Natco Pharma’s cancer-drug sales in India will fall 20% by March 2027.

India has approved a 30% cap on trade margins for around 110 cancer drugs outside existing price controls, including 35 patented medicines. The cap limits hospital markups but not manufacturer prices, so domestic drugmakers are most affected because branded generics have thus far relied on hospital markups averaging 170% to drive sales. Natco faces the greatest risk as India’s largest domestic oncology generics maker. When Dehli imposed a similar cap on 42 drugs back in March 2019, Natco’s domestic sales fell 37% within five months. Natco is therefore likely to lose oncology market share to competing brands already priced inside the cap.