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Centre Caps Trade Margins on Non-Scheduled Cancer Drugs at 30%

The Centre has approved a 30% trade-margin cap on non-scheduled cancer medicines, aiming to lower prices and reduce patients’ out-of-pocket treatment costs.

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Cancer medicine price regulation in India illustrated by assorted tablets and capsules on a purple background.
The Centre has approved a 30% cap on trade margins for non-scheduled cancer medicines, aiming to reduce prices and patients’ out-of-pocket treatment costs. Representational image. Image credit: SHVETS production/ Pexels

The Union government has approved a 30% cap on trade margins for non-scheduled cancer medicines, seeking to curb the mark-ups that inflate patients’ pharmacy bills. The Department of Pharmaceuticals estimates that the measure could reduce the maximum retail prices (MRPs) of affected drugs by up to 70% and save patients 2,500 crore rupees annually.

The cap will apply to branded and generic medicines, whether manufactured in India or imported, and whether patented or non-patented. An expert committee under the Directorate General of Health Services (DGHS) will identify the medicines covered. The National Pharmaceutical Pricing Authority (NPPA) will then issue the implementation notification.

The government’s estimates are projections. The extent of the price reductions will become clear after the covered medicines and revised prices are notified.

NPPA Finds Mark-ups of Upto 700%

An NPPA analysis found that trade mark-ups on non-scheduled anti-cancer medicines averaged around 170%, with some reaching 700%. Such margins can create a substantial gap between the price at which a medicine enters the distribution chain and the amount charged at the retail counter.

For patients who need costly medicines over multiple treatment cycles, even a modest reduction in the price of each purchase can ease recurring expenses. The effect is particularly relevant to households paying directly for medicines that are not fully covered by insurance or public health schemes.

The 30% limit is intended to restrict the margin added through the relevant stages of distribution and retail. It does not mean that every affected medicine will become 70% cheaper. The reduction will depend on the medicine’s existing price and trade margins.

How India Regulates Medicine Prices

India’s drug-pricing framework distinguishes between scheduled and non-scheduled formulations. The NPPA fixes ceiling prices for scheduled medicines under the Drugs (Prices Control) Order, 2013, with the National List of Essential Medicines (NLEM) forming the basis for coverage.

Chemotherapy drug vials, illustrating India's move to cap trade margins on non-scheduled cancer medicines to improve affordability.
Chemotherapy drugs in vials. India has capped trade margins on non-scheduled cancer medicines at 30% of their maximum retail price (MRP) to reduce treatment costs. Representational image. Image credit: Wikimedia Commons

Non-scheduled medicines generally do not have the same routine ceiling-price controls, although manufacturers are restricted from increasing their maximum retail prices by more than 10% over the preceding 12 months. The government can also intervene in the public interest under Paragraph 19 of the DPCO, 2013.

The new decision uses this intervention power to regulate trade margins across a wider range of non-scheduled cancer medicines. Rather than setting a single ceiling price for every drug in the category, it seeks to limit the margin added as medicines pass through the supply chain.

A precedent from 2019

In February 2019, the NPPA imposed a 30% trade-margin cap on 42 selected non-scheduled anti-cancer medicines. The intervention covered 526 brands and was estimated to save patients 984 crore rupees annually. The authority reported that the maximum retail prices of some brands fell by as much as 90%.

That exercise provides a precedent for using trade-margin regulation to lower medicine prices. The latest measure has a broader proposed scope, although its eventual reach will depend on the list finalised by the expert committee.

The earlier figures should not be treated as a forecast for the new intervention. The medicines covered, their existing margins and the price changes required will determine the savings achieved this time.

Production Must be Maintained

The government has said manufacturers will be required to maintain current production levels. The condition addresses a practical concern in price regulation: patients must continue to have access to prescribed medicines after the pricing rules change.

Implementation will require monitoring both prices and availability. A lower listed price offers little relief if a medicine becomes difficult to obtain or patients must turn to a more expensive alternative.

The DGHS expert committee must identify the medicines covered before the NPPA issues its implementation notification. Until then, patients and pharmacists cannot determine the precise price changes for individual products.

The projected 2,500-crore rupees annual saving will depend on the final list, the reductions achieved and how consistently the revised prices are reflected in sales. The cap addresses the retail cost of medicines; hospital charges, surgery, radiation, diagnostic tests and other treatment expenses fall outside this measure.

