The battle against cancer is long and hard and continues to be fought across the world. While some valiantly survive the disease, inspiring hope in others, several succumb to the dangerous illness, which affects millions worldwide. Globally, in 2020, there were 19.3 million cancer cases, with India bearing the third highest disease burden. In 2022, the country reported over 1.4 million cases and the Global Cancer Observatory predicted that this number would increase by 57.5 per cent by 2040.

The reduction of cancer burden primarily depends on three factors: early screening, precise diagnosis, and timely treatment. However, screening and diagnosis programmes are not as prevalent in India as compared to the rest of the world and, as a result, patients are often diagnosed at advanced stages.

An obstacle most patients face is the exorbitant cost of treatment, which can leave families impoverished. Per a parliamentary report, nearly six crore Indians are driven below the poverty line every year due to cancer-related healthcare costs. This impact is further exacerbated by the Goods and Services Tax (GST) levied on cancer drugs.

Affordability issue

In 2021, the 45th GST Council meeting decreased the GST on pembrolizumab, a drug used for the treatment of multiple cancers, from 12 per cent to 5 per cent. Similarly, one of the key decisions taken during the 50th meeting of the Council (2023), was to exempt IGST levied on dinutuximab “when imported for personal use.” This drug is used in the treatment of high-risk neuroblastoma, a rare cancer in children.

Reduction of GST on all cancer drugs can be a compelling initiative making innovative drugs more accessible and affordable.

Alleviating financial burden: Cancer patients in India bear the burden of high out-of-pocket (OOP) expenditure coupled with low insurance coverage. A study showed that cancer patients (45-60 years) incurred an average OOP expenditure of ₹8,053 and ₹39,085 for each outpatient consultation and hospitalisation, respectively. The annual figure per patient was estimated to be ₹3,31,177. More than 80 per cent of this expenditure was attributed to medicines and diagnostics. Hence, reduction of GST can go a long way towards alleviating this financial burden. Furthermore, lowered costs can make these drugs more accessible to underserved populations.

Facilitating timely treatment: In India, it is common for cancer patients to be diagnosed at advanced stages. A report from the National Cancer Registry Programme revealed that a majority of patients with breast, cervix uteri, head and neck, and stomach cancers were diagnosed at advanced stages. Similarly, in more than 40 per cent of cases, lung cancers were diagnosed after they had spread to other areas. Since the complexity and costs of treatment increase with advanced stages of cancer, reducing the GST can make treatment more affordable for such patients, and encourage the patients to go for timely consultations and consistent use of necessary medications, improving treatment outcomes.

Encouraging innovation: Reducing GST on cancer drugs can make newer innovations more accessible benefiting larger pool of patients, which in turn can be encouraging for pharmaceutical companies to invest more in research and development and creating newer and more advanced drugs that can effectively treat the disease.

Aligning with global practices: In countries such as Canada and the US, zero taxes or significantly reduced taxes are levied on prescription drugs, enhancing accessibility and affordability. The same principle must be applied in India by reducing GST on cancer drugs, thereby aligning with the global best practices of healthcare accessibility.

The call for waiving GST on cancer drugs is not merely a matter of economics, but a moral imperative. It is a decisive step towards alleviating the burden on those already facing the toughest battle of their lives.

The writer is Managing Director & Country President, AstraZeneca Pharma India Ltd

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