The Union Budget 2026-27 has announced a significant measure by exempting basic customs duty on 17 critical cancer drugs, aiming to reduce the financial burden of treatment for patients across India. However, this move offers little more than a grim reality check for many families, as the costs remain prohibitively high despite the tax break.
High Costs Persist Despite Customs Duty Waiver
According to an analysis by public health researchers, even with the customs duty exemption, the annual cost for these path-breaking medicines can still range from several lakhs to as much as Rs 1 crore. This places a severe strain on patients and their families, many of whom are forced to make difficult financial decisions.
Example: Ribociclib for Breast Cancer
One of the drugs exempted is Ribociclib, used for treating advanced, metastatic, or high-risk early-stage breast cancers. The drug costs Rs 24,355 per strip of 21 tablets, with a clinical dose of 600mg per day typically split into three 200mg tablets.
As per calculations by the Working Group on Access to Medicines and Treatment, patients need 63 tablets per cycle, equivalent to three strips. This translates to a monthly expenditure of Rs 73,065 and nearly Rs 9.5 lakh annually. Even with the customs waiver, the cost remains slightly over Rs 8.5 lakh per year, and treatment can last up to three years.
Impact on Breast Cancer Patients in India
India reports more than two lakh breast cancer cases annually, with Maharashtra accounting for 10% of these cases, according to past National Cancer Registry data. K M Gopakumar, co-convenor of the access group, highlighted that many women are either deprived of these advanced medicines or are prescribed alternative treatments that lack the same scientific advancement.
In some instances, families decide to bear the out-of-pocket expenses, often falling into debt traps. Gopakumar remarked, "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 government to intervene and pressure companies to reduce prices by threatening earlier generic approvals, but there is no will."
Historical Context: The Sorafenib Case
The only time such intervention occurred for cancer medicine was in 2012, when sorafenib was issued a compulsory licence. This action reduced the cost of this liver and renal cancer drug from around Rs 2.8 lakh (5,500 USD) to Rs 8,800, demonstrating the potential impact of government measures.
Hospital Perspectives and Alternative Treatments
While Tata Memorial Hospital offers most drugs at 30% less than the market price, director Dr Sudeep Gupta noted that these 17 medicines remain close to market prices as they are still under patent protection. "These medicines are considered superior because they have fewer side-effects and higher efficacy. However, in India, we still have less expensive alternatives that are pharmacologically equivalent," he explained.
Dr Gupta added, "The government move is still welcome because we are trying to make treatment more affordable. For someone on long-term treatment, it represents a substantial reduction in price."
Broader Implications for Cancer Care in India
The exemption of customs duty on these 17 cancer drugs is a step toward improving access to advanced treatments, but it underscores the ongoing challenges in making healthcare affordable. The high costs highlight the need for more comprehensive strategies, including price controls, generic drug approvals, and increased government intervention under existing patent laws.
As India continues to grapple with rising cancer cases, balancing innovation with affordability remains critical. The Union Budget 2026-27's measure, while beneficial, calls for further action to ensure that life-saving treatments are accessible to all patients without pushing families into financial distress.
