Affordable access to medicines is integral to the right to health. Evaluate the role of NPPA and DPCO, 2013 in achieving this.

The Supreme Court has read the right to health into Article 21, and affordable medicines are central to it. The Drugs (Prices Control) Order (DPCO), 2013, enforced by the National Pharmaceutical Pricing Authority (NPPA), is India's main tool for keeping medicine prices down [1]. It has helped patients, but important gaps remain.

Achievements

• Ceiling prices: NPPA has capped 930 scheduled formulations from the NLEM, including 131 anti-cancer ones. Makers must sell at or below the ceiling price plus GST [1][2].
• Trade Margin Rationalisation (TMR): a 30% trade-margin cap on 42 non-scheduled anti-cancer drugs cut the MRPs of 526 brands by up to 90%. This saves patients about ₹984 crore a year [3].
• Monitoring: NPPA also tracks the prices of non-scheduled medicines [4].

Limitations

• Narrow coverage: ceiling prices apply only to Schedule-I drugs. TMR has been used only for selected products, such as cancer drugs [2][3].
• Unregulated trade margins: in September 2026 the SC found a cancer drug sold at about ten times its price to the retailer. It called this "carnage" and asked why DPCO's 16% retailer margin should not apply to all essential drugs [8].
• Market-based pricing: caps are set from market data, not production cost, so inflated MRPs can feed into them [1].
• Weak enforcement: of the ₹2,328.53 crore in overcharging that NPPA flagged between 1997 and January 2011, ₹1,930.41 crore was stuck in litigation [5].
• Burden on the taxpayer: the government's share of health spending rose from 29% to 48% between 2014-15 and 2021-22 [6]. Inflated MRPs therefore also drain public budgets.

Way forward

• Extend TMR to all essential non-scheduled drugs. Allow higher margins only for specific products with real extra costs, such as cold-chain or rural supply.
• Scale up Jan Aushadhi Kendras, whose generics cost 50–80% less. The target is 25,000 outlets by March 2027 [7].
• Prevent overcharging before the sale instead of trying to recover money later.

DPCO and NPPA have made many essential drugs cheaper, especially cancer drugs. However, a system that caps final prices but leaves trade margins open gives only partial affordability. Rational margin caps, wider access to generics and preventive enforcement would make affordable medicines a real part of Article 21 and advance SDG 3.8 (universal health coverage).