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The patient advocacy group Working Group (WG) on Access to Medicines and Treatments has alleged that the exemption of basic customs duty (BCD) on the cancer drugs announced in the Union Budget 2026-27 would not be sufficient to reduce the burden of patented life-saving medicines on the patients, as against the legally available tools such as compulsory licensing and action against evergreening of patents.
Elaborating on the sustained higher prices continue to prevail for various BDC exempted medicines during 2026, the WG said that the exemption is a narrow, indirect measure, which does little to guarantee affordable access and allows states to sidestep its constitutional obligation to ensure affordability and accessibility of medicines.
"We therefore call on the Government of India to immediately publish the MRP of all medicines benefitting from BCD exemption along with transparent data on the actual price reduction passed on to the patients after exemptions are granted," said the WG in a statement following the Central government's presentation of Budget 2026-27.
Taking the prices of certain medicines displayed in the online pharmacies, and calculating the cumulative burden based on the standard clinical dosing schedules, the WG said that the estimated per year cost of cancer drug trastuzumab deruxtecan, listed for BCD exemption in 2024, is around Rs. 1.14 crore, while the estimated cost for ipilimumab, which has been exempted from BCD in the latest budget, will be Rs. 36.6 lakh per patient.
However, estimated cost for tremelimumab as a one time dose, which has also been added into the list of BCD exempted drugs in the latest budget, will be around Rs. 4.44 lakh, which makes it a rare case where the high unit price does not translate into catastrophic annual cost, added the WG.
The BCD exemption will deliver minimal benefit to patients. Since the maximum retail prices of these medicines remain unaffordable for most Indians even after the BCD exemption. Only a fraction of population with access to huge finance or schemes like CGHS can afford them.
"More troubling is the fact that there is no evidence that companies reduced prices in response to the BCD waiver. The companies are not passing the benefit of lowering of price to the patients and hence, the waiver is benefitting the foreign multi-nationals, not the Indian patients," alleged the WG in its post budget reaction.
Intellectual Property monopolies especially patent monopolies are the key drivers of exorbitant prices in India. Rather than deploying available legal tools under the Patents Act like govt use license, compulsory license and stricter scrutiny of secondary patents and improving the drug regulatory framework including streamlining approval pathway for quality assured generics and biosimilars, the government relies on BCD exemption on selected drugs, it added.
The Group welcomed the Rs. 10,000 crore Biopharma Shakti initiative, adding that its success requires three critical reforms: waiving animal studies and comparative clinical trials for certain approvals, establishing biosimilar pathways, and blocking multiple patents on the same molecules.
"The government must act urgently on these reforms and target Biopharma Shakti to address the unmet health needs of India. This direction of this initiative should be towards bringing down the price of medicines in the country," it added.
The Budget 2026-27 exempted basic customs duty (BCD) on 17 drugs and medicines for cancer patients and exempted seven more rare diseases from import duties on personal imports of drugs, medicines.
The exemption of BCD is on 17 drugs namely - ribociclib, abemaciclib, talycabtagene autoleucel, tremelimumab, venetoclax, ceritinib, brigatinib, darolutamide, toripalimab, serplulimab, tislelizumab, inotuzumab ozogamicin, ponatinib, ibrutinib, dabrafenib, trametinib, and ipilimumab, to provide relief to patients, particularly those suffering from cancer. With this, the total number of drugs exempted from BCD is around 129.
It also proposes to add 7 more rare diseases, which are part of National Policy for Rare Disease (NPRD), 2021, for which import duties on personal imports of drugs, medicines and Food for Special Medical Purposes (FSMP) used in their treatment will be exempted. The diseases exempted include congenital hyperinsulinemic hypoglycemia (CHI), familial homozygous hypercholestrolemia, alpha mannosidosis, primary hyperoxaluria, cystinosis, hereditary angioedema, primary immune deficiency disorders.
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