The exemption of three additional cancer medicines —Trastuzumab Deruxtecan, Osimertinib, and Durvalumab — from customs duty in the Union Budget 2024-25 has come as a relief for cancer patients in Meghalaya.
The three cancer drugs namely Trastuzumab Deruxtecan, Osimertinib and Durvalumab are used for different tumour types – Trastuzumab Deruxtecan for breast cancer, Osimertinib for lung cancer, and Durvalumab for lung cancer and biliary tract cancer.
Trastuzumab Injection 440mg/50ml is a scheduled drug under National List of Essential Medicines (NLEM) 2022 and the National Pharmaceutical Pricing Authority (NPPA) has fixed the ceiling price of the same. The current applicable ceiling price is Rs 54,725.21 per vial. However, its other strength variants are not under the schedules list. Trastuzumab comes in different strengths and dosages.
The other two medicines, Osimertinib and Durvalumab, are non-scheduled medicines under Drug Price Control Order (DPCO), 2013. Hence, the NPPA monitors the maximum retail price (MRP) of the non-scheduled formulation to ensure that the same does not increase by more than 10 per cent of MRP during the preceding twelve months.
With most of the cancer patients in Meghalaya coming from poor economic backgrounds, the exemption of the customs duty will bring down the price of the three cancer medicines making treatment more affordable for the suffering patients.
Meghalaya has two cancer hospitals, one at Shillong Civil Hospital Shillong and another at NEIGRIHMS.
The financial burden associated with cancer can force patients and households to acute misery, destitution, and even insolvency. Therefore, cancer drugs need to be affordable so that whenever required the treatment can be provided at the earliest in the early stages when the cancer is curable. Availability and affordability of cancer drugs will give impetus to treatment outcomes bringing down the cost of treatment.
In the past, the MRP of Erlotinib 150 mg tablets under Brand Birlotib was brought down from Rs 9999 to Rs 891.79, showing a decrease of 91.08 per cent. Similarly, the MRP of Pemetrexed 500 mg injection sold as Pemestar 500 was revised from Rs 25,400 to Rs 2509 which was 90 per cent less than pre-revised price.
According to health experts, cancer is among the top five leading causes of death in Meghalaya. The Age-Adjusted Incidence Rate is 176.8 per 100,000 in males in the State.
About two-thirds (66.9 per cent) of cancers in males and 43.1 per cent in females were tobacco-use-related cancer sites, among which oesophagus was the leading site in both genders (31.0 per cent in males; 22.3 per cent in females).
Hypopharynx (8.8 per cent) and stomach (6.3 per cent) were the other leading cancer sites in males, whereas, in females, cervix-uteri (10.0 per cent) and mouth (8.2 per cent) were other common cancer sites.
