Even after customs exemption in Union Budget, best cancer drugs still far from affordable

Mumbai: The Union Budget 2026-27 has exempted basic customs duty on 17 critical cancer drugs to reduce treatment costs, but it seems to offer little more than a "grim reality check" for patients' families. According to an analysis by public health researchers, even with the tax break, the annual cost for these medicines, considered path-breaking, can still range from over several lakhs to as much as Rs 1 crore.For instance, one of the drugs exempted includes Ribociclib, which is used for the treatment of breast cancers that are advanced, metastatic, or even high-risk early-stage, and costs Rs 24,355 per strip of 21 tablets. The clinical dose is 600mg per day, which is often split between three tablets of 200mg in a day. As per calculations by the Working Group on Access to Medicines and Treatment, the tablets needed per cycle are 63, or three strips, which translates to expenditure of Rs 73,065 per month and nearly Rs 9.5 lakh a year. Even with the waiver, this is still a little over Rs 8.5 lakh. The treatment could last for three years.
India reports more than two lakh breast cancer cases annually, with Maharashtra accounting for 10% of them, according to the past National Cancer Registry.Speaking to TOI, K M Gopakumar, co-convenor of the access group, said that a large number of women are either deprived of these medicines or are put on alternative medicines that are not of the same scientific advancement. In some cases, the families decide to bear this out-of-pocket expense and fall into debt traps. "This makes the customs waiver just for optics. Generics are far in the future for many of the exempted drugs. The Patents Act allows the govt to intervene and make the companies reduce the price by warning them generics would be permitted earlier, but there is no will," said Gopakumar.The only time this happened for cancer medicine was in 2012, when sorafenib was issued a compulsory licence, bringing the cost of this liver and renal cancer drug down to Rs 8,800 from 5,500 USD (around Rs 2.8 lakh).While Tata Memorial Hospital allows for most drugs at 30% less than the market price, director Dr Sudeep Gupta noted that these 17 medicines are still close to the market price as they are on-patent. "These medicines are considered superior because the side-effects are less and efficacy is higher. But in India we still have less expensive alternatives that are pharmacologically equivalent to them," he said.Dr Gupta added, "The govt move is still welcome because we are trying to make it affordable. For someone on long-term treatment, it is still a substantial reduction in the price."