Karnataka has urged the Centre to extend proposed price controls on expensive, non-scheduled cancer medicines to other high-cost life-saving drugs used to treat cardiac and kidney ailments, widening a national debate over medicine affordability and trade margins.
The state government welcomed the Supreme Court’s observations on excessive mark-ups on essential medicines and asked the Union government to apply similar controls to drugs used for other serious conditions. “The state government also hereby requests the Union Government to extend this capping to other essential life-saving medicines necessary for treatment of cardiac, kidney ailments etc., particularly high-cost drugs, to reduce the burden of treatment in terms of cost to the common man,” it said.
The appeal follows an in-principle decision by the National Pharmaceutical Pricing Authority (NPPA) to cap trade margins on identified non-scheduled anti-cancer medicines at 30 per cent of their maximum retail price. The final list of medicines to be covered is yet to be determined.
The Supreme Court has questioned why the maximum retail price of essential medicines, including cancer drugs, could not be capped at 16 per cent above the price to retailer, a limit applicable to scheduled medicines under the Drugs (Prices Control) Order, 2013. The court’s observations have added legal and policy pressure to the pricing discussion, although the proposed anti-cancer measure is proceeding through the NPPA and government framework.
In a letter dated September 23 to Union Health Minister J P Nadda, Karnataka sought urgent national measures after inspections identified pricing concerns in 253 medicines and medical consumables. The state cited substantial differences between procurement costs and the prices charged to patients. The inspection findings formed the basis for Karnataka’s request to bring additional high-cost medicines under a more comprehensive pricing framework.
Karnataka has also proposed bringing advanced chemotherapy, targeted therapy and other expensive cancer medicines under the Drugs (Prices Control) Order. Its suggestions include comprehensive trade-margin limits and a requirement for hospitals and pharmacies to disclose the purchase cost, maximum retail price and additional margins in patient bills.
A circular issued to healthcare institutions on October 1 directs them to mention the purchase cost and maximum retail price of medicines in bills from November 1. The instructions are advisory in nature, meaning the circular seeks greater visibility for patients but does not itself establish a mandatory national price ceiling for the medicines covered by the state’s request.
The NPPA approved the proposed 30 per cent trade-margin cap in principle at its meeting on October 8 under Paragraph 19 of the Drugs (Prices Control) Order, 2013. An expert committee under the Directorate General of Health Services is expected to recommend the medicines to be included by October 14.
The Centre estimates that the proposed measure could reduce the maximum retail prices of several cancer medicines by 20 to 70 per cent and potentially save patients around Rs 2,500 crore. Karnataka’s latest request seeks to extend that affordability effort beyond oncology, but any wider price-control framework for cardiac, kidney and other life-saving medicines would require further action by the Union government.