For patients managing cancer treatment over months or years, the relevant figure will be the revised price of each prescribed medicine, not the maximum reduction projected for the category as a whole.

EP Staff is the editorial team at EdPublica, an independent media organisation focused on science, education, environment and public policy. The team produces evidence-based news, features, explainers and analysis on issues that shape society and everyday life.

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FSSAI Moves to Restrict Added Sugars in Infant Foods, Citing Need for Stronger Nutritional Safeguards

FSSAI has proposed restricting the addition of sucrose and fructose to infant foods for babies up to six months. The draft amendment aims to strengthen nutritional safeguards.

Vaishnavi V S

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Mother feeding a newborn baby with a spoon, illustrating concerns around infant nutrition and feeding practices.
FSSAI has proposed prohibiting the addition of sucrose and fructose to food products intended for infants up to six months of age. Representational image. Image credit: Pragyan Bezbaruah/ Pexels

The first months of life leave little room for nutritional guesswork. An infant’s food must supply the energy and nutrients needed for growth, making the composition of commercial infant nutrition products a matter of public health. Whether manufacturers need to add particular sugars to these products is therefore an important regulatory question.

Research published in recent years has begun examining how added sugars enter infants’ diets, including through formula milk, and whether early exposure is associated with subsequent eating patterns and weight gain. Although the evidence does not establish that added sucrose or fructose in infant formula directly causes obesity, it has raised questions about the nutritional value of adding sugars when alternative carbohydrate sources are available.

Against this backdrop, the Food Safety and Standards Authority of India (FSSAI) has proposed prohibiting the addition of sucrose and fructose to food products intended for infants up to six months of age. The draft amendment, published in the Gazette of India on 16 October 2026, would tighten the existing rules governing the composition of these products.

Early Exposure to Added Sugars

An Indian study published in the Indian Journal of Community Medicine in 2021 examined the sugar and salt content of 114 commercially available infant formulas and baby foods. The researchers found that around 28% of the products had a high-sugar profile, while approximately 51% listed sugar or related ingredients among their first four ingredients.

The study covered products intended for children aged up to 24 months, including infant formulas and complementary foods. Its findings offer evidence that sugar content warrants scrutiny in India’s infant and young-child food market. However, the assessment relied on product labels and did not establish whether the products caused adverse health outcomes. It also did not demonstrate that infant formulas intended specifically for babies under six months routinely contained added sucrose or fructose.

Research elsewhere has examined possible links between added sugars in infant formula and early growth. A 2025 study published in The Journal of Nutrition followed 234 infants from predominantly low-income households in the United States. Researchers assessed dietary intake at six, nine and 12 months and found an association between higher added-sugar intake from formula and higher weight-for-length scores.

For every additional 10 grams of added sugar consumed daily through formula, weight-for-length scores increased by an average of 0.060. The study was observational, so it cannot establish that sugar caused the difference. Its findings also cannot be directly generalised to Indian infants.

A separate study published in Frontiers in Nutrition in 2023 examined dietary data from 95 infants and toddlers aged nine to under 16 months. It found an association between added sugars consumed through infant formula and sugar-sweetened beverage consumption later in infancy. The researchers did not establish a significant association between formula-derived added sugars and added-sugar intake from table foods. The small sample and cross-sectional design limit the conclusions that can be drawn.

These studies examine different aspects of early sugar exposure: the composition of products available in India, associations with infant weight and possible links with later dietary patterns. None establishes that the proposed restriction will prevent childhood obesity. They do, however, provide grounds for examining whether particular sugars need to be added to products intended for very young infants.

Infant’s Food: Why the First Six Months Matter

The World Health Organization (WHO) and UNICEF recommend exclusive breastfeeding during the first six months of life, followed by the introduction of appropriate complementary foods at around six months while breastfeeding continues.

Infant's food: Infant drinking milk from a feeding bottle held by an adult.
FSSAI has proposed restricting the addition of sucrose and fructose to food products intended for infants up to six months, as part of efforts to strengthen infant nutrition standards in India. Representational image. Image credit: hartono subagio/ Pexels

For infants who require an alternative to breast milk, appropriately formulated infant formula can provide essential nutrition. Its carbohydrate composition must meet nutritional requirements for growth and development. The question for regulators is whether adding particular sugars serves a necessary nutritional purpose in products designed for this age group.

