For a woman in Bengaluru on long-term hormone therapy for breast cancer, a month of anastrozole 1 mg costs around ₹2,087. From November 9, the same supply is estimated to cost ₹219.
Oncologists call that a real gain for families. Most also say it is only a first step, because the drug is one line in a bill that runs to scans, surgery, hospital beds and travel. Whether the new price rules are enough depends on what they cover and what they leave out.
“The new cap on drug margins will bring down pharmacy-related costs substantially,” says Dr Aju Mathew, consultant oncologist at MOSC Medical College, Kolenchery. Dr Arun R Warrier, senior consultant in medical oncology at Aster Medcity, Kochi, calls it “a welcome change towards reduction of financial burden.”
The gains are largest in long treatments. Dr Poovanma C U, head of breast oncology at Aster CMI Hospital, Bengaluru, says a 100 mg bevacizumab injection vial falls from about ₹21,768 to ₹5,930, a saving of nearly `15,838 per vial. Together with the anastrozole saving of about `1,868/month, she says, reductions like these are significant financial assistance for families in treatment for months or years. “These savings will vary from patient to patient depending upon their dosages and treatment regimen,” she adds.
Dr Joshi says what is at stake is whether families can continue at all. Those without adequate insurance are often forced to delay treatment or struggle to afford follow-up medication.
What is left out
The first gap is coverage. The cap applies to non-scheduled drugs, while 65 single-source, high-cost patented drugs stay at their current prices because of limited competition. Dr Warrier notes the cap is not applicable to all drugs. “Particularly, immunotherapy drugs still remain expensive,” he says. Dr Joshi says the real impact will depend on the new price of each drug and on whether it is available in the market.
The second is the rest of the bill. Dr Poovanma points out that investigations, admission, surgery and radiotherapy add to the cost of treatment. Dr Joshi says patients also pay for further tests, hospitalisation and managing side effects. Dr Warrier sounds a caution: “It must also be ensured that reduction in cost should not be offset by an increase in the service charges. Only then will patients get full benefit of the drop in cost of cancer drugs.”
The third is capacity. “Governmental capacity to treat cancer based on contemporary protocols in a timely manner is still lacking,” says Dr Mathew. “Even now, for basic biopsies, there are insufficient doctors and facilities. The latest treatment modalities mostly remain outside of governmental infrastructure.” A cheaper drug does little for a patient who cannot get a timely biopsy or a place in a public facility.
Dr Manjunath says affordable drugs matter but cannot stand alone. Lower prices, he says, should be accompanied by “rational diagnostic services, good treatment infrastructure, supportive and palliative therapy, rehabilitation, and counselling.” Cancer treatment must be “not just about curing the disease, but also preserving quality of life and the patient’s finances during the process.”
Dr Rajagopal of Pallium India argues that the missing piece is community-based support. He advocates involving communities in healthcare delivery so that patients receive comprehensive care, with prevention, treatment and relief of suffering addressed together rather than left entirely to hospitals. Trained local support, he says, can help meet the physical, psychological and social needs that medical treatment alone may not resolve.
Capping drug margins will save families crores at the pharmacy counter, a vital and long-overdue step.
What the doctors quoted here ask for next is the rest of the system: timely diagnosis, stronger public treatment capacity and care closer to home.