# A National Cancer Grid pooled procurement initiative, India

Source: https://onco.cc/key-papers/paper-pramesh-ncg-pooled-procurement-2023/  
OnCo record `paper-pramesh-ncg-pooled-procurement-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

When 23 Indian cancer centres bought 40 cancer drugs together instead of separately, prices fell by a median of 82%, saving about 13 billion rupees against list prices.

## Summary

Report in the Bulletin of the World Health Organization of the National Cancer Grid's pooled procurement pilot: 40 anticancer drugs, pooled demand from 23 cancer centres worth about 15.6 billion Indian rupees (197 million dollars) at maximum retail price, and a negotiated cost reduction of about 13.2 billion rupees (166.7 million dollars). Savings ranged from 23% to 99% per drug (median 82%), larger for generics than for innovator or newly patented drugs, and were achieved through group negotiation of fixed prices and uniform contracts with standardised terms.

## Fields

- Kind: Key paper
- Last checked: 2026-09-10
- Journal: Bulletin of the World Health Organization
- Year: 2023
- DOI: 10.2471/BLT.23.289714
- Authors: Pramesh CS, Sengar M, Patankar S, et al.
- Findings: 40 drugs, 23 centres, pooled demand of about 15.6 billion rupees at maximum retail price.; Cost reduction of about 13.2 billion rupees (166.7 million dollars).; Savings per drug 23% to 99%, median 82%; larger for generics than innovator drugs.; Mechanism: group negotiation, fixed prices, uniform contracts with standardised terms.
- What it means: Buying power, not new science, is the fastest lever on cancer drug prices in a decentralised, under-funded system. The Grid's model is being extended across its 360-plus centres and offers a template for other middle-income countries and for pooled buying of newer, patented drugs.
- Caveats: Savings are measured against maximum retail price, which overstates the gain versus prices large centres already negotiated.; Innovator and patented drugs saw far smaller discounts; the model works best for generics.; Sustaining supply quality and adherence to contracts across many hospitals is an ongoing task.

## Sources

- Bull WHO 2023: https://doi.org/10.2471/BLT.23.289714

## Connected records

- technologies: [Global oncology and access in low- and middle-income countries](https://onco.cc/technologies/global-oncology-access/)
- institutions: [National Cancer Grid of India](https://onco.cc/institutions/national-cancer-grid/), [Tata Memorial Centre](https://onco.cc/institutions/tata-memorial/)
- people: [C. S. Pramesh](https://onco.cc/people/pramesh-c-s/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)
- roadmaps: [Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation](https://onco.cc/roadmaps/global-access-roadmap/)

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