Presenting her 9th straight budget, Sitharaman said the government wanted to ease the financial burden on families that depend on imported drugs. “To provide relief to patients, particularly those suffering from cancer, I propose to exempt basic customs duty on 17 drugs or medicines,” she said.

These are targeted therapies or immunotherapies used in breast cancer, brain tumours and melanoma.

Imported cancer drugs in India attract a basic customs duty of 10 percent, while some categories of lifesaving drugs/vaccines attract a concessional rate of 5 percent, which has now been made zero for these drugs.

Cancer is a major and growing public health challenge in India. The disease imposes catastrophic health expenditure in India, with medicines constituting more than 60 percent of out-of-pocket expenditure.

Last year, a parliamentary committee asked the government to impose price caps on certain cancer medicines. A Tata Memorial Centre study found that fewer than 3 percent of Indian cancer patients have access to newer, promising treatments.

Dr Kanika Sood Sharma, Director of Radiation Oncology at Dharamshila Narayana Hospital, said that while the exemption could help more patients access newer cancer treatments, especially targeted therapies and immunotherapies, only a small segment of patients would benefit.

“In a few malignancies, they have been life-changing,” Sharma said. She said that around 20 years ago, patients with metastatic lung cancer typically survived for nine to eleven months. Even for stage three disease, five-year survival rates were low despite aggressive chemotherapy and radiation. “Many drugs like durvalumab, which came as adjuvant therapy, have increased survival,” she said.

According to Sharma, the main barrier to using these drugs widely has been cost. She said that when customs duty is removed, a few more patients become eligible by virtue of their ability to afford that drug.

Referring to the list of drugs exempted this year, she said that these are not basic medicines, but high-end drugs often used as second- or third-line treatment.

Rare diseases

In her budget announcement, FM Sitharaman also said that seven additional rare diseases will now qualify for duty-free personal imports of medicines, drugs, and special medical foods (FSMP), making these essential treatments cheaper and easier for patients to bring into India.

The seven rare diseases added to the duty-exempt list are Congenital Hyperinsulinemic Hypoglycaemia (CHI), Familial Homozygous Hypercholesterolaemia, Alpha-Mannosidosis, Primary Hyperoxaluria, Cystinosis, Hereditary Angioedema, and Primary Immune Deficiency Disorders.

All of these conditions are already covered under the National Policy for Rare Diseases (NPRD), 2021.

Prasanna Shirol, co-founder and executive director of Organisation for Rare Diseases India (ORDI), said, “No individual patient can afford to import these, even after the exemption,” he said. “If the drug costs Rs 75 lakh to Rs 1 crore per year, which patient will be able to afford it.” Shirol said the exemption on special formula diets and FSMPs may help some families, but only a limited section.

“By reducing the import duty, the treatment may extend another one or two months,” Shirol said.

He pointed out that similar exemptions have been announced in earlier budgets, with more drugs added each year, but the core problem remains. What patient groups are asking for, Shirol said, is not duty exemption but assured and consistent government funding.

(Edited by Ajeet Tiwari)

Source : https://theprint.in/health/budget-cuts-import-costs-of-17-cancer-7-rare-disease-drugs-why-it-offers-little-relief-to-patients/2842842/