When treatment exists, no life should be lost because it is unaffordable

There are few things more painful than watching a loved one battle a life-threatening disease. But perhaps even more heartbreaking is knowing that a treatment exists, and yet a family cannot afford to give its loved one that chance.For such families, the struggle is not only against cancer. It is also against the financial burden of fighting cancer.This is what makes the Government of India's decision to cap trade margins at 30% on 137 identified non-scheduled anti-cancer medicines so significant. From November 9, the maximum retail prices of some of these medicines are expected to fall by as much as 70%, depending on their existing price structures, with estimated annual savings of ?2,500 crore for patients. It builds on a 2019 intervention covering 42 anti-cancer medicines, which led to price reductions of up to 90% across 526 brands.But the real impact cannot be measured in rupees alone. It must also be measured in families who can continue treatment, and patients who no longer have to choose between their savings and their survival.Cancer does not discriminate between rich and poor. Unfortunately, access to treatment often does.India is at an important juncture. Lifestyle-related diseases are rising, our population is ageing, and cancer is becoming a serious public health challenge. Many patients are still diagnosed at advanced stages, when treatment becomes more complicated, prolonged and expensive.For these patients, medicines are only one part of the financial burden. There are consultations, biopsies, scans, hospitalisation, surgery, chemotherapy, radiation and follow-ups. There is also the cost of travel, staying away from home and income lost during a prolonged illness.According to India's National Health Accounts Estimates for 2022-23, out-of-pocket expenditure accounted for 43.4% of the country's total health expenditure. While this is a significant decline from 64.2% in 2013-14, it highlights how much of the financial responsibility for healthcare continues to rest with Indian households.We must ask ourselves a fundamental question: Should a family lose its lifetime savings simply because one of its members has fallen seriously ill? Surely, as a society, we can do better.India has earned global recognition as the pharmacy of the world, making quality medicines available at competitive prices and benefiting millions of patients across the globe.Our contribution to HIV treatment is a powerful example. Two decades ago, antiretroviral therapy cost thousands of dollars per patient each year. Indian manufacturers helped bring that cost down to less than a dollar a day, making treatment accessible to millions across Africa and Asia.However, we cannot become complacent simply because our medicines are affordable by international standards. Affordability must always be viewed from the perspective of the Indian patient. For a family with a modest income, a medicine that looks inexpensive by global standards may still be beyond reach, especially when treatment continues for months or years.A medicine is not truly affordable because it is cheaper than the same medicine abroad. It is affordable only when the patient who needs it can access it without being pushed into financial hardship.Having spent more than three decades in this industry, I understand that innovation requires substantial investment. Developing new molecules, biological medicines, and advanced therapies involves years of research, scientific uncertainty and significant financial risk. Pharmaceutical companies need sustainable returns to continue investing in the next generation of treatments.But innovation and affordability should never be treated as competing objectives. What is the value of a medical breakthrough if it remains beyond the reach of the very patients it was developed to save?Too often, breakthrough therapies are developed first, and questions of access are addressed much later. Not every therapy can be inexpensive. But affordability should be a design choice, not an afterthought.India has demonstrated its ability to make quality generic medicines accessible at scale. We must now bring the same thinking to complex therapies, biotechnology, diagnostics and next-generation treatments. The future of Indian pharmaceuticals should be built on both scientific excellence and patient affordability.The government's decision also sends a message to every participant in the healthcare value chain: manufacturers, distributors, stockists, retailers, hospitals and healthcare providers. Each must earn enough to sustain operations, maintain quality and invest in better services.The question is not whether businesses should earn profits. Of course they should. The question is whether every layer of the system is creating value proportionate to the cost ultimately borne by the patient.Healthcare is not an ordinary business. When a family is fighting to save a life, it is rarely in a position to negotiate. That places a greater moral responsibility on all of us.A price reduction achieves its purpose only when patients experience the savings at the point of purchase. Revised prices must be reflected in patient bills, and medicines must remain available. Patients and caregivers should also be able to verify revised prices through the NPPA website and the Pharma Sahi Daam app. A medicine that is affordable on paper but unavailable when a patient needs it does little to help.Lower medicine prices are a major step, but India's affordability challenge is much broader. Too many patients delay consultations and diagnostic tests because they fear the cost. By the time a disease is detected, treatment may be longer and more expensive. We must strengthen screening and diagnostics, particularly beyond our major cities.A patient does not experience healthcare as a series of separate bills. They experience it as one continuous treatment journey. Our goal must evolve from making individual medicines affordable to making that entire journey financially sustainable. This will require the government, industry, hospitals and insurers to work together.I sincerely commend the Government of India for this decision. It addresses the difficult balance between commercial interests and public welfare, while placing patient access at the centre.We must continue to build a strong, globally competitive pharmaceutical industry. But we must never forget why this industry exists in the first place.If this policy helps even one more family afford a life-saving treatment, it will have achieved something far more valuable than a reduction in medicine prices.Because ultimately, medical science exists to make treatment possible. Our responsibility is to make it accessible to those who need it.Disclaimer: Views expressed above are the author's own.