BlitzIndia Special Investigations Desk
NEW DELHI: Walk into any pharmacy in India today, and you are stepping into one of the world’s most complex consumer battlegrounds. On one side stands a ₹4,71,898-crore pharmaceutical industry — the third-largest on the planet by volume — that supplies generic medicines to over 150 countries and proudly calls itself the ‘Pharmacy of the World.’ On the other side stands you, the patient. And if Parliament’s own Standing Committee is to be believed, you are getting a raw deal.
A landmark report tabled in December 2025 by the Standing Committee on Chemicals and Fertilisers — a cross-party body of elected Members of Parliament — laid bare a crisis hiding in plain sight. The report’s title alone is an indictment: ‘Price Rise of Medicines in the Pharmaceutical Sector Impacting the Lives of Ordinary Citizens Adversely.’
Its findings were blunter still: Commonly prescribed medicines in India carry mark-ups of between 500 and 1,800 per cent above production cost. Half the market operates entirely outside price regulation. And online pharmacies — where millions now buy their medicines — operate in a complete regulatory vacuum.
The scale of the problem
The numbers tell a story that no Government press release can soften. According to data presented to the Rajya Sabha in July 2025 by Health Minister JP Nadda, a total of 1,16,323 drug samples were tested across India in FY 2024-25.
Of these, 3,104 were declared “Not of Standard Quality” and 245 were found to be spurious or adulterated — meaning manufactured by unauthorised parties using stolen brand names. The year before, the figure for spurious drugs was 282. The year before that, 424.
A decade-long analysis by data intelligence platform Dataful.in found that roughly one in every 25 drugs tested in India fails quality standards — a rate of approximately 3.7 per cent. In December 2025 alone, Central Drugs Standard Control Organisation’s (CDSCO) monthly drug alert flagged seven spurious medicines including Telma-AM, a widely prescribed hypertension tablet.
In one confirmed case, the brand owner’s own manufacturer told investigators that the batch under scrutiny had not been produced by them at all — a textbook counterfeit, circulating freely in the market.
Between 2019-20 and 2023-24, the Parliamentary Committee found that 4,57,910 drug samples were tested across India, of which 13,735 were “Not of Standard Quality” and 1,547 were declared spurious or adulterated.
Yet in that same five-year period, only 2,516 prosecutions were launched and 1,228 arrests made. The Committee’s verdict was damning: These figures were ‘disproportionately low,’ pointing to weak enforcement, inadequate punitive action, and possible regulatory oversight lapses.
Paying, but not protected
If unsafe medicines are one half of the crisis, unaffordable medicines are the other. India’s out-of-pocket expenditure (OOPE) on healthcare — the amount patients pay directly from their own pockets — stood at 39.4 per cent of total health expenditure in 2021-22, down from 64 per cent in 2013-14.
That is real progress. But research published in February 2026 in the peer-reviewed journal Discover Health Systems found that over 52 per cent of all out-of-pocket health spending in India goes on medicines alone. The Observer Research Foundation (ORF) estimates that between three and seven per cent of Indian households fall below the poverty line every single year because of healthcare costs — medicines being the primary driver.
The regulatory architecture meant to protect consumers from this is, in the words of multiple Parliamentary Committee reports, inadequate. The Drugs (Prices Control) Order, 2013 gives the National Pharmaceutical Pricing Authority (NPPA) power to fix ceiling prices — but only for medicines on the National List of Essential Medicines.
Everything else can be launched at any price a manufacturer chooses. Annual increases beyond 10 per cent require notification, but the launch price itself is entirely unregulated. Fixed dose combination drugs — prescribed for everything from diabetes to respiratory infections — fall completely outside the system.
The Committee pointed to one egregious example: A combination of Ciprofloxacin 500mg and Tinidazole 600mg was being sold at an MRP of ₹3,500 per strip. The Department of Pharmaceuticals, when asked, confirmed the drugs were ‘not scheduled formulations’ — meaning the NPPA had no jurisdiction over their price. The department could only shrug.
Is anyone listening?
Across party lines, MPs have raised pharmaceutical consumer concerns with unusual consistency. A peer-reviewed study published in BMC Public Health in September 2025 analysed the Lok Sabha’s digital repository from January 2017 to February 2024, spanning 11 parliamentary sessions.
It found that 1,121 medication-related questions were asked by MPs during this period — nearly one in five of all health-related questions raised in Parliament. Drug pricing, availability, quality, and e-pharmacy regulation featured most prominently.
