Supreme Court Calls 10-Fold Cancer Drug Markup 'Carnage', Weighs Uniform 16% Margin
核心洞察
India's Supreme Court on September 29, 2026 questioned a nearly ten-fold markup on an essential cancer (搜索) drug supplied to retailers at about Rs 2,700 and sold at Rs 27,000 MRP.
The bench of Justices Vikram Nath and Sandeep Mehta asked why the 16% retailer margin under the DPCO 2013 should not apply uniformly to all medicines.
Solicitor General Tushar Mehta said private hospitals, not pharmaceutical companies, appear to gain from the steep markups and sought two weeks to consult officials.
The Supreme Court of India (搜索) on September 29, 2026 pressed the Centre over a nearly ten-fold markup on an essential cancer (搜索) drug, describing the gap between the price to retailer and the maximum retail price as "carnage" and asking why the 16% retailer margin prescribed under the Drugs (Prices Control) Order, 2013 should not apply uniformly to all medicines.
A Bench of Justices Vikram Nath and Sandeep Mehta was hearing petitions filed by advocate Kishan Chand Jain and paediatric surgeon Sanjay Kulshrestha seeking regulation of prices for drugs, medical equipment and generic medicines. Justice Mehta pointed to a cancer (搜索) drug supplied to retailers for around Rs 3,000 and sold to consumers for Rs 27,000, asking who benefits from the roughly Rs 24,000 difference. "You tell us why this difference... Where does this chunk of money go? Ten times..." he remarked.
"Why not keep the 16% margin on MRP, which is prescribed in the DPCO, on everything? ... Ultimately, the loser is the taxpayer. This is carnage, as simple as that," the Bench said.
Where the margin accrues
Solicitor General Tushar Mehta, appearing for the Centre, acknowledged the concern and said the government would have to find a way forward while "balancing equities." He told the court that private hospitals, rather than pharmaceutical companies, benefit from the steep markups. "The pharma company is not the gainer. The gainer is the private hospital," he submitted. He sought two weeks to consult officials and place details of existing drug pricing mechanisms before the court.
The Bench also flagged the practice of private hospitals requiring patients to purchase medicines from their in-house pharmacies, leaving them little choice to procure the same drugs at lower prices elsewhere. The court said complaints that corporate hospitals insist on purchases from their own chemist or a designated pharmacy, and that treatment is not assured if medicines are bought outside, are serious.
Taxpayer burden under public schemes
The court pointed to the effect of inflated prices on public finances, observing that when treatment is covered under government-funded schemes such as Ayushman Bharat (搜索), the cost is ultimately borne by taxpayers. "Suppose the patient is taking treatment through government services... The government doesn't pay, the taxpayer pays. This affects a larger section of society," the Bench remarked.
The Bench also cited the pricing of a simple statin, which it said costs Rs 40 without combination and Rs 70 with aspirin, and questioned how such differences arise. "Corporate hospitals are industries. It is not a service at all. Why should the common man suffer all this?" the court asked.
Scope of the petitions
The petitions seek directions to make drug formulations more affordable by curbing alleged overpricing of essential medicines by pharmaceutical companies and retailers, and stricter enforcement of price controls under the DPCO, 2013 to prevent violations of the prescribed pricing mechanism and disproportionate profit margins across the supply chain. One petition also seeks disciplinary action against medical practitioners for not prescribing generic medicines.
The court noted that while scheduled medicines face ceiling prices, the bulk of non-scheduled formulations, estimated at around 80% or more by number and value in the market, allow manufacturers greater freedom in setting MRPs, subject to annual increase limits of 10%.
At the previous hearing on September 22, the top court described the wide difference between the price to retailers and the MRP as "dacoity" and "extortion," noting that one drug carried an MRP of Rs 27,000 despite being supplied to retailers for Rs 2,700. "People sell their houses, ornaments to get treatment," the Bench had remarked, adding that it was "very surprising that the authorities who are supposed to take action on this are silent."
The court said it will examine both the pricing of medicines and ethical practices in the medical sector in detail, and posted the matter for further hearing on October 12, 2026, when the Centre is expected to respond.