India’s healthcare system has made significant progress in expanding coverage and reducing out-of-pocket expenditure, yet affordability and price transparency remain persistent challenges. Out-of-pocket expenditure declined from 64.2% of total health expenditure in 2013–14 to 39.4% in 2021–22, but remains well above India’s policy target of 30%. At the same time, healthcare pricing remains fragmented, with pharmaceuticals subject to price regulation while consultations, diagnostics, procedures and hospital services are largely market-driven. The proposed National Medical Pricing and Regulation Commission Bill, 2026 seeks to address this structural gap through a national framework for standardized healthcare pricing, greater transparency and stronger financial protection. The proposed framework, the healthcare affordability challenges it seeks to address, the role of India’s private healthcare sector, and the key implementation challenges that could shape its effectiveness are explored in detail.
Key Highlights
- Out-of-pocket expenditure fell from 64.2% to 39.4% of total health expenditure, still above the 30% policy target.
- Unlike medicines, hospital services, diagnostics and consultations lack a nationwide pricing framework, creating cost variability.
- In 15 States/UTs covering nearly 74% of India’s population, around 69–70% of key healthcare infrastructure is privately owned.
- The proposed Commission would standardize pricing and strengthen enforcement, but cost benchmarking, Centre–State coordination and provider response remain key challenges.
About The Author
Ankur Malhotra
Ankur is a research and knowledge leader with 20+ years of experience in business and financial research, serving clients across investment banking, consulting, accounting, and advisory. He has expertise in establishing global knowledge centers, delivering business intelligence solutions, and driving thought leadership. Before joining HBGTM Insights, Ankur worked with Forvis Mazars, Korn Ferry, and was part of the founding team of Acuity Knowledge Partners. He is a CFA charterholder from ICFAI, Hyderabad, and a graduate of Delhi University.
Know More