Centre Clears Cancer Drug Price Rise To Tackle Shortages, But Affordability Concerns Linger

The Centre has approved a price increase for two critical chemotherapy medicines—Cisplatin and Carboplatin—to address shortages that have disrupted cancer care nationwide.

However, the decision is likely to heighten affordability concerns for patients who are already struggling with the mounting financial burden of cancer treatment.

The move to hike prices follows warnings from oncologists and pharmaceutical manufacturers that supplies of the two platinum-based drugs, considered first-line treatment for several common cancers, were becoming increasingly difficult to sustain under existing price controls amid rising raw material costs.

The approval was granted by the Department of Pharmaceuticals (DoP), which has authorised the National Pharmaceutical Pricing Authority (NPPA) to invoke special provisions under the Drugs (Prices Control) Order (DPCO), 2013, to revise prices.

Cisplatin and Carboplatin are among the most widely used chemotherapy agents in India and form the backbone of treatment for oral, breast, ovarian, cervical, oesophageal, lung and testicular cancers. Many standard chemotherapy protocols for solid tumours rely on one of these medicines, making uninterrupted availability crucial for patient care.

The shortage has been attributed largely to a sharp increase in manufacturing costs. Both medicines are derived from platinum, while key active pharmaceutical ingredients (APIs) used in production are imported. Industry representatives have pointed to rising global commodity prices, higher logistics costs and geopolitical disruptions in West Asia as major factors affecting supply.

"The production cost has increased because the API, or active pharmaceutical ingredient, which is imported from abroad, has become more expensive. As a result, manufacturing costs have gone up, but the MRP has not increased," Dr. Shyam Agarwal, Senior Consultant, Medical Oncology, Sir Ganga Ram Hospital, had sounded the alarm last week through his post on social media platform X.

According to official correspondence, pharmaceutical companies approached the government seeking an upward revision of prices for 82 formulations, citing increases in API costs, production expenses and fluctuations in foreign exchange rates that had affected the commercial viability of manufacturing several essential medicines.

The requests were examined by an Inter-Ministerial Committee (IMC), which reviewed all 82 applications. After detailed scrutiny, the committee recommended price revisions in only four formulations—one Carboplatin injection, one Cisplatin injection and two anti-tetanus immunoglobulin injections.

The committee noted that the recommendation was based on significant increases in raw material costs and concerns regarding the continued availability of the medicines.

Documents reviewed by the authorities show that concerns raised by clinicians also influenced the decision. The committee specifically referred to representations from Tata Memorial Hospital regarding shortages of Carboplatin and Cisplatin injections.

The government's approval was issued under Para 19 of the DPCO, an exceptional provision that allows intervention beyond the normal price-control framework in circumstances where action is considered necessary to ensure the availability or affordability of medicines.

In a communication dated June 7, the Department of Pharmaceuticals informed the NPPA that "in-principle approval" of the Union Minister for Chemicals and Fertilizers had been granted for invoking Para 19 for the identified formulations.

The ministry has asked the pricing regulator to determine the extent of the increase after examining actual increases in raw material costs and their impact on manufacturing viability.

A framework discussed during deliberations suggested that a 10 per cent increase per year from the last price fixation, subject to a ceiling, could serve as a guide. However, officials emphasised that the primary consideration should be the actual escalation in production costs.

For oncologists, ensuring a stable supply of Cisplatin and Carboplatin is an immediate priority. The shortage has affected hospitals and cancer centres in several parts of the country, forcing clinicians to manage treatment schedules amid uncertainty over drug availability.

At the same time, the price revision is likely to raise concerns among patients already facing substantial treatment expenses.

Cancer treatment in India often involves not only medicines but also repeated diagnostic tests, hospital visits, supportive therapies and travel costs. Patient advocacy groups have repeatedly highlighted the financial burden associated with prolonged cancer care, particularly for families without comprehensive insurance coverage.

For instance, for weeks, Radheshyam, a lung cancer patient undergoing chemotherapy, had been closely following reports of shortages of the two most widely used chemotherapy drugs.

Like thousands of cancer patients across the country, he was worried that disruptions in supply could delay treatment and affect his chances of recovery. When news emerged that the government had stepped in to address the shortage, he hoped it would bring relief.

Instead, the decision has left him with a different concern.

