Bevacizumab, identified in the source as Ivzumab by RPG Life Sciences. However, the available information does not provide the complete previous and revised prices needed to calculate its reduction.

Across the wider group of medicines, the scale of price changes varied considerably. Some formulations recorded major cuts, while others became cheaper by less than ₹100.

The smallest reported reductions started at ₹0.79 and were seen among lower-priced medicines costing from a few hundred rupees to approximately ₹2,800.

This variation matters because a large percentage reduction in one medicine does not mean that all patients receiving cancer treatment will see comparable savings.

How Many Cancer Drug Formulations Have Become Cheaper?

The government’s intervention covered 137 cancer medicines, with companies reporting revised prices for 543 formulations representing different brands, strengths and doses.

The reported figures show three important trends:

• 146 formulations had no price change. Their listed prices remained the same following the revision exercise.

• 21 formulations saw reductions of less than ₹100. The monetary savings were relatively small for these products.

• Some medicines recorded substantial cuts. Thiotepa and Pertuzumab were among the clearest examples, with reductions of approximately 91% and 68%, respectively.

The average change across all formulations stood at just over ₹5,000, according to the reported data.

However, averages can conceal significant differences. A small number of expensive medicines with large price reductions can influence the overall figure, even when many formulations see limited changes or no reduction at all.

For patients, the most relevant figure is therefore the revised price of the medicine they actually need, rather than the average change across the entire list.

Why Have Keytruda and Ribociclib Prices Remained Unchanged?

One of the most significant findings is that the prices of medicines covered by patents, licences or other protection mechanisms remained unchanged.

Two examples highlighted in the report are pembrolizumab, sold as Keytruda, and ribociclib, marketed under the brands Kryxana and Kisqali.

These medicines are associated with substantial treatment costs, making their unchanged prices an important part of the wider affordability debate.

Pembrolizumab: Keytruda remains at ₹2.16 lakh per vial

Pembrolizumab is an immunotherapy medicine used to treat several cancers, including certain cases of lung and breast cancer. Its use depends on the specific diagnosis and approved treatment indication.

According to the reported figures, the price of a 100 mg vial remained unchanged at approximately ₹2.16 lakh.

The continued high price is significant because patients may need repeated doses as part of a prescribed treatment regimen. The total medicine cost depends on the treatment schedule, dosage and duration recommended by the oncologist.

An investigation by The Indian Express reportedly found that some patients struggled to afford pembrolizumab even with assistance through patient support programmes.

The unchanged MRP illustrates a central limitation of trade margin regulation. Controlling margins across the distribution chain may not be sufficient to reduce the underlying price of a patented medicine, particularly when competition from alternative manufacturers is limited.

Ribociclib: Monthly treatment costs remain a concern

Ribociclib is used in certain breast cancer treatment settings and is marketed under the brands Kryxana and Kisqali.

The reported price of a pack containing 21 tablets of 200 mg each remained unchanged at ₹24,435.

The medicine has previously featured in affordability concerns, including a petition before the Kerala High Court seeking government intervention to improve access.

According to the source report, the monthly cost of ribociclib increased from approximately ₹58,000 in 2022 to ₹78,000 in 2025.

The report also notes that ribociclib was among the medicines included in a government pilot initiative launched in 2019 to address medicine pricing.

The continued high cost raises questions about whether trade margin controls alone can provide sustained relief for patients who need long-term cancer treatment.

For people who require ongoing medication, the monthly expense can accumulate over time. Even when individual price changes appear modest, the cumulative cost can have a significant effect on household finances.

What Is Trade Margin Capping, and How Does It Work?

Trade margin capping is a pricing measure intended to limit the margin added as a medicine moves through the distribution chain.

Medicines may pass from manufacturers or importers to distributors, stockists, pharmacies and, ultimately, patients. Each stage can involve commercial margins that contribute to the final retail price.

By placing a limit on these margins, regulators aim to prevent excessive mark-ups and improve medicine affordability.

However, the effect of such a policy depends partly on the price used as the starting point for calculating the permitted margin.

If the initial price is already high, restricting the percentage added further along the distribution chain may not reduce the final price enough to make the medicine affordable.

This distinction is particularly important for high-cost cancer therapies, where the underlying price can account for a substantial share of the patient’s total medicine expenditure.

Why Experts Say the Price Caps May Have Limited Impact

K. M. Gopakumar, co-convenor of the Working Group on Access to Medicines and treatments, said the revised MRPs supported concerns that trade margin rationalisation was unlikely to affect the prices of patented medicines in the absence of competition, as seen among generic manufacturers.

He also highlighted the continued inclusion of 34 of the 42 medicines covered by a government pilot project initiated in 2019.

In his assessment, the persistence of these medicines on the current list raised questions about the effectiveness of the measure in controlling medicine costs and improving affordability.

The reported experience of ribociclib was one example of the challenge: despite its inclusion in the earlier initiative, its monthly cost reportedly rose between 2022 and 2025.

