NMC Healthcare offers 50% discount on prostate screening and ultrasound in November as part of men's health awareness campaign

The National Pharmaceutical Pricing Authority of India (NPPA) has made changes to the Maximum Retail Prices (MRP) of 543 cancer treatment drugs in India. As a result of these changes, the cost of some medicines has decreased by more than 90%, however, the impact of this reduction did not extend to some extremely expensive drugs, such as Keytruda.

According to the new prices set by NPPA, the price of one brand and package of Palbociclib, used for breast cancer treatment, was reduced from 40,421 rupees to 2,720 rupees. Similarly, the cost of a vial of the drug Tiotep, used in chemotherapy, decreased from approximately 80,072 rupees to 7,150 rupees. Furthermore, prices for drugs such as Dasatinib, Lenvatinib, and Olaparib were significantly lowered, although no price changes were made to a number of other anti-cancer agents.

Despite the overall price reduction, the cost of several very expensive cancer drugs remained unchanged. Among them is the immunotherapy drug Keytruda, which is used to treat over 21 types of cancer and retains its price at 216,500 rupees. The price of Rebosiclib, used in breast cancer treatment, also remains stable at 24,435 rupees. The MRP for drugs such as Tagrisso, Tcentric, Darzalex, and Imfinzi was also not altered.

Malini Asola from the 'All India Drug Action Network' (AIDAN), which advocates for patient interests, explained that one reason for the lack of price changes on patented medicines is that the government carefully excluded from the list those drugs provided free under the 'Patient Assistance Programs' (PAPs). Under PAPs, pharmaceutical companies offer prescription drugs free of charge or at a significant discount, for example, providing a third package free when two are purchased.

Asola expressed disagreement with the exclusion of PAP, noting that it allows hospitals and intermediaries to earn huge profits. She also pointed out that significant price reductions in many cases occur within a subsidized format that still allows the hospital or distributor to earn 42.8% profit. According to her, if the government did not allow such a high level of margin, the price reduction would be even more substantial.

The court is examining the issue of margins on cancer drugs. The Supreme Court is studying the possibility of setting margin limits for all drugs that exceed price restrictions in the country. A decision on this matter has not yet been issued by the court. It should be noted that the costs of cancer treatment are not limited to medications; they include surgeries, various types of examinations, and hospitalization. While the reduction in drug prices will bring relief to patients, it is necessary that these rules apply to all drugs. Following NPPA's decision to limit the trade markup on 137 non-patented anti-cancer drugs to 30% of the MRP, the new prices will come into effect on November 9.

The National Medical Commission (NMC) has repealed the 2023 Regulation on Maintaining Medical Education Standards. As a result of this repeal, all specific fines against medical institutions that fail to comply with established legal provisions, rules, or minimum standards cease to be in effect.

Any actions taken during the period these rules were in force remain unchanged. However, the NMC had not taken action against many colleges violating the rules, such as in cases of non-payment of scholarships to MBBS interns and postgraduate students. Now, colleges may worry less about scholarship non-payment since the NMC Law does not stipulate a fine for such a violation.

Without an assessment, the disclosed information from medical colleges will merely constitute unverified statements. The law stipulates that the Medical Assessment and Rating Board can take measures, including issuing a warning, imposing a monetary fine, reducing enrollment, suspending admission, or recommending the withdrawal of recognition for a medical institution for non-compliance with minimum necessary standards.

Despite this repeal, the requirement to submit an annual disclosure report will continue to be in effect according to relevant sections of the NMC Law 2019, as per the cancellation announcement published on October 14. The NMC Law provides that the Undergraduate Medical Education Council and the Postgraduate Medical Education Council must determine the norms for mandatory annual disclosure by medical institutions.

Furthermore, the 2019 Law states that the MARB can assess any institute at any time without prior notice. However, after the repeal, aspects that were supposed to be included in the assessment report, such as checking physical infrastructure, the presence of the required number of faculty, and student feedback analysis, have been excluded.

Without an assessment by the MARB, the mandatory annual disclosure will simply become statements from the medical college, unconfirmed by independent expertise.