WHO’s 2023 guideline on complementary feeding recommends that children aged six to 23 months should not consume foods high in sugar, salt and trans fats. Its evidence review identified associations between sugar-sweetened beverage consumption during infancy and later obesity in some studies, although the certainty of the evidence was low. The recommendation concerns the broader diet of children aged six months and older; it does not specifically establish the effects of sucrose or fructose in infant formula.

The distinction between naturally occurring sugars and added sugars is equally important. Milk naturally contains lactose, which provides energy. Sucrose and fructose may instead be introduced as ingredients during product formulation. Their use needs to be assessed against the nutritional requirements of the intended age group.

What the FSSAI Amendment Proposes

Under the Food Safety and Standards (Foods for Infant Nutrition) Regulations, 2020, lactose and glucose polymers are the preferred carbohydrate sources in infant nutrition products. The existing rules permit sucrose and/or fructose when required as a carbohydrate source, subject to prescribed limits.

The draft Food Safety and Standards (Foods for Infant Nutrition) Amendment Regulations, 2026, proposes prohibiting the addition of sucrose and fructose to products intended for infants up to six months of age. This would remove the existing allowance for these two sugars in products for this age group. FSSAI has invited objections and suggestions from stakeholders within 60 days from the date on which copies of the relevant Gazette notification are made available to the public. The submissions will be considered before the amendment is finalised.

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NMC Directs Medical Colleges to Set Up Patient Safety Committees

The National Medical Commission has directed medical colleges and medical institutions to establish patient safety committees, designate nodal officers and strengthen procedures to prevent avoidable harm.

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NMC: Medical professionals in protective equipment review documents during a patient safety meeting.
Medical professionals review documents during a meeting, highlighting the importance of coordinated safety practices in healthcare institutions. Representational image. Image credit: Dave Gracia/ Pexels

The National Medical Commission (NMC) has directed medical colleges and medical institutions across India to establish Patient Safety Committees or Cells and designate Patient Safety Nodal Officers to strengthen safety practices and reduce preventable harm in healthcare settings.

The Commission asked the heads of medical institutions to share the composition of their committees and the details of the designated nodal officers with the National Patient Safety Secretariat (NPSS) under the Directorate General of Health Services (DGHS).

The directive follows a communication dated May 8, 2026, from the Additional Director General of Health Services in the Union Ministry of Health and Family Welfare. It seeks to strengthen the adoption of patient safety protocols and standard operating procedures across medical institutions.

NMC’s Multidisciplinary Oversight

The proposed committee will be chaired by the director, head of the institution or medical superintendent. Its membership must include representatives from relevant medical specialties and the patient safety domains identified by the NPSS. Institutions are also advised to designate a nodal officer with sufficient seniority and authority to coordinate safety initiatives.

The framework covers 11 patient safety domains, including medication safety, surgical safety, blood transfusion safety, medical device safety, laboratory and diagnostic safety, infection prevention and control, healthcare-associated infections, antimicrobial resistance, patient and family engagement, vaccine and injection safety, and facility safety. It also encompasses operational research in patient safety and safety in AYUSH services.

The scope extends beyond clinical treatment to areas such as biomedical waste management, fire safety, structural safety and environmental safety. Nursing, hospital administration and other relevant professionals can contribute to the committee’s work.

From Protocols to Institutional Accountability

The directive places responsibility for patient safety within an organised institutional framework. Rather than leaving safety measures to individual departments or healthcare professionals, the proposed mechanism brings clinical, diagnostic and administrative functions under coordinated oversight.

The committee’s terms of reference include reviewing patient safety incidents and near misses, analysing their causes, promoting reporting and recommending corrective and preventive measures. Such reviews can help institutions identify weaknesses in procedures and address risks before they result in further harm.

The effectiveness of these committees will depend on how consistently institutions implement safety protocols, review incidents and act on their findings. Establishing a committee is an administrative step; sustained monitoring and corrective action are essential to translating the framework into safer care.

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World Food Day: India’s Childhood Obesity Burden Raises Concerns Over Diabetes Risk

More than 41 million Indian children and adolescents aged 5–19 were living with overweight or obesity in 2025, according to the World Obesity Atlas 2026. The growing burden raises concerns about long-term health risks, including type 2 diabetes, and highlights the need for healthier food environments, better nutrition and stronger school-based interventions.

