Supreme Court questions large price gaps for essential cancer medicines

India’s Supreme Court has questioned the large difference between the prices at which essential medicines are supplied to retailers and the prices charged to patients, highlighting the financial burden created by steep mark-ups on cancer drugs. A Bench of Justices Vikram Nath and Sandeep Mehta asked the Centre why the 16% retailer margin provided under the Drugs (Prices Control) Order, 2013, should not be applied uniformly to essential medicines. The court said the resulting burden ultimately falls on taxpayers and described the situation as “carnage”.

The observations came during a hearing on petitions filed by advocate Kishan Chand Jain and paediatric surgeon Sanjay Kulshrestha. The petitions seek regulation of prices for medicines, medical equipment and generic drugs and call for stronger enforcement of existing controls. Justice Mehta referred to an essential cancer drug supplied to retailers for about ₹3,000 but sold to consumers for ₹27,000.

He questioned who benefited from the difference of nearly ₹24,000. Solicitor General Tushar Mehta, appearing for the Centre, acknowledged the concern and said the government would need to find a way forward while balancing competing interests. He argued that private hospitals, rather than pharmaceutical companies, benefited from the mark-ups.

The Bench also raised concerns about private hospitals requiring patients to buy medicines from in-house pharmacies, potentially limiting their ability to obtain the same drugs elsewhere at lower prices. It noted that inflated prices affect public finances when treatment is paid for through government-funded schemes such as Ayushman Bharat. The Solicitor General sought time to submit details of existing pricing mechanisms.

The court listed the matter for further hearing on October 12, 2026. The petitions also seek action against alleged overpricing and disproportionate margins across the supply chain.