Activists seek early decision on better access to life-saving breast cancer medicine

Seeking to expedite the final hearing involving access to breast cancer medicine Ribociclib, activists batting for the right to healthcare have written to the Chief Justice of the Kerala High Court Soumen Sen to end a prolonged delay and ensure timely access for patients who urgently need the life-saving medicine.

The case has been pending before the Kerala High Court since June 2022, and the writ petition has been listed 57 times for final hearing without the case being heard since January 21, 2023, the Working Group on Access to Medicines and Treatment said in its letter.

The letter has also been sent to the President of India Droupadi Murmu and the Chief Justice of India Justice Surya Kant. 

The Working Group on Access to Medicines and Treatment is a collaborative network of patient advocates, civil society organisations, legal experts, and healthcare professionals. Their primary goal is to campaign for affordable and equitable healthcare, and access to medicines for vulnerable populations.

Despite the demise of the original petitioner during the early stage of litigation, the High Court continued the case suo motu, recognising larger public interest, the group said.

Breast cancer is the most common cancer among women, and the leading cause of cancer-related deaths. In 2022, India reported over 1.9 lakh new cases and nearly 98,337 deaths from breast cancer, according to a report by GLOBOCAN, the International Agency for Research on Cancer’s interactive online database.

Among them, patients with Luminal A (HR+/HER2-) breast cancer, an invasive subtype that can spread to other parts of the body, require targeted medicines, including Ribociclib and Abemaciclib, to save their lives. The medicines are critical for HR+HER2- patients because they can be used to treat them at an early stage.

However, these medicines are prohibitively expensive as they are under patent protection — Ribociclib costs ₹78,468.75 per month, and Abemaciclib from ₹47,752 to ₹95,504 per month. The 2026 Union Budget exempted Ribociclib from basic customs duty. The reduction only modestly lowers the cost, leaving annual treatment expenses above ₹8.5 lakh for many patients.

In June 2022, the original petitioner filed a petition seeking Government Use License under Section 100 of the Patents Act, an intervention that could have enabled access to Ribociclib at affordable prices.

A Government Use License facilitates production of the generic version of the drug locally, and at an affordable price. Often, the price of the generic versions are 90-95% cheaper than that of the originator drug. While the government acknowledged the medicine’s effectiveness, it refused to issue a Government Use License, stating that breast cancer did not constitute a matter of national urgency.

“Furthermore, the government has not yet provided a reasoned response regarding access to life-saving medicines and the enjoyment of right to health,’’ K.M. Gopakumar, co-convenor, Working Group on Access to Medicines and Treatment, said. 

All pleadings stand completed in court, but constitutional questions on the obligations of the government under Article 21 with regard to access to medicines remain unaddressed. After being listed on July 2, 2026, the case now stands posted to July 15, 2026.

Breast cancer disproportionately impacts women’s health, and access to life-saving medicines is essential for reducing preventable deaths. Delays in adjudicating cases involving access to essential medicines deprive patients of their fundamental right to health and life under Article 21 of the Constitution of India, which has repeatedly been underlined by the Supreme Court of India. Moreover, such delays undermine India’s public health obligations under international agreements, including the Doha Declaration on the TRIPS Agreement and public health, which emphasises the importance of access to affordable medicines, the Working Group on Access to Medicines and Treatment said.