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A young boy eating a slice of pepperoni pizza in front of a chain-link fence.
Children’s food environments and dietary habits are increasingly important in discussions about childhood obesity and long-term health risks.Image credit:Pexels

With more than 41 million Indian children and adolescents living with overweight or obesity, experts warn that unhealthy food environments could increase future risks of type 2 diabetes. New national guidance on childhood diabetes and proposed restrictions on junk food sales near schools highlight the need for preventive action.

As the world observes World Food Day on October 16, childhood nutrition is emerging as a challenge that extends beyond hunger and undernutrition. The growing prevalence of overweight and obesity among children is raising concerns about their long-term health, including their risk of developing type 2 diabetes.

India faces a particularly significant challenge. The World Obesity Atlas 2026 estimates that approximately 14.9 million children aged five to nine and 26.4 million children and adolescents aged 10–19 in India were living with overweight or obesity in 2025. Together, these figures amount to more than 41 million young people.

The report also estimates that around 1.39 million Indian children aged five to 19 had hyperglycaemia attributable to high body mass index in 2025. Hyperglycaemia refers to elevated blood glucose levels and is a health indicator associated with metabolic risk; it should not be interpreted as a count of children diagnosed with diabetes.

The figures highlight the importance of addressing childhood obesity early, before associated health risks become more difficult to manage.

Food environments and the risk of early-onset diabetes

The World Health Organization (WHO) reported in September 2026 that 400 million children and adolescents aged five to 19 worldwide were overweight in 2024, including 170 million living with obesity. The prevalence of overweight in this age group increased from 8% in 1990 to 20% in 2024.

Childhood obesity is influenced by a combination of biological, social, economic and environmental factors. Diets high in energy but low in essential nutrients, limited opportunities for physical activity and the easy availability of heavily marketed processed foods can contribute to unhealthy weight gain.

Obesity can increase insulin resistance, in which the body’s cells respond less effectively to insulin. This can raise the risk of type 2 diabetes, a condition that is increasingly important to consider in children and adolescents.

However, the relationship between food and diabetes requires an important distinction. Type 1 diabetes is an autoimmune condition in which the body’s immune system attacks insulin-producing cells in the pancreas. It is not caused by eating sugary foods or being overweight. Type 2 diabetes develops through different mechanisms and is associated with factors including excess body weight, genetics and physical inactivity.

The two conditions require different approaches to prevention and treatment.

India introduces a national childhood diabetes framework

In a significant policy development, the Union Ministry of Health and Family Welfare released a comprehensive guidance document on diabetes mellitus in children on May 3, 2026.

childhood
obesity
diabtetes

Diabetic checkup.Representational image.Image credit:Pexels

The framework outlines a structured approach to screening, diagnosis, treatment and long-term management, linking community-level identification with district hospitals and medical colleges. It also provides for free-of-cost care at public health facilities, including insulin therapy, blood glucose monitoring supplies and follow-up services.

The guidance promotes awareness of the early warning signs of type 1 diabetes through the “4Ts”: Toilet, Thirsty, Tired and Thinner. These refer to frequent urination, excessive thirst, unusual tiredness and unexplained weight loss.

The initiative is important because timely diagnosis and access to insulin can be lifesaving for children with type 1 diabetes. It also highlights the need for health systems to identify and manage diabetes before complications develop.

Schools become a focus of food policy

India is also considering measures to improve the food environments surrounding schools. A Reuters report published on September 24, 2026, said the country was moving towards restrictions on the sale of foods high in fat, salt and sugar within a 50-metre radius of schools.

The proposed measures would affect vendors and shops selling products such as sugary drinks and packaged snacks near educational institutions. The proposal reflects growing concern about the availability of unhealthy foods in places where children spend much of their day.

If implemented effectively, school-focused measures could form part of a wider strategy that includes healthier school meals, accessible drinking water, nutrition education, physical activity and clearer food labelling.

However, restrictions alone cannot address the problem. Families also need affordable access to fruits, vegetables, pulses and other nutritious foods. Public-health measures must account for household budgets and the realities of food access in different communities.

Beyond calories

World Food Day 2026, themed “Innovate today. Nourish tomorrow,” offers an opportunity to reconsider what food security means for children. Access to sufficient calories is essential, but the nutritional quality of food also matters.

Reducing the future burden of type 2 diabetes requires action across healthcare, education, food policy and community environments. At the same time, children living with type 1 diabetes need timely diagnosis, uninterrupted insulin supplies and long-term medical support

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