The National Pharmaceutical Pricing Authority (NPPA) has capped trade margins at 30 per cent of the maximum retail price (MRP) for 137 non-scheduled anti-cancer drugs in a move aimed at making cancer treatment more affordable.The revised prices will come into effect on November 9 and remain in force until further orders.The measure covers a range of expensive cancer medicines, including targeted therapies and immunotherapies such as pembrolizumab, nivolumab, osimertinib, palbociclib, ribociclib, abemaciclib, atezolizumab and bevacizumab.“The intervention followed deliberations on excessive trade mark-ups in non-scheduled anti-cancer medicines. We had observed that such mark-ups warranted extraordinary action in the public interest, following the precedent set in 2019,” the NPPA said.The revised MRP will be calculated using manufacturers’ net sales realisation for March 2026, excluding government sales. If no sales were recorded during that month, sales data for the period from April 2025 to March 2026 will be considered, it said.Manufacturers will have to reduce prices wherever the existing MRP exceeds the amount calculated under the new formula. If the existing MRP is lower, the lower price will continue to apply.The order will cover all non-scheduled formulations containing any of the 137 specified drugs, whether prescribed individually or in combination, irrespective of strength, dosage form or route of administration. The provisions will also apply when these formulations are used for therapeutic indications other than cancer.“The list of 137 medicines has been drawn up on the basis of recommendations from an expert committee of the Union Health Ministry and may be updated periodically in response to market developments and public health requirements,” the statement said.In a significant clarification, the NPPA has included patented medicines within the scope of the order unless an exemption has been granted.The regulator has also laid down conditions for excluding medicines supplied free of cost under Patient Assistance Programmes (PAPs) from price-to-stockist (PTS) and price-to-distributor (PTD) calculations. Manufacturers will have to submit the prescribed undertaking, maintain comprehensive patient records, including identity and treatment details, and permit NPPA audits.Failure to meet these conditions will make the quantities supplied under such programmes liable for inclusion in the calculations.“For formulations launched after March 31, 2026, the MRP will be determined using the prevailing PTS/PTD (price to retailer) and the same formula. In cases where medicines are supplied directly to hospitals or medical institutions, the institution will be treated as the stockist or distributor,” the NPPA said.Companies have also been directed to issue price lists in Form V through the Integrated Pharmaceutical Database Management System (IPDMS) and ensure that the revised prices are prominently displayed at retail outlets and hospitals.To prevent shortages, manufacturers have been instructed to maintain existing production levels. Any reduction in average monthly production will require prior permission from the NPPA, while discontinuation of a formulation will require six months’ advance notice in Form IV, the statement added.Hospitals and medical institutions have been asked to monitor prices and report violations, while State Drug Controllers will oversee compliance.