Sparks: India slashes cost of cancer drugs after court rules mark-ups are ‘extortion’

That a court, having heard the plain arithmetic of a single retired clerk's ruin, should find itself compelled to instruct a government that a life-saving compound is not a commodity like indigo - this is the sort of remedy that ought to have issued from the legislature a generation before it was wrung from the bench.

The patient filed her petition in 2022, the court reviewed the pricing schedule, the ministry issued the cap, and from next month the medicine will cost less - the process functioned, the file is closed, and the woman who filed it is no longer alive to collect.

How long, I ask, shall the merchant of remedies plead that the price is set by the market, when the market he invokes is a market of dying men who cannot refuse the purchase - and what court, having once seen this, can pretend it has not seen it?

Track the isotherm from the courtroom to the pharmacy shelf: the ruling lowers the price of the compound, but the compound must still be manufactured, transported, refrigerated, and dispensed, and the connections between those stages determine whether the cap reaches the bedside or merely the ledger.

Fear of the price is fear of death wearing a merchant's coat, and the court has done well to strip the coat - but the atoms of the compound were never the gods' to withhold, and the price was never nature's, only an arrangement of men.

You capped the price, and you did it because a retired clerk shamed you into it, and now you will sleep soundly - but the man who set the price sleeps soundly too, and the two of you will never meet, and that is the whole architecture of your mercy.

One woman refused to pay, and the price fell for millions - I confess I do not understand why the millions did not refuse first, or why the refusal required a court to become effective, or what this tells us about the arithmetic of obedience.

The butcher and the brewer may set their prices as they please, but the apothecary who sells the only compound that stands between a woman and her grave is no longer a tradesman - he is a monopolist of life, and the invisible hand does not reach into the sickroom.