Centre green-lights higher prices for cancer chemotherapy drugs as shortage continues: Report

The government has reportedly approved price increases for select life-saving cancer medicines amid the shortage, primarily affecting platinum-based chemotherapy drugs, including cisplatin and carboplatin, which are widely used in the treatment of various cancers such as lung, ovarian, cervical, head and neck, bladder, and gastrointestinal cancers.

According to a News18 report, the letter written by the Department of Pharmaceuticals to the Member Secretary, National Pharmaceuticals Pricing Authority (NPPA) on 7 June, stated, “In principle approval of the Hon’ble Minister (Chemicals & Fertilisers) is granted for utilising para 19 of DPCO, 2013 in respect of aforesaid formulations."

The price revision was approved under Para 19, a special provision that allows the government to intervene outside the regular price-control framework when it considers such action necessary to ensure the availability or affordability of essential medicines.

The National Pharmaceutical Pricing Authority (NPPA), which functions under the Department of Pharmaceuticals in the Ministry of Chemicals and Fertilisers, granted the approval after a government committee reviewed 82 drug formulations seeking higher prices, the report noted. Of these, only four were deemed urgent enough to warrant a price increase.

According to a 4 June communication from the NPPA to the Economic Adviser in the Department of Pharmaceuticals, the department had received numerous requests for price revisions.

“…applications received by NPPA from various pharmaceutical companies seeking upward revision of prices… for certain scheduled formulations. The applicants have cited factors such as a substantial increase in Active Pharmaceutical Ingredient (API) prices, escalation in production costs, fluctuations in foreign exchange rates, and other related factors adversely affecting the economic viability of manufacturing and marketing of these formulations on a sustainable basis."

It states that “applications pertaining to 82 formulations were examined by the Inter-Ministerial Committee IMC)… After detailed examination, the IMC recommended consideration of price revision in respect of four formulations, one of carboplatin Injection, one of cisplatin injection, and two of anti-tetanus immunoglobulin injection, in view of the significant increase in API costs and concerns regarding their continued availability."

The committee reportedly took note of concerns raised by Tata Memorial Cancer Hospital over shortages of carboplatin and cisplatin injections, which are commonly used as first-line treatments for several cancers. It was of the view that maintaining an uninterrupted supply of these critical medicines is important from a public health standpoint, it said, adding that the remaining 78 applications are still under review, with the committee seeking additional information before making a decision.

The NPPA had approached the Department of Pharmaceuticals (DoP) seeking approval for the proposed price increases.

“In view of the emerging shortages of carboplatin injection and cisplatin injection, and the viability concerns reported for these four formulations, the matter merits consideration by the authority…The issue was discussed during a review meeting by the Secretary, DoP, on pending applications for price increase, and NPPA was directed to process the requests in accordance with the frameworks… Further, DoP advised NPPA that any specific circumstances warranting the invocation of Para 19 should be flagged to the department," the letter stated, as per the report.

On 7 June, the department informed the regulator that the minister had granted in-principle approval for invoking powers under Para 19.

The ministry reportedly asked the pricing regulator to determine the extent to which the prices could be increased. The formula outlined, “The Standing Committee recommended a 10 per cent increase per year from the last fixation, with a ceiling of 50 per cent, which could also be a guide, but the primary principle should be cost increase."

The DoP further advised the NPPA to assess the rise in raw material costs for the concerned medicines before deciding the extent of the price increase. It also suggested that the regulator examine similar requests from pharmaceutical companies seeking price revisions due to higher input costs and apply a consistent approach in such cases.

Cancer patients face a shortage of drugs

Kumar Ajit spent over a week contacting numerous pharmacies across India in search of cisplatin, a platinum-based cancer drug required for the treatment of his 70-year-old mother's liver cancer, as per Reuters.

After an extensive search, he located the medicine in New Delhi and had it delivered to his village in Bihar. However, he said, "I could not even get the desired dosage," and expressed concern about future treatment, adding, "I'm unsure what I will do for the next dose."

The ordeal faced by the 52-year-old bank employee underscores the worsening shortage of platinum-based cancer medicines in India, with patients increasingly struggling to secure treatment as hospitals, particularly government-run facilities, grapple with limited supplies.

According to doctors and industry executives, India depends on imported platinum, and supplies from major sources such as South Africa have been affected by rising prices and disruptions linked to the conflict in the Middle East.

Medical professionals and drug distributors have reported that stocks of medicines such as cisplatin and carboplatin, commonly used to treat lung, ovarian, and gallbladder cancers, have become increasingly scarce in recent weeks.

Pavan Kumar of Kethan Pharma Distributors in the southern tech hub of Hyderabad, stated, "I get about 10 calls a day from patients asking for help with cisplatin.”