A petition filed in the High Court of Kerala in June 2022 demanding access to the vital breast cancer drug Ribociclib was scheduled for a final hearing 57 times since January 2023, but the case was never heard.
Call to expedite judicial process
The drug access working group appealed to the Chief Justice of India to consider measures to speed up hearings to ensure justice for those urgently needing this medication. After the petitioner's death early in the proceedings, the High Court decided to continue the case suo motu due to greater public interest.
Statistics and treatment need
The working group, comprising patient rights activists, patient groups, civil society organizations, scientists, and lawyers, emphasized that breast cancer is one of the most common types of cancer among women in India. According to the Global Cancer Observatory report for 2022, over 190,000 new cases and 98,300 deaths were registered in India.
The letter addressed to the Chief Justice indicated that official data presented by the Ministry of Health and Social Welfare in Parliament in early February 2026 projected 240,000 cases. Among these are patients with Luminal A type breast cancer (HR+/HER2-), which is an invasive subtype capable of spreading throughout the body, who require targeted therapy such as Ribociclib and Abemaciclib to save their lives.
Cost issue and licensing
These drugs are critical for HR+HER2- type patients as they can be used in early stages of the disease. However, they are extremely expensive because they are under patent protection (Ribociclib costs over 78,400 rupees per month, and Abemaciclib ranges from 47,700 to 95,500 rupees per month). The petition demanded the issuance of a government license agreement under Section 100 of the Patent Act, which could ensure access to Ribociclib at affordable prices.
The group explained in the letter that a government license promotes local production of low-cost generics, which are often 90–95% cheaper than original drugs. Despite acknowledging the drug's effectiveness, the government refused to grant such licensing, stating that breast cancer is not a matter of national urgency. Furthermore, the group noted that the government failed to provide a reasoned response regarding access to essential medicines and the realization of the right to health.
Course of judicial proceedings
After the decision to continue the case suo motu, the court appointed an amicus curiae, and various respondents, including the Union of India, submitted detailed replies. Drug manufacturers were also involved in the case and filed their objections. The letter noted that all interested parties had been heard, and all reports requested by the court had been submitted. Nevertheless, the letter stated that while procedural documents were complete, the constitutional questions regarding the government's obligations concerning drug access under Article 21 remained unanswered.
The letter concluded by asserting that the premature death of the petitioner in this case highlights the devastating human cost of judicial delays in cases concerning access to life-saving drugs, and that a swift resolution would give hope to others suffering from this disease who cannot seek legal recourse.
}, {