A new government study has raised concerns over India’s drug pricing and regulation frameworks, exposing major inefficiencies that impact both affordability and availability of essential medicines. Despite India’s status as the “pharmacy of the world,” the report underscores a troubling paradox—while the country manufactures affordable drugs for global markets, millions of Indians still find essential and life-saving medicines either too costly or unavailable. The findings, published by the National Pharmaceutical Pricing Authority (NPPA), reveal how systemic flaws and market opacity continue to undermine the goal of universal healthcare access.

The study, prepared by a consortium of leading policy think tanks and academic institutions including the Bridge Policy Think Tank, Bangalore Bio-Innovation Centre, and Gujarat National Law University, argues that the current structure of the Drug Price Control Order (2013) and the National List of Essential Medicines has not adequately addressed the growing inequity in healthcare access. While price capping has succeeded in keeping common medicines affordable, the report finds that the policy largely fails patients battling rare and serious diseases, where high-cost imported drugs remain beyond reach.

One of the key challenges highlighted in the report is the availability issue. Pharmaceutical companies, the study notes, often shift marketing efforts toward unregulated or high-margin drugs, leaving hospitals and pharmacies short of affordable generic options. A lack of transparency in how price ceilings are determined further complicates the situation, discouraging new entrants and reducing competition. “Data opacity and inconsistencies in the market-based price calculation have created a complex and unpredictable environment for manufacturers,” the study observes.

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The failures are particularly acute in the case of rare and chronic diseases, where patients are dependent on expensive imported therapies. Without dedicated pricing mechanisms or subsidies for such treatments, the report warns that many families face catastrophic health expenditures. The study also details the increasing regulatory burden on the NPPA, which struggles to monitor thousands of drugs and frequently updated essential medicine lists, leading to gaps in oversight and enforcement.

To address these challenges, the report calls for a comprehensive structural reform of India’s drug policy. Recommendations include improving transparency in pricing mechanisms, easing market access for pharmaceutical startups, and expanding subsidies and insurance coverage for high-cost medications. Experts argue that a long-term solution requires blending competition policy with stronger government support for patients suffering from rare diseases and chronic ailments. The NPPA’s findings serve as an urgent reminder for the Union Health Ministry to prioritize reforms that ensure equitable, transparent, and affordable access to essential medicines for every Indian citizen.

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