Examine the role of Centre–State coordination and citizen-facing technology in enforcing drug price regulation in India.

Drug price regulation under the Drugs (Prices Control) Order, 2013 (DPCO) works only if notified prices reach the patient. NPPA's recent Trade Margin Rationalisation (TMR) order on 137 non-scheduled anti-cancer drugs shows that enforcement rests on two pillars: federal coordination and citizen-facing technology [1].

Role of Centre–State coordination

• Division of labour: NPPA, under the Department of Pharmaceuticals, fixes and notifies prices. State Drug Controllers (SDCs) check compliance by manufacturers, dealers, hospitals and institutions [1].
• Feedback loop: SDCs must send Action Taken Reports to NPPA within a week of the revised prices taking effect (9 to 16 November 2026) [1].
• Deterrence: violations found in the field lead to overcharging proceedings under DPCO [1].

Role of citizen-facing technology

• Transparency: the Pharma Sahi Daam app/portal publishes price lists, which reduces information asymmetry at the counter [1].
• Grievance redressal: patients report overcharging, shortage or non-availability through the app or helpline 1800-111-255 [1].
• Filling blind spots: NPPA's market data leaves out hospital sales and e-commerce [2], where many cancer drugs are sold. Citizen complaints cover this gap.

Limitations

• Capacity: 15 of 48 sanctioned NPPA posts are vacant [2].
• Weak recovery: Rs 8,526 crore (85%) of overcharging dues was unrecovered as of 2025, mostly stuck in litigation [2]. This weakens the deterrent.
• Low participation: only 30 representations, all from industry, came in on 1,426 draft price worksheets (2022–25) [2].
• Online pharmacies: there is no mechanism to ensure fair prices on online drug platforms [3].

Way forward

• Fill vacancies and extend data coverage to hospitals and online sellers [2]. Create a regulatory framework for online drug sales [3].
• Set up a fast-track dispute mechanism and a dedicated legal cell in NPPA [2].
• Publish supply-chain prices, in line with WHO's guidance on regulating mark-ups and price transparency [4].

Centre–State coordination provides the enforcement machinery, and technology provides information and public vigilance. The Standing Committee has recommended a permanent TMR framework [2]. Backed by stronger SDCs and wider use of Pharma Sahi Daam, it can turn one-off notifications into lasting affordability. This would fulfil the Article 47 duty to improve public health and the SDG 3.8 goal of affordable essential medicines.