The Supreme Court on Tuesday (September 29, 2026) expressed concern over the sharp disparity between the prices charged to retailers and consumers for essential medicines, particularly cancer drugs, observing that steep mark-ups placed an enormous burden on taxpayers and amounted to “carnage”.
A Bench of Justices Vikram Nath and Sandeep Mehta questioned the Centre on why the 16% retailer margin provided for under the Drugs (Prices Control) Order (DPCO), 2013 should not be applied uniformly to essential medicines to curb steep mark-ups over the price to retailer (PTR).
“Why not keep the 16% margin on MRP, which is prescribed in the DPCO, on everything? ... Ultimately, the loser is the taxpayer. This is carnage, as simple as that,” the Bench remarked.
Bench questions nearly ten-fold cancer drug mark-up
The observations came while the top court heard petitions filed by advocate Kishan Chand Jain and paediatric surgeon Sanjay Kulshrestha, seeking its intervention to regulate the prices of drugs, medical equipment, and generic medicines and make them more affordable.
Justice Mehta pointed, in particular, to the nearly ten-fold mark-up on an essential cancer drug, which was supplied to retailers for around ₹3,000 but sold to consumers for ₹27,000. He questioned who ultimately benefited from the nearly ₹24,000 difference.
“You tell us why this difference... Where does this chunk of money go? Ten times...” Justice Mehta remarked.
Centre says private hospitals benefit from steep mark-ups
Solicitor General Tushar Mehta, appearing for the Centre, acknowledged the concern and said the government would have to find a way forward while “balancing equities”. He, however, said it was private hospitals, rather than pharmaceutical companies, that benefited from the steep mark-ups.
“The pharma company is not the gainer. The gainer is the private hospital,” the Solicitor General submitted.
The Bench also flagged the practice of private hospitals insisting that patients purchase medicines from their in-house pharmacies, leaving them with little choice to procure the same drugs at lower prices elsewhere.
Supreme Court flags impact on taxpayers
It also pointed to the impact of such inflated prices on public finances, observing that when treatment is covered under government-funded health schemes such as Ayushman Bharat, the cost is ultimately borne by taxpayers.
“Suppose the patient is taking treatment through government services... The government doesn’t pay, the taxpayer pays. This affects a larger section of society,” the Bench remarked.
Mehta sought time to place before the court details of the existing mechanisms governing drug pricing and assured the Bench that he would make his submissions on the next date of hearing.
The Bench accordingly posted the matter for further hearing on October 12, 2026.
Petitions seek stricter enforcement of drug price controls
The petitions have sought directions to make drug formulations more affordable by curbing alleged overpricing of essential medicines by pharmaceutical companies and retailers. They have also sought stricter enforcement of price controls under the Drugs (Prices Control) Order, 2013, to prevent violations of the prescribed pricing mechanism and disproportionate profit margins across the drug supply chain.
Earlier, the top court had described the wide difference between the price to retailers and the MRP of medicines as “dacoity”, while drawing attention to the financial distress faced by patients struggling to meet treatment costs.
“The MRP is 10 times the rate at which it is provided to the retailers. If this is not extortion, then what is it? People sell their houses, ornaments to get treatment,” the Bench had remarked.
Published on September 29, 2026
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