A new study has raised serious questions about the affordability of modern cancer treatment in India, showing that a six-month course of the immunotherapy drug Keytruda costs the equivalent of nearly eight years of an average Indian's income.
The study, carried out by oncologists at Tata Memorial Centre accessed by India Today, laid out the financial burden faced by patients and health systems as expensive cancer drugs become more widely used.
While drugs like Keytruda are often described as breakthroughs, the study shows that their price places them far beyond the reach of the majority of patients who may need them.
Keytruda in India
According to the study, a standard six-month course of the immunotherapy drug Keytruda costs the equivalent of 7,994% of the average monthly income in India.
This means that roughly eight years of income for an average Indian earner, the India Today report stated.
The research was conducted in Mumbai and focuses on the economic realities of cancer care in low- and middle-income countries. It highlights the growing gap between the clinical promise of new cancer treatments and their affordability for patients and health systems.
ALSO READ: Rinku Singh's Father Khanchand Singh Dies After Battling Cancer; Condolences Pour In
Keytruda, whose generic name is Pembrolizumab, is developed by US pharmaceutical company Merck & Co.
It is one of the highest-selling cancer drugs globally and is approved for use in head and neck cancers, as well as cancers of the lung, cervix and melanoma. The drug is widely described as a major advance in immunotherapy.
The study estimates that the cost of pembrolizumab for an average patient in India is about Rs 10.1 lakh per month. Over a year, this adds up to more than Rs 1.2 crore. For most Indian households, the researchers note, such expenses are far beyond reach.
The analysis contrasts this with alternative treatments. In South Asia, the amount required to treat one patient with pembrolizumab for six months could instead fund treatment for 18 to 22 patients using oral tyrosine kinase inhibitors such as Gefitinib, which is an established therapy for head and neck cancers.
The researchers raise concerns about what they describe as a disconnect between the extremely high prices of immunotherapy drugs and the scale of their clinical benefit.
While these treatments have changed outcomes for some patients, the study notes that many clinical trials show an extension of median overall survival by only two to three months.
The study describes this price burden as "catastrophic" and questions whether modest survival gains can justify such high costs, particularly in countries with limited healthcare resources.
The findings show that the affordability problem is not limited to poorer nations.
The study also reportedly assessed the cost of several commonly used systemic cancer therapies, pembrolizumab, Nivolumab, Cetuximab, gefitinib and Erlotinib, across seven countries, namely the United States, the United Kingdom, Australia, South Africa, India, Pakistan and Bangladesh.
These countries were selected to represent high-income, upper-middle-income and lower-middle-income settings. The drugs studied are widely used in head and neck cancers and other malignancies. Across all countries examined, immunotherapy was found to be unaffordable. In India, six months of pembrolizumab amounted to 7,994% of monthly income.
The corresponding figures were 4,311% in Pakistan and 3,133% in Bangladesh. Even in high-income countries, the costs crossed what the study defined as catastrophic levels, 591% in the United States and 903% in the United Kingdom.
ALSO READ: Dubai No More Safe? Why Iran Targeted The Gulf Arab City After US Strikes - Explained
In India, the study notes that a single month of pembrolizumab treatment can exceed an average worker's annual income. Families often face difficult choices between continuing treatment and meeting basic needs such as food, housing and education.
India records close to 15 lakh new cancer cases every year and more than 9 lakh cancer-related deaths annually. Both numbers are rising steadily.
The study points out that cancer treatment is a major cause of catastrophic out-of-pocket spending in the country, pushing tens of thousands of families into extreme poverty each year. For many households, a cancer diagnosis becomes both a medical emergency and a financial crisis that wipes out years of savings within months.
The researchers reportedly argue that the findings expose both inefficiencies in how high-cost therapies are financed in resource-limited health systems and deeper ethical questions about how public funds should be allocated.
The study concludes that small or incremental price cuts will not be enough to solve the problem. Instead, the authors call for structural changes, including the development of locally produced generic versions or new branded drugs manufactured at scale. They argue that such steps are necessary to challenge what they describe as the dominance of Western immuno-oncology markets.
India Today's report also refers to earlier coverage highlighting similar affordability concerns. Despite policy measures such as exemptions from import duties and goods and services tax, several cancer drugs remain out of reach for most Indian patients.
One example cited is Enhertu, developed by Daiichi Sankyo and AstraZeneca. Treatment with this drug can cost between Rs 50 lakh and Rs 1 crore per patient annually for breast and lung cancers.
Essential Business Intelligence, Continuous LIVE TV, Sharp Market Insights, Practical Personal Finance Advice and Latest Stories — On NDTV Profit.
