Prices of several cancer drugs unchanged despite trade margin cap

Prices of several cancer medicines, including expensive patented drugs, remained unchanged after the government capped trade margins on 137 cancer medicines, according to revised maximum retail prices (MRPs) announced by manufacturers on Tuesday.

Of the 543 formulations covering different brands and doses of the selected drugs, 146 saw no price change, while 21 recorded reductions of less than Rs 100. The average price reduction across all formulations was just over Rs 5,000.

The prices of patented drugs, including pembrolizumab, sold as Keytruda by Merck, and ribociclib, sold as Kryxana or Kisqali by Novartis, remained unchanged. A 100 mg vial of Keytruda costs Rs 2.16 lakh, while a pack of 21 ribociclib tablets of 200 mg each costs Rs 24,435.

“The list of revised MRP confirms our view that trade margin rationalisation is unlikely to affect the prices of patent drug in the absence of competition as seen among generic manufacturers,” said K M Gopakumar, co-convenor of the Working Group on Access to Medicines and Treatments.

He added that 34 of the 42 drugs included in the government’s 2019 pilot project remained on the current list, “meaning the measure remained ineffective in controlling the cost of the medicines and making them affordable.”

Ribociclib's monthly cost rose from Rs 58,000 in 2022 to Rs 78,000 in 2025, despite being part of the pilot project.

The steepest price reduction was recorded for thiotepa, sold as Samtepa by Samarth Life Sciences. Its price fell 91%, from Rs 80,071 to Rs 7,150 for a 100 mg vial. Pertuzumab, sold as Hertumab by Glenmark, saw a 68% reduction, from Rs 94,951 to Rs 30,593 for a 30 mg vial.

Experts said price reductions could be more significant if trade margins were capped based on manufacturing or import costs rather than the price at the first point of sale.