Drugmaker AstraZeneca, beneficiary of the customs waiver on three cancer drugs this Budget, said it is working out how to pass on the benefit to patients.
The drugs Trastuzumab Deruxtecan (breast cancer), Osimertinib ( Lung Cancer) and Durvalumab (Lung Cancer and Biliary Tract Cancer) were exempted from 10 percent customs duty (Budget ’24), in an effort to make them more affordable.
Prices on the exempted drugs range between ₹15,000 (for a tablet/capsule) to ₹1.89 lakh (a vial). Besides, there are no generic versions of these drugs, available at lower prices.
This has put the spotlight back on critical cancer drugs and their pricing, and the need for local research, manufacturing and partnerships to make them affordable for patients, says specialists.
The duty cut is a step in the right direction, but the overall cost of treatment remains high, says Dr Kumar Prabhash, Professor Medical Oncology, Tata Memorial Hospital, calling for local research to develop medicines tailored to local needs. “We use all three drugs,” but they are costly, Prabhash told businessline. Citing multiple surveys on cancer drugs, he said, only 10 percent of those who need these drugs actually get it.
Despite duty cuts, the drugs would be out of bounds for many patients, he said, pointing to the challenges with importing drugs, especially newer drugs from multinational companies. “This highlights the limitation …if you don’t have research here, then we do land up importing it and then it becomes costly.”
Treatment costs
Each of these drugs need to be taken once in three weeks or a month and usually for years, he said, pointing to the recurring cost for long-term treatment, besides the additional cost of diagnostics, medicines and hospitalization. Government insurances are useful, and private health insurance are there, but are often not adequate to cover these costs, he said, outlining patient challenges.
Responding to a businessline query on when the exemptions would translate into price benefits for patients, AZ said, “We deeply appreciate the decision and are now working on how the benefit can be passed to the patients in our country that will help expand access to innovative medicines.”
On pricing, it said, Durvalumab was priced at ₹45,500 (120 mg injection / one vial), and ₹1,89,585 (500 mg injection / one vial); Osimertinib was priced at ₹15,167 (80 mg one tablet / capsule) and Trastuzumab Deruxtecan was priced at ₹1,87,000 (100 mg injection/one vial).
“All three are good drugs and have increased life of the patient, substantially,” said Prabhash. The Centre should make the research ecosystem encouraging for trials on newer drugs to be done here – facilitating better access to these drugs. Multinationals can be encouraged to manufacture locally, and this would bring down prices, he said. Also, home-grown drugmakers should be encouraged to partner with public institutions and develop alternatives, he said, adding that they could also partner with the multinationals to possibly make the drugs locally.
Duty exemption
In its statement on the Budget duty exemption, the Union Health Ministry had said, it had forwarded a request to the Union Finance Ministry, in view of the 27 lakh cancer patients in the country.
The Trastuzumab injection 440mg/50ml is under price control, and its current ceiling price is ₹54,725.21 per vial, the Health Ministry said. However, its other strength variants are not price-controlled, it said, adding that Trastuzumab (in different strengths and dosages) had a combined annual turnover of more than ₹276 crores. Osimertinib and Durvalumab are non-scheduled medicines under DPCO (Drugs Prices Control Order), 2013 – monitored to ensure that the MRP (maximum retail price) did not increase by more than 10 percent in twelve months.
The annual turnover of Durvalumab for the year 2023-24 was ₹28.8 crore. Osimertinib was covered under the list of 42 anti-cancer drugs for which trade margin was regulated and its annual turnover for the year 2023-24 was ₹52.26 crore, the Ministry said.