Who decides what medicines cost in India?

India licenses medicines through the CDSCO but sets prices through the NPPA, a split that creates a policy gap. In one case cited before the Supreme Court in September 2026, a cancer drug supplied to retailers at ₹2,700 carried an MRP of ₹27,000. On October 17, the NPPA capped trade margins at 30% on 137 anti-cancer drugs.