These concerns point to a broader issue. A policy can regulate distribution margins without necessarily addressing the factors that determine the initial price of a medicine.

As a result, the impact on patients may vary according to the medicine, the number of available manufacturers and the pricing arrangements used throughout the supply chain.

Why the Starting Price Matters in Medicine Pricing

Experts have argued that price reductions could be more substantial if trade margins were capped against the cost of manufacturing or importing a medicine rather than the price at the first point of sale.

The starting point matters because it determines the base on which the permitted margin is calculated.

Gopakumar previously described a hypothetical situation in which a company sells 1,000 vials to a distributor at an inflated price and offers another 500 vials free. He argued that arrangements of this kind could allow prices to remain artificially high even if the company complied with a 30% margin cap.

The example illustrates why the percentage margin alone may not provide a complete picture of medicine affordability.

If the base price is inflated, a capped margin can still result in a high final price. Effective regulation therefore depends not only on the permitted margin but also on how the initial price is determined, monitored and enforced.

Transparent pricing practices and effective oversight can be important in ensuring that reductions translate into meaningful savings for patients.

Can Patent Rules Help Make Expensive Cancer Drugs More Affordable?

The unchanged prices of certain patented medicines have renewed attention on the role of competition and patent-related provisions in improving access to treatment.

Generic competition can help place downward pressure on medicine prices when multiple manufacturers offer comparable products. Patented medicines may face fewer direct competitors while relevant patent protections remain in force.

Gopakumar argued that mechanisms available under Indian patent law, including compulsory licensing and government use of a patent, should be considered where necessary to improve the affordability of patented medicines.

These mechanisms are distinct from trade margin caps and are subject to specific legal requirements and procedures. Their use is not automatic and would depend on the relevant legal and factual circumstances.

The wider policy challenge is to determine how different tools can work together: trade margin regulation may address distribution mark-ups, while other pricing, competition or patent-related measures may be relevant when the underlying price remains high.

The unchanged prices of pembrolizumab and ribociclib demonstrate why the affordability debate extends beyond a single pricing intervention.

Did the Price Reductions Meet Regulatory Expectations?

The National Pharmaceutical Pricing Authority had indicated that the reductions in MRP would broadly fall within a range of 20% to 70%.

The reported revisions included cuts within that range, as well as larger reductions such as the 91% decrease for Thiotepa.

Yet a significant number of medicines, including some of the most expensive ones, remained unchanged.

This makes it important to distinguish between the scale of individual price reductions and the overall effectiveness of the policy.

A reduction of several thousand rupees may represent meaningful relief for one formulation, while a similarly sized reduction may have a different impact on a much more expensive medicine. Percentage reductions, absolute savings and the number of affected formulations all provide useful but different perspectives.

The unchanged prices of several patented therapies also show that the latest intervention has not addressed every source of high cancer medicine costs.

What Should Patients Do Before Buying Cancer Medicines?

Patients and caregivers can take several practical steps to understand whether the new prices apply to their prescribed medicines.

Check the exact medicine and strength. Confirm the brand name, active ingredient, strength, formulation and pack size. Different products may have different listed prices.

Ask for the revised MRP. Request a price quotation from the hospital pharmacy or retailer and check that it reflects the applicable price for the exact formulation.

Discuss alternatives with the oncologist. If a medicine remains unaffordable, ask whether a clinically appropriate alternative is available. Do not replace or discontinue a prescribed cancer medicine without medical advice.

Explore assistance programmes. Some manufacturers, hospitals and charitable organisations offer financial assistance to eligible patients. Availability and eligibility vary, so patients should confirm the current terms directly.

Review the full treatment bill. Medicine prices are only one part of cancer care. Hospitalisation, diagnostic tests, consultations, administration and supportive medicines may add to the total cost.

Patients should not assume that a reduction in one formulation’s MRP will automatically lower every component of their treatment bill. The actual savings depend on the prescribed regimen and the medicines required.

The Bigger Picture: Will Cancer Treatment Become More Affordable?

The latest cancer drug price revisions represent a substantial change for some formulations, particularly Thiotepa and Pertuzumab. Their reported reductions could offer meaningful savings to patients who need those specific medicines.

However, the unchanged prices of pembrolizumab and ribociclib highlight the limits of relying on trade margin caps alone.

The intervention has produced an uneven result: some formulations became considerably cheaper, others saw only marginal reductions, and 146 formulations recorded no change.

For policymakers, the next challenge is to assess whether the revised prices are being reflected in actual transactions and whether additional measures are needed for high-cost medicines with limited competition.

For patients and families, the most important step is to confirm the revised price of the exact prescribed formulation and discuss affordability concerns with the treating medical team.

Ultimately, making cancer treatment more affordable may require a combination of effective price regulation, transparent supply-chain practices, competition where possible and appropriate use of existing legal mechanisms. The latest reductions offer relief in some cases, but they do not yet resolve the wider challenge of access to expensive cancer medicines in India.