Congress MP Jebi Mather Hisham used Rajya Sabha Zero Hour in December 2025 to describe raids in Kozhikode, Thrissur and Thiruvananthapuram that had uncovered an ‘unregulated network of manufacturers and marketing companies pushing substandard medicines.’
She called it not a small lapse but a systemic failure of state drug control departments, and demanded a Central probe. NITI Aayog, meanwhile, has formally authorised its Committee on Affordable Medicines and Health Products (CAMPH) to recommend drugs for price control — yet in 2024, the same body guided the NPPA in approving price hikes for 11 essential formulations, earning sharp criticism from the Parliamentary Committee.
Deep-seated malaise
The e-pharmacy front is, if anything, more alarming. India’s online medicine market is booming — and almost entirely unregulated. A Parliamentary panel headed by MP V. Vijayasai Reddy declared it was ‘appalled’ that draft e-pharmacy rules had not been finalised, warning that the delay was creating uncertainty in a fast-moving digital market and enabling illegal platforms to sell prescription drugs, habit-forming substances, and outright counterfeits without any oversight.
There are green shoots. The Jan Aushadhi network has grown to 17,990 outlets and generated an estimated ₹38,000 crore in consumer savings by June 2025. The UCPMP 2024 turned the voluntary pharmaceutical marketing ethics code into a mandatory one.
The Indian Pharmacopoeia 2026 — effective 1 July 2026 — upgrades national medicine quality benchmarks to international standards. A new law to replace the Drugs and Cosmetics Act of 1940 is in development, and will for the first time give CDSCO statutory powers to act immediately against fake medicines.
But policy watchers and consumer groups argue that these measures, welcome as they are, address symptoms rather than the structural disease. The Parliamentary Committee has been clear on what must change: Amend the DPCO to permanently enable trade margin rationalisation; bring non-scheduled medicines and fixed dose combinations under launch-price regulation; enact a dedicated e-pharmacy law; expand Price Monitoring and Resource Units to all states; and create a single national medicine grievance portal.
These are not radical demands. They are the minimum floor of consumer protection that a ₹4,71,898-crore industry — one that confidently calls itself the world’s pharmacy — owes to its own citizens.
India’s pharmaceutical sector exports hope to the world. It is past time it delivered the same to the people living within its own borders.
“Commonly prescribed medicines carry mark-ups of 500 to 1,800 per cent above production cost. Half the market operates entirely outside price regulation.”
— Parliamentary Standing Committee on Chemicals and Fertilisers, December 2025
Sick numbers
₹4,71,898 crore — India’s annual pharmaceutical sector turnover (FY 2024-25). India ranks 3rd globally by volume, 11th by value.
39.4% — Share of total health expenditure still paid out-of-pocket by Indians (2021-22), down from 64% in 2013-14 but still dangerously high.
52%+ — Of all out-of-pocket health spending goes on medicines alone (Discover Health Systems, Feb 2026).
3,104 NSQ + 245 spurious — Drug samples failing quality or confirmed counterfeit in FY 2024-25 alone, out of 1.16 lakh tested.
1 in 25 — Drugs tested over a decade (2014–2025) that failed quality standards on average (Dataful.in, Oct 2025).
500% – 1,800% — Mark-ups on some commonly prescribed medicines above production cost (Parliamentary Standing Committee, Dec 2025).
3% – 7% — Indian households pushed below the poverty line every year due to health costs — medicines the primary driver (Observer Research Foundation).
₹38,000 crore — Estimated consumer savings generated by Jan Aushadhi Kendras (17,990 outlets) by June 2025.
The reform agenda
The December 2025 Parliamentary Standing Committee report — the most detailed legislative examination of medicine prices in years — sets out what Indian consumers should rightfully receive. BlitzIndia summarises its core demands.
Permanent trade margin rationalisation: Amend DPCO 2013 to make margin capping a permanent legal right, not a time-limited tool.
Price control on non-scheduled drugs: Extend NPPA authority to regulate launch prices of medicines currently outside the NLEM framework.
Transparent pricing data: Make Price to Stockist (PTS) data publicly accessible so patients can see the true cost of what they buy.
E-pharmacy law now: Finalise and enact dedicated e-pharmacy rules covering prescription verification, authenticity, delivery standards and grievance redressal.
Maximum enforcement: Swift prosecution and maximum penalties for manufacturers of spurious or substandard drugs — 2,516 prosecutions over five years is not enough.
Single national grievance portal: Integrate NPPA, CDSCO, State Drug Controllers and Jan Aushadhi complaints into one accessible platform for every Indian patient.