The revised prices of 137 anti-cancer drugs announced by the Centre came into effect on Monday, following the National Pharmaceutical Pricing Authority's decision to cap trade margins on their Maximum Retail Price (MRP). The question now is: are medical devices and hospital consumables next?
The Centre's decision on anti-cancer drugs is expected to deliver immediate financial relief to patients. As the government turns its spotlight onto the steep markups on medical devices and hospital consumables, regulators face a far more complex challenge as hospitals routinely bundle their costs into treatment packages, masking their true retail cost.
According to experts, this makes it difficult to track their procurement costs and what patients are ultimately charged.
Consumable charges are levied on treatment packages by private hospitals, making them extremely difficult to track and monitor," said an official from the Kerala Drugs Control Department.
Syringes, gauze, bandages, needles, IV cannulas, infusion tubes, surgical tape, cotton balls, antiseptic wipes, face masks, disposable gowns, surgical staples, surgical drapes, catheter tubes, and nebuliser masks are widely included in the medical consumables category.
"Even if capping the prices of medical devices brings down costs, it might not entirely reduce the final hospital bill, as authorities can simply inflate charges on consumables. Who is going to audit how many syringes or wipes were actually used during a patient's stay?" said the official, who requested anonymity.
The attention on the excessive markups came into focus after a Maharashtra Food and Drug Administration (FDA) survey, flagged by Commissioner Tukaram Mundhe in September 2026, found markups of up to 2,841 per cent on hospital consumables.
The Print, quoting an official, reported that the Drugs (Prices Control) Order (DPCO) is "manufacturer-centric". It regulates prices at the manufacturing level, not the final amount a hospital charges patients.
Capping margins on separately billed consumables may prove futile, as hospitals can easily recoup losses through nursing, surgeon, or consultation fees. "A patient in the ICU cannot monitor these micro-charges," the official noted.
Another challenge lies in tracking the procurement costs. How regulators could establish what hospitals actually pay for medical devices and consumables.
“There is no way to establish what a hospital actually paid to purchase a particular item. GST data is not shared. Even if you look at the bill, it will show the MRP. But you will not know how much the hospital itself paid to procure that item,” an official was quoted by The Print.
In 2017, the government fixed ceiling prices, which directly limit the maximum price at which a product can be sold, for coronary stents in February and knee implants in August.
On the other hand, trade margin rationalisation limits the margin added as a product moves through the supply chain. The National Pharmaceutical Pricing Authority (NPPA) used this approach for 42 anti-cancer drugs in February 2019, and then on 137 anti-cancer drugs in October 2026.
During the COVID-19 pandemic, the government capped trade margins at 70 per cent on the price to distributor (PTD) for six critical devices: oxygen concentrators, pulse oximeters, blood pressure monitors, nebulisers, digital thermometers, and glucometers. Introduced in June–July 2021, the cap was subsequently extended until 30 June 2023.
However, the NPPA operates under significant statutory limits. Under DPCO 2013, direct price control applies strictly to scheduled drugs and medical equipment. Non-scheduled products, such as the IV sets and catheters raised by the Maharashtra FDA, enter the market at manufacturer-determined prices, with NPPA oversight restricted to enforcing a 10 per cent annual price increase ceiling.
The Parliamentary Standing Committee has recommended capping the trade margin on medical devices at 20 per cent over their landing cost—the total expense incurred by an importer, including foreign price, insurance, customs duty, and freight. Enforcing such a ceiling would require either amending the DPCO, 2013, or extending Trade Margin Rationalisation (TMR) to specific devices, mirroring the policy route used for 42 anti-cancer drugs in 2019 and six critical medical devices during the COVID-19 pandemic.
