India’s National Pharmaceutical Pricing Authority (NPPA) is on an overdrive. Since June, it has forced several drug companies to reverse price hikes. The Delhi-based watchdog, which directly controls the prices of 74 drugs specified in a 1995 government order, clamped down on drug prices outside its list for the first time since 1998. NPPA’s action covers one supplement for healthy joints, two commonly-prescribed antibiotics, one for irritable bowel syndrome, two anti-ulcerants, and an anti-allergy drug. Just the threat has got 29 companies to cut prices of 49 packs on other medicines. (Every medicine has packs of different doses and deliveries.) Others, says NPPA chairman Ashok Kumar, are being forced by fiat.

But the impact of NPPA’s actions — routine or extraordinary — is likely to be lost on a growing number of Indian patients.

Every year, Mumbai’s Tata Memorial Centre (TMC) treats 12,000 cancer patients for free or at a heavy discount. Medicines account for a chunk of that subsidy. Bulk buying helps the hospital cut an average 30 per cent from the retail price of anti-cancer drugs. Yet, patients find it a stretch, says Rekha Batura, assistant medical superintendent at TMC. Many families sell their land, homes and even wipe out their savings to pay for treatment. “Medicines are the most expensive part of cancer treatment,” she says. “Patients shouldn’t have to hawk their future for a cure.”

India has 2.5 million cancer patients at any given point in time. But the list of 74 doesn’t include any new anti-cancer medicines, nor any recent advances against other chronic and costly-to-treat ailments like HIV, hypertension and heart disease. These account for a growing portion of India’s disease burden. According to the World Health Organization, chronic disease (defined as lasting three months or longer) caused half the country’s deaths in 2005. After three decades of drug price control, most Indians still struggle to pay for life-saving medicines. “We produce all the medicines we need,” says Amit Sengupta, a health expert with the Delhi Science Forum (DSF), a non-profit organisation that works on issues related to science. “The real constraint is economics.”