NPPA: Revised MRPs for 137 anti-cancer drugs, effective 9 Nov

Revised maximum retail prices for medicines covered by the National Pharmaceutical Pricing Authority’s (NPPA) intervention on 137 anti-cancer drugs are to take effect on 9 November 2026, according to the authority’s meeting minutes. Manufacturers must reduce prices that exceed the prescribed formula, while retaining existing prices wherever these are already lower.

The implementation now includes a brand-level price list. Moneycontrol reported, citing a government release, that revised maximum retail prices (MRPs) had been listed for 543 brands, based on information submitted by pharmaceutical companies up to 27 October. The report said NPPA would update the list as further submissions arrived.

The change follows the NPPA’s decision to cap trade margins on 137 anti-cancer drugs. The authority’s minutes of meetings held on 16 and 17 October 2026 set the maximum trade margin at 30 per cent of MRP, excluding GST. That is a limit on the distribution margin, not a uniform 30 per cent reduction in every medicine’s price.

Moneycontrol reported that Anarzole, an anastrozole tablet manufactured by RPG Life Sciences, had its MRP revised from Rs 695.76 to Rs 73 for a pack of 10 tablets. It also reported a reduction for Dr Reddy’s Laboratories’ Azacytin injection from Rs 6,337 to Rs 1,495.04. These are individual product revisions, rather than a common discount applying across the covered drugs.

How the revised price is calculated

The NPPA minutes record that the authority invoked Paragraph 19 of the Drugs (Prices Control) Order, 2013, citing extraordinary circumstances and public-interest grounds for intervening in excessive trade mark-ups.

The intervention covers non-scheduled formulations. Under the Department of Pharmaceuticals’ Drugs (Prices Control) Order, 2013, these are medicines whose dosage and strength are not specified in the order’s First Schedule.

NPPA’s formula starts with the price to stockist or distributor: the manufacturer’s price at the first point of sale. The minutes specify a trade margin of no more than 30 per cent of the resulting MRP before GST, equivalent to a maximum mark-up of 42.86 per cent on that first-sale price. Applicable GST is then added.

For the reference price, manufacturers must divide their net sales realisation for March 2026 by the quantity sold that month, according to the minutes. If there were no sales in March, they must use sales realisation and quantities for April 2025 to March 2026. Government sales are excluded from this calculation.

For covered formulations launched after 31 March 2026, the authority decided that the formula would use the current price to stockist or distributor.

The minutes require both branded and generic versions priced above the calculated limit to be reduced. A manufacturer cannot use the formula to raise an existing lower MRP. The revised prices are to remain in force until further orders, with annual increases permitted under Paragraph 20(1) only while continuing to comply with the maximum trade margin.

Coverage extends to direct hospital supplies

The NPPA minutes say the Ministry of Health and Family Welfare’s expert committee recommended the 137 drugs for the exercise after examining information and options for improving affordability. The authority said the list could be updated periodically in response to market developments and public-health considerations.

According to the minutes, the formula applies to non-scheduled formulations containing a listed drug, whether alone or in combination. Coverage does not depend on strength, dosage form or route of administration, and also extends to formulations used for another therapeutic indication.

Patented medicines are covered too, unless an exemption has been approved under Paragraph 32 of the pricing order, the authority decided.

Direct supplies to hospitals are expressly addressed. Where a manufacturer supplies a formulation directly to a hospital or medical institution, NPPA’s minutes treat that institution as the stockist or distributor. The manufacturer’s invoice data to the institution must therefore be used to calculate the revised MRP.

The authority also allowed a conditional exclusion for quantities supplied free to patients under manufacturers’ Patient Assistance Programmes. According to the minutes, manufacturers must provide an undertaking and maintain supporting records to qualify. NPPA reserved the right to seek information, conduct audits or inspections, and verify programme implementation through third parties.

Price disclosure, monitoring and supply

Manufacturers were required to submit revised MRP information to NPPA and the relevant State Drug Controller within seven days of publication of the order in the Official Gazette, according to the authority’s minutes. This reporting requirement applies even when a product’s MRP does not change.

The minutes also require manufacturers to issue the prescribed Form V price list and provide copies to State Drug Controllers, dealers and other required recipients within the same period. Retailers, dealers, hospitals and institutions must display the price lists prominently under Paragraph 25(3), the provision governing such display.

DD India reported that retailers and hospitals must charge the reduced prices from 9 November and display the revised lists in their pharmacies. It also reported that hospitals must prominently publish the prices on their websites.

The NPPA minutes assign compliance monitoring to State Drug Controllers and require manufacturers, dealers, hospitals and medical institutions to assist verification. Hospitals and institutions must also monitor MRPs and report violations to NPPA, reflecting the volume of anti-cancer medicines supplied directly to them.

The authority said violations would attract action to recover overcharged amounts under the pricing order. Its minutes also state that failure to submit revised MRP information would be treated as non-reduction of prices and trigger recovery proceedings.

Alongside pricing compliance, NPPA directed manufacturers to maintain existing production levels. The minutes require prior permission before reducing average monthly production and prescribed notice at least six months before discontinuing production or imports.