New Delhi, September 29, 2026 (SDNA) — The rising cost of cancer treatment has once again come under judicial scrutiny, with the Supreme Court raising pointed questions over the wide gap between the cost of medicines and their maximum retail prices.
During Tuesday’s hearing on petitions concerning the pricing of cancer medicines, the bench of Justice Vikram Nath and Justice Sandeep Mehta was presented with an example of a medicine reportedly costing around ₹2,700 but carrying an MRP of ₹27,000. The substantial difference prompted the court to question how such pricing affects patients and who ultimately bears the financial burden.
Who ultimately pays the additional cost?
The court also examined the issue from the perspective of government-funded healthcare schemes. Questions were raised about who bears the additional expenditure when expensive medicines are used in the treatment of patients covered under public health programmes.
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The broader concern is that higher medicine costs can eventually have an impact on public expenditure and, indirectly, on taxpayers. The bench also raised issues relating to private hospitals and the practice of patients being required to purchase medicines from hospital-operated pharmacies.
Appearing for the government, Solicitor General Tushar Mehta presented the Centre’s position on medicine pricing and the economics of the pharmaceutical sector. The hearing also brought attention to the respective roles and commercial interests of drug manufacturers and private hospitals.
Cancer medicine market has expanded
Data from the Department of Pharmaceuticals’ Annual Report 2025-26 was also referred to during the proceedings. According to the figures cited, sales of anti-cancer medicines in India stood at around ₹5,281 crore in 2024-25, compared with approximately ₹3,382 crore in 2021-22.
The increase in sales does not necessarily mean that the entire rise resulted from higher medicine prices. Factors such as the number of patients, treatment patterns, availability of medicines and broader market conditions can also influence total sales.
How are medicine prices regulated?
The pricing framework for medicines varies depending on the category. Certain essential medicines fall under government price regulation, while direct price control is more limited for several other medicines.
Under the Drug Price Control Order (DPCO), 2013, medicines included in the National List of Essential Medicines (NLEM) are subject to price-control provisions. The applicable regulated ceiling price limits the maximum price at which such medicines can be sold.
The NLEM covers medicines considered essential from the perspective of the country’s healthcare requirements. The list is periodically reviewed and can be revised in response to changing medical and public-health needs.
Petitioners question limited coverage of price control
During the hearing, the petitioners argued that medicines directly covered by government price controls represent only a limited portion of the overall market, while many other medicines remain outside direct price regulation.
According to the arguments presented, substantial differences in medicine prices can have a direct impact on the overall cost of treatment. For patients requiring prolonged therapy, recurring medicine expenses can become a significant financial challenge for their families.
Court had raised pricing concerns earlier
The issue had also come up during the September 22 hearing in the same matter. At that stage, the court had raised concerns about differences between regulated prices of essential medicines and the amounts charged to patients.
The latest example involving a medicine reportedly costing ₹2,700 but carrying an MRP of ₹27,000 has brought the question of pricing transparency and affordability back into focus.
The larger issue is the total cost of treatment
Cancer treatment can extend over a long period and may involve several expenses beyond medicines, including diagnostic tests, hospitalisation, consultation, radiation therapy, surgery and other medical services.
Against this backdrop, a significant difference between the underlying cost of a medicine and its retail price can become an important component of a patient’s overall healthcare expenditure.
The Supreme Court proceedings therefore extend beyond the pricing of a particular medicine. They touch upon the broader framework of drug-price regulation, pharmaceutical and hospital practices, public healthcare expenditure and the financial burden on patients.
What lies ahead?
The ongoing proceedings have brought several questions surrounding medicine pricing, regulation of essential drugs, pharmacy practices in private hospitals and healthcare affordability before the court.
Further hearings may bring additional clarification from the government and other stakeholders on these issues.
For cancer patients and their families, the debate goes beyond the MRP printed on a medicine pack. It raises a larger question of how healthcare systems can ensure greater transparency in pricing while keeping essential treatment financially accessible to those who need it.