"Ever since news of the shortage emerged, I have been anxious and constantly keeping track of the government's efforts to restore supplies," said Radheshyam. "Today, when I learnt that the government has approved a price hike for these drugs, my heart sank. Even if the medicines become available now, I will have to pay more. As cancer patients, we remain trapped in a Catch-22 situation. Earlier the medicines were unavailable; now they may be available but at a higher cost."

His concerns reflect the dilemma facing many patients following the government nod for an upward revision in prices of Cisplatin and Carboplatin.

While oncologists acknowledge that restoring supply is critical, many fear the price increase could worsen the financial burden on patients already struggling with the high costs of cancer care.

"In several cases, we are compelled to balance ideal treatment with what the patient can realistically afford. This is not a deviation from science, but a response to financial constraints," said Dr. Tarun Batra, Director, Surgical Oncology, ApolloMedics Super Speciality Hospital, Lucknow.

He noted that advances in cancer treatment, including immunotherapies and targeted medicines, have significantly improved outcomes but have also increased treatment costs.

"Cancer treatment has always been expensive. But newer drugs are launched at premium prices due to research and development costs. These therapies have improved survival by years in many cancers, yet remain unaffordable for a large section of patients in India," he said.

Financial stress is increasingly becoming a hidden challenge in oncology care.

Doctors and mental health specialists say many patients now worry as much about treatment costs as they do about the disease itself.

"A cancer patient can completely derail the finances of a family, where they are forced to choose between life-saving drugs and basic needs like food and housing," Dr. Batra said.

Dr. (Maj.) Ravi Shankar, Consultant – Paediatric Haemato-Oncology and Bone Marrow Transplantation, Yatharth Super Speciality Hospital, Greater Noida, stressed the need to address both medical and financial distress.

"Cancer care must extend beyond medical treatment to include emotional and financial support systems. A patient-centred approach that integrates mental health services, social support and affordable care is essential," he said.

Dr. Shankar added that financial stress frequently influences treatment adherence and quality of life.

Dr. (Maj.) Ravi Shankar, Consultant - Paediatric Haemato-Oncology & BMT, Yatharth Super Speciality Hospital, Omega 1, Greater Noida, said rising cancer drug prices are becoming a major concern worldwide, adding a significant financial burden to patients and their families at a time when they are already coping with the emotional impact of a cancer diagnosis.

"Financial stress often forces families to make difficult choices regarding the continuation of treatment, supportive care and daily living expenses," he said.

Experts also caution that focusing solely on medicine prices may not capture the full extent of the burden.

Vivek Sharma, social entrepreneur, philanthropist and founder of Uhapo Health Services, a community that serves cancer patients and caregivers, said, “I would be a little careful in calling it only a case of rising cancer drug prices”, because many established and effective cancer drugs in India are already under government price control, and several pharmaceutical companies also support patients through access programmes, often with active inputs from patient support organisations.

“The larger issue is that the overall cost of cancer care has gone up — diagnostics, hospitalisation, repeated investigations, travel, nutrition, loss of income, and newer treatment options all add to the burden. Every new drug or technology usually enters at a higher cost because innovation and research come with huge investments. But while these advances bring hope, they also create a silent psychological burden for families who are unable to afford them.”

"In our community, we have seen patients and caregivers live with deep guilt — the guilt of not being able to arrange money for a newer drug, an advanced test, or a better treatment option. Sadly, there is no real barometer to measure this emotional suffering," said Mr Sharma.

"The way forward is to bring credible patient advocates into policy and access discussions, especially those working closely in specific disease areas. Along with doctors, policymakers, industry and support organisations, patient voices must be included so that cancer care becomes more humane, realistic and equitable," he suggested.

According to Dr. Manish Pruthi, Professor and Surgeon at Tata Memorial Hospital, Mumbai, and ACTREC, Kharghar, many conventional chemotherapy medicines remain relatively affordable because of government price controls. However, newer targeted therapies continue to pose major affordability challenges.

"Many of these remain under patent protection and are associated with substantial costs. This creates a significant financial burden for patients and families, potentially affecting treatment decisions," he said.

Across institutions, experts are increasingly calling for broader reforms, including the expansion of insurance coverage, stronger patient assistance programmes, wider use of biosimilars and centralised procurement mechanisms for cancer medicines.

"There is also a need for a centralised procurement system for cancer drugs so that India can leverage scale to reduce costs," Dr. Batra said.

For patients such as Radheshyam, however, the immediate concern remains simple: access to treatment without being pushed deeper into financial distress.