Cancer treatment can be expensive, but the cost of medicines that are used to treat the disease varies widely. In a move to make cancer care more affordable, the National Pharmaceutical Pricing Authority (NPPA) has revised the maximum retail prices (MRPs) of 543 cancer drug brands and pack sizes. This comes after the government's decision to cap trade margins on 137 non-scheduled anti-cancer medicines at 30 per cent. The revised prices, which will come into effect from November 9, 2026, have brought significant relief for several patients.
Some cancer medicines have become more than 90 per cent cheaper. Price reductions have also been seen in drugs that are used to treat breast, prostate and other cancers. However, the price cuts have not been uniform. Several expensive medicines, including Keytruda, have remained unchanged. This raises an important question: Why do some cancer drugs cost much less while others continue to be expensive?
Why Are Some Cancer Drugs Cheaper Than Others?
The price of a cancer medicine depends on several factors, including how it is developed, whether its patent protection has expired, the number of companies manufacturing it and how it reaches patients. Here are some important reasons behind the difference.
1. Generic Medicines Cost Less
One of the biggest reasons some cancer medicines are cheaper is the availability of generic versions. A generic medicine contains the same active ingredient as the original branded drug and is expected to provide the same therapeutic effect when approved for the same use. However, it is usually sold at a lower price.
This is because generic manufacturers do not have to repeat the entire original drug discovery and development process. When multiple manufacturers produce the same generic medicine, competition can further bring down prices.
2. Patent Protection Can Keep Medicines Expensive
Patents give pharmaceutical companies exclusive rights to manufacture and sell a newly developed drug for a specified period. During this time, other companies generally cannot manufacture and sell the same drug as a generic version without the patent holder's permission. This gives the original manufacturer control over pricing because there may be no direct generic competition. Once patent protection expires, other manufacturers can enter the market. The availability of cheaper alternatives can then bring down the price. Therefore, newer cancer medicines, particularly those still under patent protection, may remain expensive.
3. Research And Development Costs Are High
Developing a new cancer drug is a long and expensive process. It involves years of research, preclinical testing and clinical trials to find whether the medicine is safe and effective. Clinical trials may involve several phases and large groups of patients. Researchers also need to study the right dosage, possible side effects and how well the drug works against a particular cancer. Not every drug that enters development successfully reaches the market.
These investments can lead to the high prices of newly developed cancer treatments. However, research costs alone do not determine a medicine's final price.
4. Limited Competition Keeps Prices High
The number of manufacturers selling a particular cancer drug can significantly impact its price. When several companies manufacture the same medicine, they compete for customers, which can reduce the prices. However, if only one company supplies a particular drug, there is little direct competition.
According to the latest NPPA price revision, at least 65 high-cost, single-source cancer medicines have remained unchanged in the comparison of their pre-cap and revised prices. Keytruda, which contains pembrolizumab and is used to treat more than 21 cancer types, remains priced at Rs 2,16,500 for a 100 mg vial. Other medicines, including Tagrisso, Tecentriq, Darzalex and Imfinzi, have also remained unchanged.
5. Manufacturing Complex Medicines Can Be Expensive
Not all cancer medicines are made in the same way. Some are relatively simple chemical compounds, while others are complex biological medicines developed using living cells or biological processes.
Biological medicines can be difficult to manufacture because the production process requires specialised facilities, advanced technology and strict quality controls. Their manufacturing and storage requirements can also be more demanding.
Biosimilars are highly similar versions of an already approved biological medicine. They can provide more affordable alternatives, although developing and manufacturing them is more complex than producing conventional generic medicines.
6. Distribution Margins Also Affect The Final Price
The price patients pay is not always the same as the amount charged by the manufacturer. Medicines go through different stages of the supply chain, including distributors, stockists and pharmacies. Each of these phases may add a margin to the price. The government's latest intervention addresses this part of the pricing structure by capping trade margins at 30 per cent for 137 non-scheduled anti-cancer medicines.
This also explains why some medicines will see a substantial price reduction while others will not. If a drug has high mark-ups across its supply chain, restricting these margins can bring down its MRP considerably. However, if the manufacturer's starting price is already high, a trade-margin cap may not be beneficial.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.