ABSTRACT
The article summarizes the key announcements and proposals part of the Union Budget 2026 for the health and pharma sector. A perspective is presented of the benefits of these proposals and some persisting concern areas.
Keywords: Budget-2026, Biopharmaceutical research, Cancer drugs, Basic Customs duty, AYUSH, Health hubs, Mental health, Allied Health Professionals (AHPs)
INTRODUCTION
The overall allocation for the Union Ministry of Health and Family Welfare for the financial year 2026-2027 was Rs. 1,06,530.42 crores (6% higher than the previous year and roughly 9.5% more than the revised estimates) with Rs. 4,821.21 crore to the Department of Health Research (24% higher allocation than last year’s Rs. 3,900.69 crores). There have been some key announcements and proposals but most importantly the course of time will give insights on whether these proposals translate into practicality with patient benefits and overall improvement of community health.
KEY PROPOSALS
A. Biopharmaceuticals Research
An investment plan of Rs 10,000 crores over the next 5 years has been proposed for biopharmaceuticals as the Biopharma Shakti scheme (Strategy for Healthcare Advancement through Knowledge, Technology and Innovation), aimed at positioning India as a global biopharma manufacturing hub. The programme will focus on building a strong ecosystem for domestic production, innovation and manufacturing of biologics and biosimilars, particularly for non-communicable diseases (NCDs) such as cancer, diabetes and autoimmune diseases.
As part of the initiative, a dedicated biopharmaceutical network will be created, including the establishment of three new National Institutes of Pharmaceutical Education and Research (NIPER) and the upgradation of the 7 existing institutes at Mohali (Punjab), Ahmedabad (Gujarat), Hyderabad (Telangana), Guwahati (Assam), Hajipur (Bihar), Kolkata (West Bengal) and Raebareli (Uttar Pradesh).
The plan also includes setting up a nationwide network of more than 1,000 accredited clinical trial sites across India to support research and innovation and help CDSCO meet global standards and approval time frames.
B. Drug Duty Waivers
Cancer Drugs: Basic customs duty (BCD) waivers on 17 of cancer drugs will be provided as below:
- Oral CDK4/6 inhibitors ribociclib and abemaciclib for HER2-negative breast cancer in both metastatic and high-risk early-stage settings.
- CAR T-cell therapy talycabtagene autoleucel for relapsed/refractory B-cell lymphoma and B-cell acute lymphoblastic leukemia (ALL).
- CTLA-4 (protein receptor that downregulates the immune system) inhibitors ipilimumab for melanoma, renal cell carcinoma (RCC), colorectal cancer, hepatocellular carcinoma, non-small cell lung cancer (NSCLC), malignant pleural mesothelioma, and esophageal cancer, and tremelimumab used alongside durvalumab to treat unresectable hepatocellular carcinoma and metastatic non-small cell lung cancer (NSCLC).
- Oral BCL-2 inhibitor venetoclax to treat adults with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), or acute myeloid leukemia (AML)
- Tyrosine kinase inhibitors (TKIs) ceritinib, and brigatinib, targeting ALK-positive non-small cell lung cancer (NSCLC), and ponatinib (treats rare forms of blood cancer, specifically Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) and chronic myeloid leukemia (CML) resistant to other treatments.
- Bruton’s Tyrosine Kinase (BTK) inhibitor ibrutinib for various B-cell cancers, such as chronic lymphocytic leukemia (CLL) and mantle cell lymphoma.
- BRAF Kinase Inhibitor dabrafenib for BRAF V600E mutation cancers including melanoma, non-small cell lung cancer (NSCLC), and anaplastic thyroid cancer.
- MEK1 and MEK2 inhibitor trametinib used in combination with dabrafenib for BRAF V600 mutation-positive melanoma, NSCLC, and other solid tumors.
- Oral androgen receptor inhibitor 3rd generation darolutamide to treat prostate cancer,
- PD1 inhibitors – monoclonal antibody immune checkpoint inhibitors designed to treat various cancers by enhancing the immune system’s ability to destroy cancer cells: toripalimab (nasopharyngeal carcinoma/ melanoma), serplulimab (extensive-stage small cell lung cancer), and tislelizumab (esophageal and stomach cancers)
- Antibody-drug conjugate medication inotuzumab ozogamicin used to treat relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).
While India reports nearly 15 lakh new cancer cases each year, with around 8 lakh deaths, fewer than 3% of patients have access to immunotherapy, largely due to cost. This move should improve access and survival rates for cancer patients.
- Rare Diseases – 7 more conditions have been added to ‘rare diseases’ which are part of National Policy for Rare Disease (NPRD), 2021 for which import duties on personal imports of drugs, medicines and Food for Special Medical Purposes (FSMP) used in their treatment will be exempted. The diseases exempted include congenital hyperinsulinemic hypoglycemia (CHI), familial homozygous hypercholestrolemia, alpha mannosidosis, primary hyperoxaluria, cystinosis, hereditary angioedema and primary immune deficiency disorders.
C. Emphasis on Ayurvedic and Integrated Medicine
The Union Budget 2026-27 proposes an allocation of around Rs 4,409 crore for the Ministry of AYUSH, 20% higher than the revised estimates of Rs 3,672 crores for 2025-26. A notable increase is earmarked for the conservation, development and sustainable management of medicinal plants under Dharti Aaba Janjatiya Gram Utkarsh Abhiyan (DAJGUA), a central scheme aimed at the holistic development of tribal communities and villages. The budget allocated Rs 15 crores for DAJGUA in 2026-27, up from Rs 5 crores in the revised estimates for the previous year. The budget noted that the additional funding will benefit farmers cultivating medicinal herbs and young workers engaged in processing them, while helping produce export-grade ayurvedic products.
