More than four-fifths of overcharging dues demanded by the NPPA remain unrecovered. Examine the institutional and legal reasons, and suggest measures to strengthen enforcement of drug-price regulation.

The National Pharmaceutical Pricing Authority (NPPA), set up in 1997, enforces the Drugs (Prices Control) Order (DPCO), 2013. As of 31 March 2026, NPPA had demanded ₹10,029.8 crore from companies that sold drugs above notified prices. Only ₹1,582.4 crore of this had been recovered, which leaves about 84% outstanding [1]. Gaps in both institutions and the law explain why.

Institutional reasons

• Understaffing: 15 of NPPA's 48 sanctioned posts are vacant, and contract staff fill the gap [2].
• Partial market visibility: NPPA's price data cover only about 70% of the market [2]. Detection depends on references from state monitoring units and drug controllers [3].
• No dedicated legal cell to pursue cases going back to 1979 [1][2].
• Limited public participation in price fixing, even though patients see the real prices at the counter [2].

Legal reasons

• Litigation: About 70% of dues are in court, some for more than 20 years [2]. While a case runs, the firm keeps the money it overcharged, much like an interest-free loan.
• Weak deterrence: Interest and penalties only bite if the firm finally pays, so the threat stays on paper.
• Regulatory loopholes: Non-scheduled drugs can launch at arbitrary initial prices and then raise MRP by up to 10% a year [2][3].
• Ad hoc margin controls: Trade-margin rationalisation has only been piloted, and there is no permanent framework for it in the DPCO [2].

Measures to strengthen enforcement

• Fast-track dispute resolution for cases not yet in court, plus a dedicated legal cell for old ones [2].
• Fill vacancies and widen data coverage, so overcharging is caught before dues pile up [2].
• Write trade-margin rules permanently into the DPCO, with a timeline [2]. The 2019 cap on 42 cancer drugs cut the MRP of 526 brands by up to 90% [5]. The 2026 cap covers 137 such drugs [4]. Extending caps step by step to other high-priced drugs is the logical next move.
• Avoid discounted settlements, which teach firms to delay payment.
• Strengthen grievance channels so patients can report overcharging directly [3].

Overall, capacity gaps and slow courts have made overcharging profitable for firms. A well-staffed NPPA, quicker dispute resolution and a permanent margin framework would restore deterrence. With the Supreme Court now asking why caps should stop at cancer drugs [1], strict enforcement would help secure the right to health under Article 21 and the SDG 3.8 goal of affordable medicines.