The Supreme Court on September 22 raised serious concerns over the pricing of essential cancer medicines after being informed that a drug supplied to retailers for ₹2,700 carried a Maximum Retail Price (MRP) of ₹27,000. A Bench of Justices Vikram Nath and Sandeep Mehta questioned how a ten-fold difference could be permitted and criticised the lack of effective action by authorities responsible for regulating medicine prices. The Court also examined allegations that some private hospitals compel patients to purchase medicines from their in-house pharmacies, potentially leaving them with little choice but to pay inflated MRPs.
It further flagged the implications for taxpayers when expensive medicines are reimbursed through government health schemes. The Centre said it was approaching the matter in a “non-adversarial” manner and indicated that it was willing to examine improvements to the system. The case is scheduled for further hearing on September 29.
A Ten-Fold Difference
The sharpest concern before the Court was the gap between the Price to Retailer (PTR), the amount at which a medicine is supplied to retailers, and the MRP printed on the package. The Bench was told that an essential cancer medicine had a PTR of ₹2,700 but an MRP of ₹27,000. Justice Sandeep Mehta described the disparity as “broad daylight dacoity” and questioned how patients could be expected to pay ten times the retailer price for a life-saving medicine. The Court also questioned why regulators had remained silent when such large differences existed.
The proceedings also brought attention to the wider financial burden of cancer treatment. The Bench noted that families can be forced to sell assets or jewellery to meet treatment expenses. While such observations were made in the context of the petitions before the Court, they underline the vulnerability of patients who may have limited ability to compare prices or seek alternatives when medicines are required urgently. The Court’s concern was therefore not limited to the printed price itself, but also to the circumstances in which patients obtain medicines during treatment.
Hospital Pharmacies Under Scrutiny
The Court also examined allegations concerning private hospitals and their pharmacies. One petition alleged that patients were sometimes prevented from buying prescribed medicines from outside pharmacies and were instead required to purchase them through hospital-run outlets, where medicines could be sold at their printed MRP. The petitions before the Court also raised concerns about pharmaceutical companies, retailers and prescribing practices, including whether cheaper generic alternatives are being adequately considered.
The issue becomes particularly significant when government-funded healthcare schemes are involved. The Court observed that if hospitals purchase medicines at inflated prices and subsequently claim reimbursement under schemes such as Ayushman Bharat, the eventual financial burden can fall on taxpayers. The Bench described this as a concern involving public money. The Court also referred to the existing price-control framework, with reports noting that medicines outside the scheduled list do not have the same ceiling-price controls. The National Pharmaceutical Pricing Authority (NPPA) regulates prices of scheduled medicines under the Drugs (Prices Control) Order, 2013.
Centre Says It Is Open To Improving The System
Additional Solicitor General K M Nataraj, representing the Union government, told the Court that the Centre was not approaching the matter as an adversarial litigation. He pointed to the government’s efforts to make affordable medicines available through Jan Aushadhi Kendras and said, “Medicine should reach the last person.” The pharmaceutical industry’s position was also raised during the hearing. Senior Advocate Kapil Sibal, appearing for the Indian Pharmaceutical Alliance, argued that manufacturers may not necessarily retain the largest margins and that margins earned by other participants in the supply chain also need examination.
The petitions seek stronger safeguards against excessive medicine pricing, better enforcement of existing price-control provisions and greater access to affordable medicines. The Court is expected to consider proposals relating to initial price fixation and generic prescribing when the matter comes up again on September 29. The proceedings could therefore have implications beyond cancer medicines, particularly for how medicine prices are determined and how patients are protected from excessive costs.
The Logical Indian’s Perspective
Healthcare becomes meaningful only when patients can access treatment without being pushed into avoidable financial distress. The concerns raised before the Supreme Court point to the need for greater transparency across the medicine supply chain, stronger enforcement of pricing rules and clearer choices for patients, while ensuring that manufacturers, retailers and hospitals can operate within fair and accountable systems. Affordable healthcare should be built around dignity, informed choice and compassion, especially when families are already navigating the emotional and financial strain of serious illness. What steps can make essential medicines more affordable while ensuring transparency and fairness for patients, hospitals and the pharmaceutical industry?
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