Three new All India Institutes of Ayurveda have been planned. Further, upgrades to AYUSH pharmacies and drug-testing labs have been envisioned for higher standards of certification ecosystem, and making more skilled personnel available. The WHO Global Traditional Medicine Centre in Jamnagar will also be strengthened for evidence-based research, training and global outreach for traditional medicine.
To promote India as a hub for medical tourism services, the budget proposes to launch a scheme to support states in establishing five regional medical hubs, in partnership with the private sector. These Hubs will serve as integrated healthcare complexes that combine medical, educational and research facilities. They will have Ayush Centres, Medical Value Tourism Facilitation Centres and infrastructure for diagnostics, post-care and rehabilitation. These hubs will provide diverse job opportunities for health professionals including doctors and AHPs.
D. Allied Healthcare Professionals (AHPs)
A Rs 100 crores provision was made for training allied healthcare professionals, alongside a stated push to expand care delivery beyond hospitals, particularly for geriatric services. The budget 2026-27 tied the goals of creating employment with that of strengthening the health workforce. Institutes for Allied Health Professionals (AHP) will be expanded across government and private sectors and existing ones will be upgraded. The training will span 10 disciplines, including Optometry, Radiology (Medical Radiology and Imaging Technology), Anaesthesia (Anaesthesia Technology), Operation Theatre Technology, Applied Psychology and Behavioural Health, Physiotherapy, Nutrition and Dietetics, Dialysis Therapy, Radiotherapy Technology and Health Information Management/Physician Associates. These courses, will blend core caregiving skills with wellness practices such as yoga, alongside training in operating medical and assistive devices.
The centre aims to add 100,000 new AHPs over the next five years and that 150,000 caregivers will be trained in the next year through National Skills Qualifications Framework-aligned programmes to support the country’s care and geriatric health ecosystem, and create jobs.
E. Other Proposals
The budget has proposed another National Institute of Mental Health and Neuro Sciences (NIMHANS)-2 in north India and upgrading national mental health institutes in Ranchi and Tezpur as regional apex centres.
In order to strengthen trauma care it proposes to increase such capacities by 50% in District Hospitals by establishing Emergency and Trauma Care Centres.
It is also proposed to support the Artificial Limbs Manufacturing Corporation of India (ALIMCO) to scale up production of assistive devices, invest in R&D and AI integration, strengthen PM Divyasha Kendras and support setting up of Assistive Technology Marts as modern retail-style centres where Divyangjans (Persons with Disabilities) and senior citizens can see, try and purchase assistive products.
DISCUSSION
While the 2026-Budget has put forward several interesting proposals, and these should all be very well appreciated and lauded no doubt, some concerns do linger. Firstly, how these proposals will translate into practicality to provide significant patient benefits and community healthcare, and secondly whether there has been an appropriate push to allopathic primary healthcare which is the backbone and foundation of India’s health system.
The target of 2.5% of GDP for health still stands unmet, with low public health investment, keeping India behind in global health rankings. Chronic shortages of specialists, physicians and nurses, particularly in rural and underserved areas, persist, along with shortages in equipment, and medicines, at Primary Health Centres (PHCs) that remain unaddressed. Improving the infrastructure of primary health centres in villages and district hospitals in smaller towns, and adequate health insurance cover to reduce massive Out-of-pocket expenditure (OOPE) in these areas is always the crying need of the hour. The overall budget needs to have the comprehensive structural reforms so badly required for universal health coverage. Access to basic life-saving medicines like antibiotics (including for TB/HIV), medicines for cardiorespiratory emergency, nutritional supplements (like iron, folic acid, calcium, vitamin D), vaccines, pediatric diarrhea support (ORS, electrolytes, anti-infectives) and antenatal, obstetric and basic neonatal care, should always be the highest priority.
Mental health particularly needs a more grassroot and primary-up approach rather than more apex centres alone, as often access to mental and neurological health becomes an urban economic luxury rather than basic need. Improving mental health awareness in all socio-economic strata and integrating it with primary care can help improve the holistic health barometer of the community at large.
Despite exemptions for certain drugs, high costs for patients remain, with, almost third of people with chronic conditions facing barriers to care due to costs. Translating duty waivers into actual price reductions, affordability and improved access for the patient are concerns. It is important to emphasize that such BCD waivers have occurred in the past but maximal retail prices (MRPs) of many such drugs continued to remain in the unaffordable categories. Therefore, detailed publication from the Health Ministry on the actual price reduction and its translation into revised MRPs for the patient is pertinent.
While 1,000 clinical trial sites are planned, there are concerns regarding whether appropriate on-ground implementation, avoidance of bureaucratic delays and regulatory monitoring of safety of patients, ethical patient recruitment and authenticity of data and evidence, will be seamlessly implemented along-side.
CONCLUSION
The 2026-Budget presents several proposals for the health-pharma sector that have the potential to boost community holistic health, medical and scientific research, healthcare and pharmaceutical advancements and the country’s health related economic growth. However, some concerns remain which need to be addressed on the practical implementation of the proposals and its translating into actual patient benefit. Primary healthcare, preventive healthcare and public health infrastructure strengthening still leaves room for a lot to be desired, as this determines the foundation and base of any country’s overall medical care and population health.
Source: Union Budget 2026 Presentation: 1st Feb 2026. PIB [online] Available from https://www.pib.gov.in/PressReleasePage.aspx?PRID=2221616®=3&lang=2
Chief Editor, The Indian Practitioner, and Medical Director, Dr. Varsha’s Health Solutions, Mumbai.