Health activists are pushing for a revision of India’s list of essential medicines to ensure price cap and availability
Image used for representational purposes. | Photo credit: Getty Images/iStockphoto
India’s list of essential medicines has not been updated in nearly four years, even as the World Health Organization (WHO) revised its own list twice in the same period, says a network of activists and civil society organizations working for affordable healthcare.
The collective — the Working Group on Access to Medicines and Treatments — has written to the government to urgently revise the National List of Essential Medicines (NLEM) so that these medicines are available at affordable prices.
NLEM is a curated list of medicines compiled by the Ministry of Health and Family Welfare. It prioritizes medicines that meet the critical health needs of the Indian population based on safety, efficacy and cost-effectiveness. Medicines on the list – currently 384 – are designated as essential medicines. These drugs are usually dispensed free of charge by government hospitals.
The government uses the NLEM to direct the National Medicines Pricing Authority (NPPA) to enforce a strict price cap on them, thereby making healthcare affordable and reducing out-of-pocket expenses for citizens. The list was last revised on September 13, 2022. No comprehensive changes or deletions have been implemented since then.
Revision in the list
Meanwhile, the WHO Model List of Essential Medicines was revised in 2023 and again in 2025, and according to the task force’s 523 drugs, India’s list now lags behind the global benchmark.
The consequences, the group says, fall most heavily on patients battling cancer and diabetes. His letter identifies 17 active cancer treatment agents and four cancer support drugs that are on the WHO list but not the NLEM. Also missing are nine monoclonal antibodies—a class of targeted biologics increasingly important to modern cancer treatment—none of which currently appear on the Indian list.
“We urge the immediate initiation of a transparent, time-bound and non-confrontational process to review the NLEM to ensure it reflects the latest evidence, public health priorities and the WHO Model List of Essential Medicines. Timely action is essential to protect the constitutional guarantee of the right to life as it ensures equitable access to essential medicines for all citizens,” said co-Working and Treatment Group’s KM Gopaking.
Price ceiling enforcement
Inclusion in NLEM is not a symbolic exercise. Medicines on the list are automatically included in the price cap regime enforced by the National Medicines Pricing Authority (NPPA) and are to be stocked and dispensed free of charge in public hospitals and health centres. The absence of a drug from the list therefore has a direct effect on both what patients pay in the private market and what they have free access to in the public system.
“The long delay results in medicines being denied to millions of citizens – who could have had free access to the newly recognized essential medicines under the public health system, while limiting affordable access in the private sector,” the paper said, adding that the delay was not just a bureaucratic delay but a matter of “profound constitutional and human rights”.
He added that the NLEM need not be a mirror image of the WHO list – India’s list is meant to reflect the country’s own public health priorities, health burden and cost considerations, and some variation is expected and legitimate.
The task force said its own analysis showed that India’s list also includes several dozen drugs that do not appear on the WHO list, reflecting locally relevant priorities such as tuberculosis treatment.
“However, the omissions – particularly in oncology, diabetes and biological therapies – are not a matter of local discretion, but critical gaps that leave patients with life-threatening conditions with a high prevalence of access to internationally recognized standard medicines,” he said.
Published – 04 Jul 2026 17:41 IST