India has two very different pharmaceutical regulators living inside the same government. Through the National Pharmaceutical Pricing Authority, or NPPA, the state acts like a market referee, setting ceiling prices for essential medicines, monitoring price revisions, and pursuing overcharging under the Drugs Prices Control Order, 2013. Through the Central Drugs Standard Control Organisation, or CDSCO, and in partnership with State Licensing Authorities, it plays a more fundamental role: ensuring that the medicine inside the pack is what the label says it is.

Both jobs matter. But they are not equally important. A government can influence whether a paracetamol tablet costs one rupee or two. Only a drug regulator can determine whether that tablet has been manufactured consistently, contains the required amount of active ingredient, is free from unacceptable contamination and complies with applicable quality standards. That distinction should sit at the centre of Indian pharmaceutical policy. Price control cannot compensate for weak quality control. And when quality is hard for the buyer to assess, excessive emphasis on price can create the wrong competitive incentives.





