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- Dr. Chandrakant Lahariya Column | Keytruda Cancer Drug Cost India Affordability
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Dr. Chandrakant Lahariya, renowned doctor
Every few years, a medicine comes which is counted among the major achievements of medical science. Currently, a new drug called Keytruda (pembrolizumab) – which is designed to treat cancer – is being considered a major breakthrough. But it has also exposed an uncomfortable truth – are life-saving medicines only for those who can afford them?
Keytruda is an immunotherapy class drug developed by Merck Company. It helps fight cancer cells by activating the body’s immune system. It is being used in many types of cancer including lung cancer, melanoma, cervical and kidney cancer. But the treatment of Keytruda in India is so expensive that the cost of one year can reach up to Rs 1 crore. The cost of each injection is in lakhs. In such a situation, it is out of reach of most patients.
Then again, due to patent protection on Keytruda, its cheaper generic or biosimilar alternatives are not yet available in the market. This maintains the monopoly of the drug manufacturing company and there is no competitive pressure on prices. Companies argue that the price of such expensive drugs is necessary to cover their research and development costs, but when the same drug is doing business worth billions of dollars globally, it is natural to question whether the prices are really based on cost or market power.
The situation becomes more complex in India, because the health system here is still based on limited resources. Even government schemes do not routinely cover such expensive medicines. Even private insurance companies often do not cover the full cost.
Additionally, Keytruda is not yet included in the list of essential medicines, thereby limiting government control over its price. The result is a widening gap between the need for treatment and the availability of treatment.
One dangerous consequence of this disparity is that some patients turn to illegal or unregulated markets in search of affordable medicine. This increases the risk of counterfeit or substandard medicines, which can pose an even greater risk to the lives of patients. This situation reflects the failure not only of law and order but also of health policy.
The controversy surrounding Keytruda is not limited to just one drug, but raises a broader ethical question – should life-saving drugs be viewed only as a commercial product? Are companies’ responsibilities limited to innovation alone or should they also ensure that their medicines reach those in need? And what should be the role of governments?
India has some policy options in this direction. If needed, production of cheaper medicines can be started through compulsory licensing. The government can negotiate pricing with drug companies or reduce prices by purchasing on a large scale.
Such medicines can be included by expanding the scope of public health insurance schemes. Indian companies are also expected to introduce cheaper alternatives when the patent expires in the coming years, but it is not possible for millions of patients to wait till then.
Another important aspect is related to the promotion of this medicine. It is presented as a miracle drug, creating high expectations among patients and their families. Whereas the truth is that its effect is not the same on every patient. In such a situation, it is important that doctors and companies provide complete and balanced information to the patients, so that they can take the right decision.
This case forces us to think about what real progress is in the medical field. Is progress just about developing new medicines, or is it equally important to ensure they are accessible to everyone? If life-saving medicines remain limited to a few people, it is a failure not only of the health system but also of social justice. The objective of medical innovation should not only be to advance science but also to extend its benefits to every person in the society.
If life-saving medicines remain limited to a few people, it is a failure not only of the health system but also of social justice. The objective of medical innovation should be to extend its benefits to every person in the society. (These are the author’s own views)
