The Indian government has moved to reduce the price of cancer drugs after a retired bank clerk took her case to the supreme court.
asserted
clerk → move → court
From next month, 137 cancer drugs in India will be cheaper as the government tries to tackle the tragedy of poorer patients either forgoing treatment, selling land or falling into debt to meet the high cost of some medicines, which are making large profits for hospitals and pharmacists.
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which → try → hospitals
Sarojam Radhakrishnan, a former bank employee in Kerala, was diagnosed with breast cancer in 2021.
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Radhakrishnan → diagnose → 2021
Doctors prescribed life-saving targeted treatments but the monthly cost, of more than 63,000 rupees (£500), was far beyond her family’s means.
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cost → prescribe → means
Realising that thousands of families were being ruined by the cost of such drugs, Radhakrishnan filed a petition to the Kerala high court in 2022 demanding government intervention to lower the costs.
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Radhakrishnan → realise → costs
When the case reached the supreme court, the judges looked at hospitals’ and retailers’ mark-ups on cancer drugs and called the situation “carnage” and “extortion”.
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judges → reach → situation
During a hearing on 29 September, justices Vikram Nath and Sandeep Mehta noted how a life-saving cancer drug supplied to hospitals at 2,700 rupees carried a vastly marked-up price of 27,000 rupees.
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drug → note → rupees
The judges found that hospitals, distributors and chemists enjoyed large margins on medicines.
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hospitals → find → medicines
Analysis by the National Pharmaceutical Pricing Authority revealed a trade mark-up on some cancer drugs averaging 170%, with some extreme examples stretching to more than 700%.
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examples → reveal → %
A 30% trade margin cap on the price of 42 drugs has been in place for some years but many others remained off this list.
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others → remain → list
Now, prodded by the supreme court’s findings, the government has imposed the cap on 137 other drugs.
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government → prod → drugs
“The measure is expected to reduce medicine prices by up to 70% and help cancer patients save 2,500 crore rupees [£199m] annually, significantly reducing the amount they pay from their own pockets,” a statement from the Department of Pharmaceuticals said.
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statement → expect → Pharmaceuticals
People on low incomes in India dread illness, as the cost of treatment can mean financial ruin, particularly for cancer patients.
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cost → dread → patients
Whenever the Indian Cancer Society holds a free diagnosis camp in Gurgaon where he lives, Krishan Kalra urges local drivers, maids, cooks and tailors to turn up because tests they cannot afford are offered free.
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they → hold → drivers
As a former member of the council of the Rajiv Gandhi Cancer Institute and Research Centre, Kalra knows the importance of early diagnosis, but he said very few people attended.
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people → know → diagnosis
“When I ask why, they say they’re too scared – if something serious like cancer is detected, they haven’t got the money to pay for the treatment so they prefer to remain in the dark,” he said.
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he → ask → dark
With the cost of cancer drugs ranging in price from 38,000 to 380,000 rupees, many families quietly walk out of the doctor’s consulting room upon hearing the estimated cost of treatment.
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families → range → treatment
Studies by the Public Health Foundation of India show that spending on healthcare pushes about 55 million Indians a year below the poverty line.
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spending → show → line
Few Indians can afford the premiums for comprehensive health insurance.
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Indians → afford → insurance
The government’s nationwide insurance scheme, Ayushman Bharat, covers treatment for some cancers but it provides only 500,000 rupees’ worth of annual cover for a family – the cost of just one dose of Kadcyla (ado-trastuzumab emtansine), a drug used to treat breast cancer.
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it → cover → cancer
Patients may need up to 14 doses.
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Patients → need → doses
He has worked in hospitals elsewhere in India and is familiar with doctors’ trauma of seeing patients walk out to go home and die.
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patients → work → trauma
“Some families start the treatment, hoping against hope to manage the cost.
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families → start → cost
They start but they don’t come back for chemotherapy or radiation.
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they → start → chemotherapy
They can’t sustain the cost,” he said.
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he → sustain → cost
“The decision is a welcome step if the outcome is that more patients can access the drugs they need.”
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they → access → drugs
India records about 1.56m new cancer cases annually – up from 1.39m cases in 2020 – making it a significant public health challenge.
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it → record → 2020
As the supreme court delves deeper into the subject, what was clear, said Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, a civil society network, was that a “total overhaul” of the healthcare system was needed.
“Right from the cost of manufacturing a drug to the point of sale, we need to make the system transparent and regulate the entire supply chain.
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system → delve → chain
Only then will these drugs become available to those who need them,” she said.
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she → become → them
Singh said companies and hospitals were likely to try to find legal loopholes to wriggle out of the 30% cap, suggesting that hospitals may offset the lower price charged for a drug by raising charges on other items.
The supreme court judges have also asked the government’s lawyers why the cap should apply only to cancer drugs and not the entire range of non-patented drugs.
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cap → say → drugs
The court has given the government until 27 October to respond.
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court → give → October
Unfortunately, the court’s ruling came too late for Radhakrishnan, who died in September 2022 while her case was still pending in Kerala.
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case → come → Kerala
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