The Centre on Saturday announced the exemption of basic customs duty (BCD) on 36 “lifesaving” medicines, but patients’ rights advocates cautioned that the proposal would offer little help in making some of the medicines affordable and accessible.

Union finance minister Nirmala Sitharaman, in her 2025-26 budget speech, said the government proposes to add 36 lifesaving medicines to the list of medicines fully exempted from BCD and add six medicines to the list attracting concessional customs duty of 5 per cent.

Full exemption and concessional duty will also respectively apply on bulk drugs for the manufacture of these medicines, Sitharaman said, explaining that the move was intended to provide relief to patients, particularly those suffering from cancer, rare diseases and other severe chronic ailments.

The 36 medicines to be exempted from BCD include, among others, alectinib, amivantamab and tepotinib, each used in the treatment of lung cancer, obinutuzumab used to treat a type of leukaemia, risdiplam used to treat spinal muscular atrophy, a rare disease, and evolucumab used to treat high cholesterol.

Patients’ rights advocates, however, have said some of these medicines are so expensive that the BCD exemption will make little difference to patients who have to pay for the medicines.

“Even if we assume a 15 per cent cut resulting from the BCD exemption, the proposed exemption will bring limited support towards making expensive medicines affordable or accessible,” said Chetali Rao, a legal expert tracking the accessibility of medicines.

Rao cited her concerns through two examples: obinutuzumab and risdiplam. The price for eight doses of obinutuzumab typically required to be administered to patients with chronic lymphocytic leukaemia would be ₹31,94,440. A 15 per cent BCD exemption if passed on to patients would lower this to ₹27,15,214, she said.

Risdiplam costs about ₹72 lakh per year. A 15 per cent BCD exemption could translate into ₹61.2 lakh, Rao said. The costs will come down but not significantly, she said.

Rao and others have long been urging the Centre to invoke provisions in Indian patent laws to facilitate the local production of generic versions of imported and patented medicines, asserting that local production would significantly help lower costs.

Sitharaman also said drugs and medicines under the Patient Assistance Programmes (PAP) run by pharmaceutical companies are fully exempt from BCD, provided the medicines are supplied free of cost to the patients.

Under a PAP, patients have to buy a specific amount of medicine and get a proportionate amount free of charge from the company. For instance, if a patient buys medicines for nine months, the company would supply three months’ medicine free.

Sitharaman said the government proposes to add 37 more medicines, along with 13 new PAPs. Patients’ rights groups said it was too early to say what impact this move might have on access to medicines. The impact is likely to depend on how many patients receive benefits through PAPs, said K. Gopakumar, a public health lawyer in New Delhi, campaigning for local production of generic versions of patented medicines.