Full Breakdown
Supreme Court Scrutinizes Ten-Fold Mark-Ups on Cancer Drugs
By Drooid · · How we work
Core Event – Court Raises Alarm Over Drug Pricing Disparities
On September 29 2026, a two-judge bench of Justices Vikram Nath and Sandeep Mehta questioned why an essential cancer drug supplied to retailers for roughly INR3,000 was sold to consumers for INR27,000. The justices described the gap as “carnage” and asked who benefits from the nearly INR24,000 difference. They also probed why the 16 % retailer margin prescribed in the Drugs (Prices Control) Order 2013 (DPCO) is not applied uniformly to all medicines.
Background & Context – Existing Price-Control Framework
The DPCO 2013 caps the maximum retail price (MRP) of “scheduled” medicines and fixes a 16 % margin on the price to retailer (PTR). Non-scheduled formulations, which the petitions estimate comprise about 80 % of the market by volume and value, are exempt from these ceilings and may see annual MRP increases of up to 10 %. The petitions before the court seek stricter enforcement of the DPCO and mandatory generic prescribing.
Timeline
- September 29 2026 – Supreme Court hearing petitions on drug pricing; justices highlight a ten-fold markup on a cancer drug and the practice of private hospitals forcing patients to buy from in-house pharmacies.
- October 12 2026 – Matter scheduled for further hearing; the Centre asked for time to consult with relevant departments.
Data & Statistics
- Retailer price of the cited cancer drug: ? INR2,700-INR3,000.
- Maximum retail price (MRP) of the same drug: INR27,000 – a ten-fold increase.
- Statin without aspirin: INR40; statin-aspirin combination: INR70.
- DPCO-mandated retailer margin: 16 % of MRP for scheduled medicines.
Official Statements & Responses
The bench warned that inflated MRPs burden both patients and taxpayers, especially when treatment is reimbursed under government schemes such as Ayushman Bharat. Justice Mehta asked why the distinction between essential and non-essential medicines matters if the same markup occurs.
Solicitor General Tushar Mehta acknowledged the concern, stating the government must find a “balance between equities.” He argued that private hospitals, rather than pharmaceutical manufacturers, are the primary beneficiaries of the markup and requested a short adjournment to confer with officials before submitting detailed submissions.
Verbatim Quotes
- “If that patient is taking treatment under a government scheme, who reimburses? The taxpayer does. So why not uniform criteria?” — Justice Mehta
Why It Matters – Impact on Patients and Public Finances
When a patient under a government-funded scheme purchases a drug at the inflated MRP, the hospital receives reimbursement from public funds, effectively shifting the cost to the taxpayer. The court also noted that large price gaps can erode patient trust, as cheaper alternatives may be perceived as counterfeit. Addressing the markup could reduce out-of-pocket expenses for vulnerable patients and lower the fiscal load on health-care schemes.
Conflicting Reports & Gaps
All sources consistently report the ten-fold price difference and the court’s call for uniform margins; no contradictory figures were identified. However, the petitions do not provide detailed breakdowns of how the INR24,000 markup is distributed across manufacturers, distributors, and hospital pharmacies, leaving a gap in understanding the exact profit channels.
