“This is the report of proceedings from a roundtable co-hosted in September 2025 by ORF and the Organization for Rare Diseases India (ORDI). It situates those discussions within current policy instruments, judicial orders, parliamentary proceedings, and peer-reviewed literature. It argues that policymakers must balance distributive equity with fiscal stewardship in a setting where evidence is still evolving. The policy problem is not only whether to finance care, but how todetermine priority, duration, and renewal in a
way that can be defended administratively and clinically ”
