When Sarojam Radhakrishnan was diagnosed with breast cancer in 2021, her doctors prescribed targeted therapies that cost more than 63,000 rupees (around £500) a month—an amount far beyond what the retired bank clerk from Kerala could afford. Knowing that thousands of families faced similar financial ruin, she filed a petition in 2022 demanding government action. Although Radhakrishnan passed away later that year while the proceedings were still underway, her legal fight eventually reached India's Supreme Court and spurred a major policy shift.
During the hearings, Supreme Court justices Vikram Nath and Sandeep Mehta examined the markups added by distributors, hospitals, and pharmacies, describing the pricing practices as "carnage" and "extortion." In one notable example, a life-saving medicine supplied to hospitals for 2,700 rupees was sold to patients for 27,000 rupees. Data from the National Pharmaceutical Pricing Authority revealed that markups on cancer drugs averaged 170%, with some extreme cases exceeding 700%.
Prompted by the court's scrutiny, the Indian government announced a 30% cap on trade margins for 137 cancer drugs, broadening a policy that previously applied to only 42 medications. According to the Department of Pharmaceuticals, the price limits are expected to cut medicine costs by up to 70% and save cancer patients roughly 2,500 crore rupees (£199 million) every year.
The relief comes amid severe financial pressures in a country that diagnoses approximately 1.56 million new cancer cases each year. Research from the Public Health Foundation of India shows that medical expenses push about 55 million people below the poverty line annually, forcing many patients to abandon care they cannot afford. Meanwhile, the Supreme Court has pressed the government to explain why such price caps should not cover all non-patented medications, giving officials until October 27 to respond.