The cost of 12 cancer drugs could soon be capped in India if a recommendation from the country's National Pharmaceutical Pricing Authority (NPPA) is approved, The Indian Express reports.
At the same time, the government is actively looking into revising its National List of Essential Medicines (NLEM) following a proposal from a parliamentary committee for price caps to be extended to all drugs two weeks ago.
In India, the prices of drugs listed under the NLEM are capped by NPPA under the country's Drug Price Control Order (DPCO). The amount these drugs can be sold for is indexed to average wholesale prices of similar products, and can only be increased once per year, as was the case in April 2015, when the price of 509 products was allowed to increase by 3.84 percent.
Capping drug prices has been controversial in India. NPPA has faced challenges on both sides, from pharmaceutical companies that want to set their own prices and from members of the public, who have called for expanding the list of price-controlled drugs and criticized the government for allowing the 3.84% price increase last April.
Adding Cancer Treatments to NLEM
According to The Indian Express, NPPA is requesting that 12 cancer drugs be added to the NLEM. The drugs are used to treat a variety of cancers, including lymphoma, breast cancer and multiple myeloma.
The proposal is being praised by oncologists, such as Dr. P K Julka, who told The Indian Express that "bringing [the drugs] under price control will help a lot of patients." However, the Indian Pharmaceutical Alliance has come out against the proposal, claiming that "enforcing price control may actually end up affecting the availability of these drugs in the long term," and suggests state funding for these drugs as a better way of making them more accessible to patients.
In India, much of the population subsists on only a few dollars a day, and few have access to health insurance. This can make access to medicines difficult, especially for cancer drugs like the ones NPPA is proposing to put under price control. The prices for the 12 cancer drugs currently range from Rs 3,000 to Rs 800,000—about $47 to $12,624 USD—but could drop considerably if capped.
Expanding the NLEM and Controlling Costs
While it remains to be seen whether the Department of Pharmaceuticals will approve NPPA's proposal, it is clear that the government is strongly considering ways to expand price controls on drugs.
In response to an inquiry from the Lok Sabha, India's lower house of parliament, on what steps the government has taken to make medicines more accessible, Minister of Chemicals and Fertilizers Ananth Kumar said his ministry "has constituted a core committee of experts to review and recommend the revision of the NLEM 2011."
Kumar also pointed to the Department of Pharmaceuticals' Jan Aushadhi initiative intended to make medicines more affordable in the country. The initiative establishes special pharmacies licensed by the government to promote the use of inexpensive generic medicines. To date, more than 100 Jan Aushadhi stores have opened across India.
Other initiatives have included restrictions on how much a company can raise the price of non-NLEM medicines in a single year and standardizing the value-added tax levied on medicines.
The Indian Express, The Economic Times